Nova Scotia

Another anesthesiologist to leave Yarmouth Regional Hospital

The departure of Dr. Husam Nashnoush means there will once again be just one anesthesiologist at Yarmouth Regional Hospital, which is supposed to have four. Some doctors have proposed another way to help.

Departure of Dr. Husam Nashnoush means there will be just one permanent physician in role

The departure of Dr. Husam Nashnoush means there will once again be just one permanent physician in that role at the hospital, which is supposed to have four anesthesiologists. (Carolyn Ray/CBC)

Another anesthesiologist is leaving Yarmouth Regional Hospital at the end of August and it's renewing calls for the provincial health authority to allow the use of new resources.

The news comes just as the community in the Yarmouth, N.S., area is celebrating the arrival of a new anesthesiologist and his family.

The departure of Dr. Husam Nashnoush means there will once again be just one permanent physician in that role at the hospital, which is supposed to have four anesthesiologists.

The Nova Scotia Health Authority said it has found temporary help to ensure there is full coverage in the area for another month — until the end of July.

In April, pregnant women were warned they may not be able to deliver babies in their community if there isn't coverage.

The health authority said it will continue to try to bring in temporary help as recruitment efforts continue.

Earlier this week, the Yarmouth and Area Chamber of Commerce received a grant from the provincial government to help hire a local person who will focus on doctor recruitment efforts.

The chamber also attended a conference for anesthesiologists, and took down more than 60 names of physicians who are interested in working in the region, either full time or to fill in temporarily.

More calls for family practice anesthesia

The situation, along with a national challenge recruiting anesthesiologists, has prompted doctors here to begin calling for the use of family practice anesthetists. The role is a family doctor who has completed an additional one-year training program to receive a certificate of added competence in anesthesiology from the College of Family Physicians of Canada.

Family practice anesthetists, or FPAs, can do anything that requires local or general anesthetics that does not call for a sub-specialist, such as heart and brain surgery.

The medical site leads at both St. Martha's Regional Hospital in Antigonish and the Aberdeen Regional in New Glasgow have called for FPAs to be used in Nova Scotia as it's become increasingly difficult to get Royal College-certified anesthesiologists to work outside major centres, such as Halifax. While FPAs are used extensively in Ontario and on out to British Columbia, there are very few on the East Coast.

Still under review

A spokesperson for the Nova Scotia Health Authority said the issue continues to be under review by the health authority's medical advisory committee.

But Dr. David Kogon, the mayor of Amherst, N.S., and a doctor who worked in the town before working at the tertiary care hospital in Moncton, N.B., said it's time for the health authority to get FPAs working for the good of rural Nova Scotia.

Kogon, who is retired from active practice but still does some operating room work in Moncton, said the role fills a major need, particularly in smaller communities.

"In my role in trying to maintain people in Amherst, we know that the scope of surgery is relatively limited compared to, for example, Moncton or Halifax."

The long-term answer

Kogon said that means two things: a doctor doesn't necessarily need the same degree of training and experience to work in surgical programs with a more limited scope; and those that do have that level of training usually want to work where they're regularly exposed to the most major cases.

"Providing the surgeries that they do in the smaller regional hospitals is vital because you can't dump all the general surgery and all the [obstetrics and gynecological cases] on Halifax —  it's impossible," he said.

"So I think the answer, the long-term sustainability answer, is going to be family practice anesthesia in these smaller regional hospitals."

Health Minister Randy Delorey said he continues to wait on a recommendation from the health authority's advisory committee, but has no timeline for when that might reach his desk. He said it's important for the people evaluating the issue to "understand and appreciate the concerns and the reasons for motivating the inquiry in the first place."

"And that is, obviously, the needs of Nova Scotians and ensuring the stability of the delivery of health-care services and really even supporting the work-life balance of existing anesthetists that may be working somewhat short in some communities.

"It's not a replacement, but rather a compliment and a support in there."

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