The need to recruit new doctors in Nova Scotia is no longer just a rural issue, as the province's health authority confirmed Wednesday that 40 per cent of the family physicians who work in Dartmouth are set to retire within the next five years.
The NDP revealed during a public accounts hearing on physician recruitment at the Nova Scotia Legislature that 28 of 71 Dartmouth doctors are planning to leave their practices.
"That is on our radar and that is accurate," said Dr. Rick Gibson, senior medical director for the Nova Scotia Health Authority.
"It's a demographic thing. There's a large number of doctors who started in Dartmouth around the same time and they're all approaching the age of 65. So several of them are contemplating retirement."
Filling recruitment gaps
Officials from the Health Department, Nova Scotia Health Authority and College of Physicians and Surgeons of Nova Scotia were questioned on recruitment efforts for two hours during the public accounts meeting.
It was peppered with statistics that indicate the physician shortage in the province will continue to be a problem for years.
The impending exodus of Dartmouth physicians comes as the province's waitlist for a family physician topped 42,000 people this month. About half of them are in the central zone, which includes the Halifax Regional Municipality.
The officials described around-the-clock efforts between the health authority and Health Department to bring in new physicians, calling it a complex issue with several layers of solutions.
And they indicated that amalgamating the provincial health boards exposed several faults in recruitment efforts. Up until last year, there was no recruiter for the central zone.
Gibson said another hurdle they faced was that doctors are not required to give notice when they are retiring. He said even five years ago, private-practice doctors would not ask for help to recruit their replacements.
The health authority, which took over recruitment efforts after amalgamation, has set what it calls a "soft goal" of recruiting 50 general practioners and 50 specialists each year, but it hopes to exceed that.
So far in this fiscal year, only 26 family doctors and 66 specialists have been hired. Another 44 offers are what are referred to as pending, and details of start dates remain to be worked out.
But health officials could not answer what many Nova Scotians are asking — whether the new recruits and soft targets will make a dent in the waitlist, or simply keep the status quo.
"Our goal, beyond any other goal, is to connect the people of this province to primary health-care providers, to the services they need. That's what they're focused on," said Denise Perret, the deputy minister of health.
When asked if people in the wait list will be waiting for years at the current pace of recruitment, Perret was quick to object.
"I think that's unfair to make that projection," she said. "We're you're not taking into account is that the system is working underneath that. So the message that I hope was heard, is a message of flexibility. How we'll rework incentive programs, how we'll look at what other options there are to take people off the list who have chronic diseases."
The shift in need from rural to city has recruiters wondering if it's time to make changes to the use of incentives to recruit physicians. Gibson said the health authority is currently limited in what it can offer potential hires in Dartmouth.
The health authority can pay for a potential recruit to visit, but things like tuition relief and incentives to practice in rural areas aren't available in urban regions.
"We have a conversation ongoing with the Department of Health about that," he said.
All of the conversation about new recruitment plans came as little comfort for opposition MLAs questioning the leaders. PC MLA Tim Houston told the health officials he worries they don't fully grasp the need.
While 42,000 have registered for a doctor, he points out that number could rise abruptly overnight, as it's estimated 100,000 Nova Scotians don't have one. The difference in the numbers is that thousands of people are not actively looking for a physician.
"I don't know that they have a full grasp on the upcoming need on the next two years, five years," he said. "Actually, I'm getting the sense they don't want to know."
NDP MLA Claudia Chender raised her own concerns, particularly about Dartmouth's future gaps.
"All of this is too little, too late," she said. "Even if they can replace some of those doctors, we know they won't replace all of them ... I am deeply concerned about what that's going to look like."
But Perret said people need to be optimistic about efforts that are underway.
"We are not underestimating the work that has to be done. And we're not underestimating what it's like to be on that list. We hear the message. We understand it. And we're acting on it."
Readers who wish to share their story about searching for a physician can contact Carolyn.Ray@cbc.ca.