Nova Scotia

As N.S. weighs using family practice anesthetists, red tape holds back Ont. doctor

A working group with the Nova Scotia Health Authority is considering the best way to introduce a family practice anesthesia pilot program. For Ontario doctor Annie Lu, it means she can't do locums in Nova Scotia.

The role is seen by some as a way to address national shortage of anesthesiologists

Advocates for the use of family practice anesthetists say it's a way to bring family doctors to a community, while also addressing a national shortage of anesthesiologists. (David Donnelly/CBC)

When Dr. Annie Lu learned of a chronic anesthesiologist shortage at Yarmouth Regional Hospital earlier this year, she thought she might be able to help.

Lu, a family practice anesthetist (FPA) based in Ontario, saw the situation in Yarmouth, N.S., as an opportunity to travel to a province she's always been curious about to provide locums while the Nova Scotia Health Authority tried to recruit anesthesiologists, a specialty that's in demand across Canada.

Despite the Yarmouth Regional Hospital having just one anesthesiologist at the time, putting into jeopardy its ability to deliver some services, Lu quickly learned she would not be able to help.

Although FPAs are widely used in Ontario, parts farther west and the United States, they aren't commonly used on Canada's East Coast and the role is not recognized in Nova Scotia.

What FPAs do

An FPA is a family doctor with an additional year of training in anesthesia. They're permitted to administer local and general anesthetics in all but the most specialized cases, such as brain and heart surgeries.

"We basically provide anesthesia for healthy patients in almost any aspect of their care that doesn't require extra interventions or requirements such as an ICU afterwards," Lu said in a recent telephone interview.

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Where she works in Fergus, Ont., Lu operates a family practice where she sees patients several days a week and spends the rest of the time working in the local operating room, which is entirely covered by FPAs 24 hours a day, seven days a week. It's a common approach used in Ontario and elsewhere to ensure smaller areas have the health-care services they need, said Lu.

The possibility of using the role in Nova Scotia was first brought to the attention of Health Minister Randy Delorey about a year ago when he was contacted by a doctor from outside the province inquiring why it wasn't used here.

Delorey referred the matter to the Nova Scotia Health Authority at the time to evaluate. Since then it's been a slow process, although there have been recent signs of possible progress.

The minister was not available for an interview Thursday, but said in a statement he continues to await options from a working group about how FPAs could be introduced to the system now that it's been determined they can be used here safely.

N.S. anesthesiologist shortage

While that process has butted up against opposition from some members of the anesthesiology community, the head of surgical services for the health authority said he and the working group are striving to address concerns before making changes.

"We also need to land on a program and pilot that provides services in the areas where anesthesia is most needed," Dr. Greg Hirsch said in the email.

Although Yarmouth Regional now has two anesthesiologists, it still has openings for two more. There are also postings right now for the regional hospitals in Bridgewater and Kentville.

'A great service to the community'

Hirsch said he's heading to the Kingston, Ont., area to see FPAs at work and would "bring lessons learned back to our working group for further discussion."

Should the role, which the College of Physicians and Surgeons of Nova Scotia has said it will license, be permitted here, Lu said she would be interested in relocating to Nova Scotia.

She opted not to pursue her medical residency in Nova Scotia because of the position on FPAs. After 11 years in practice, she's more convinced than ever of what FPAs can do for patients and the broader health-care system.

"It's a great service to the community and it helps to provide care closer to home for patients," she said.