Nova Scotia

More funding approved for in-hospital doc program

The provincial government and Doctors Nova Scotia have reached an agreement to try to address a doctor shortage, but it’s not the one that’s been dominating headlines for more than a year.

Additional $3.2 million intended to create equal payments across the province

Nova Scotia's hospitalist program will see a $3.2-million increase after an agreement between Doctors Nova Scotia and the province. (Shutterstock)

The provincial government and Doctors Nova Scotia have reached an agreement to try to address a doctor shortage, but it's not the one that's been dominating headlines for more than a year.

Last week, the two sides settled on a $3.2-million increase for the hospitalist program. A hospitalist is a doctor who focuses on treating patients in hospital. Right now there are 23 full-time equivalent positions working through the week and 20 working weekends and holidays; other doctors do it as a small portion of their overall practice.

Bracing for blowback

Doctors Nova Scotia president-elect Dr. Tim Holland said hospitals across the province have faced "a crisis in in-patient care." The hospitalist program has struggled in recent years from either shortages, such as in Truro and Dartmouth, he said, or inconsistent payment.

The new funding will create a provincewide day rate of $1,300 for providers and also reduces the cumbersome paperwork people faced to get paid, said Holland.

A letter from Doctors Nova Scotia to its members informing them of the change seemed to be preparing for backlash from family doctors, who will now see an even bigger pay disparity than they already faced for similar work.

Tim Holland is president-elect of Doctors Nova Scotia. (CBC)

Dr. Natasha Deshwal, a general practitioner in Bedford, said most doctors understand the hospitalist program is a necessary "Band-Aid" to help mitigate problems with doctor shortages and it needs to be supported, but the new funding also creates angst, she said.

"We want to be seen that we're all equal and in some ways this makes us feel that we're not equal," she said.

Holland, who is a family doctor, said work continues on a new payment model for family doctors that reflects the full scope of their work, but it's likely months away from becoming reality.

'We are working on it'

"We wanted to caution family physicians to not get too upset that this discrepancy might be growing and we really need them to know that we are working on it and I really feel like the cards are aligning in such a way that we will finally be able to see a new payment model for family medicine."

Holland said he thinks Doctors Nova Scotia, the Nova Scotia Health Authority and the Health Department all realize "the crisis that exists in family medicine" and he believes a new blended payment model will help keep and attract doctors and improve access for patients.

Deshwal said many of her colleagues feel their concerns have not been made a priority and that they should feel more included in the process to improve the health-care system.

'We want to make patient care better'

"I don't think you can make a decision from the top and then have it trickle down and think that that's going to be effective or efficient, because it's not and we've certainly seen that happen," she said.

"We need to be invited to those tables and when we say something, you really need to listen to what we're saying. We're not just talking because we can, we're talking because we want to make access better for our patients; we want to make patient care better."

Doctors Nova Scotia is organizing a family medicine summit in January to work out the final details of how a new payment model would look.

Holland appealed to his colleagues to be patient.

"I know they've heard it before, but I'm just asking, if they can hold on a little longer we are really within reach of a solution."

About the Author

Michael Gorman is a reporter in Nova Scotia whose coverage areas include Province House, rural communities, and health care. Contact him with story ideas at michael.gorman@cbc.ca