DIGBY, N.S. – Dr. Jennifer Chang stood in front of those gathered in Digby for a discussion on health care and said it’s heartbreaking to hear people without doctors repeatedly ask her if and when the Digby clinic where she works can take on more patients.
“It’s a question we probably get asked 100 times a day. I see patients in outpatients. It’s a heartbreaking question for me because I feel like I’m torn in so many ways,” Dr. Chang said during a Feb. 22 conversation about health care held in Digby, organized by the Digby Area Health Coalition and Doctors Nova Scotia. “I would love to see all of you in my clinic but practically speaking that’s not possible. We’ve been trying to get as many patients as we can onto our roster of the clinic but, as was pointed out, our time is limited and we can’t work 24/7.”
Finding ways to enable communities to be part of the doctor recruitment process – whether it’s Digby, Shelburne, Yarmouth or elsewhere – was a big part of the evening’s discussion.
And not just recruiting doctors but retaining them.
Make your community a place that family doctors will want to come to, said Dr. Manoj Vohra, president of Doctors Nova Scotia. “Make it impossible for them to leave because they love it so much.”
During the discussion there was reference to Goderich, Ontario, a town that is home to roughly 8,000 residents and has 18 doctors serving it.
Undoubtedly, other communities want to tap into that kind of success.
“How do we work together to want to make physicians come to the Digby County area and to (other) communities like Digby?” asked Kevin Chapman, director of Partnerships and Finance for Doctors Nova Scotia. Members of the Nova Scotia Health Authority were also in attendance to field questions about doctor recruitment.
“What makes (doctors) want to come here and, almost more importantly, what makes them want to stay? Because the best recruiting tool is a retention tool," Chapman said.
One local resident who answered the question said, “We seem to overwork them. If we could maybe try to find a way that we’re not overworking them.”
That’s not always an easy mindset, it was noted, particularly if you’re without a family doctor and you’re desperate to have one.
Something that has been celebrated locally is the Digby Area Health Services Centre and its collaborative practice team approach to providing health services to residents by having family physicians, nurse practitioners and a family practice nurse all involved. Continuing to move forward with this type of model is seen as beneficial for treating patients and enticing doctors.
Still, this and other programs fall into long-term solutions, Chapman said. He said long-term solutions also include having more international medical students on a defined licence practising in underserviced areas, continuing to expand the family medicine residency program such as the one in Yarmouth. Shorter-term options, he said, include improving locum support and coverage to communities so that doctors can take time off and still have their patients cared for and/or those without doctors can have access to care.
But the question also kept returning to what can communities do to make their areas attractive and enticing to potential doctors.
“I think one of the biggest things for me, feeling like I’m part of a community really goes a long way,” shared Dr. Genna Bourget, one of the new family doctors that make up the local health collaboration team. “In Digby, I have no family here. I have no connections to Digby. I am slowly making new friends in the community, but being new is certainly not easy.
“Feeling like there are things to do, there are people in the community reaching out and supporting us, means a lot to me and I’m sure would mean a lot to a lot of people,” Dr. Bourget said.
Dr. Chang agreed, saying the little things really can make a big difference in making doctors feel welcome to a community and also feel like they’re a part of it. Going back to that heartbreaking question she said they often hear, she said understanding is also needed.
“It takes time for us to see all of you and although all of us would like to see all of you, we only have so much time,” she said. “Not that I want you to stop asking us to take you on, please keep doing that, but I think it would be nice to hear that there is understanding that it will take time for us to do that.”
Another thing that was discussed was ensuring the needs of a doctor’s partner and family are taken into consideration. A spokesperson for the Nova Scotia Health Authority said this is always an important piece of the recruitment pie.
Dr. Vohra said it’s important and meaningful to ensure there is a life-work balance when doctors are looking to come into a new community.
“We can’t be isolated about talking medicine 24/7 and so the more we get a chance to understand what’s there, what’s there for my kids, my spouse, if we don’t have a spouse, maybe find us a spouse,” he said. People laughed at that last comment, but even in Goderich, Ontario, a local physician recruiter played a little matchmaking and introduced a single doctor to a woman who eventually became his wife.
The issue of needing doctors is not unique to Digby, and there is much competition when it comes to recruiting doctors. But no matter where people are without doctors, it is a serious issue, said Chapman.
One local resident, who does not have a family doctor, asked people in the Digby theatre where the session was held to raise their hand if they were without a family physician. Nearly half the room did. “There’s the problem,” he said.
The challenge, it was noted, is implementing the solution. And it isn’t going to get any easier, said Chapman, who spoke of the grey tsunami facing the province.
He said over the next 10 years the province needs to recruit roughly 1,000 physicians to replace doctors who will retire and relocate and, of that number, at least 500 will be family physicians.
“The plan tells us we cannot exist with the number of folks we are training today, we need to train more. And we’re doing that,” he said.
He said that of 428 family physicians now practising in Nova Scotia, 252 are 61 years old or older, and 131 are over the age of 66.
“That’s a lot of physicians who are practising and when I say over 66 we have some that are 75, 80 years old,” he said. “Physicians are not immune to the greying workforce in much the same way as the rest of us.”