Nova Scotia

North Sydney doctor makes 'gut-wrenching decision' to stop call shifts

Dr. Joan Salah, a family and emergency room doctor in North Sydney, is among the 30 Cape Breton physicians who have withdrawn inpatient hospital coverage.

Unlike doctors in other parts of Nova Scotia, physicians in North Sydney get no stipend for time spent on call

About 30 family doctors in Cape Breton have withdrawn inpatient hospital coverage. (Tom Ayers/CBC)

Dr. Joan Salah made what she called a "gut-wrenching decision" earlier this year.

Salah, a family and emergency room doctor in North Sydney, is one of about 30 family doctors in Cape Breton who recently withdrew inpatient hospital coverage.

That means any of their patients requiring hospital care now have to be admitted to the Cape Breton Regional Hospital in Sydney, where they are followed by physicians who provide what is called a "hospitalist" role.

"I know it does place some degree of hardship on my patients. I'm sure that they would prefer to be in their home hospital," said Salah.

"So, I wouldn't say it was a decision that I took lightly, or that I didn't recognize what the difficulties with it were. But I also knew that I was no longer willing to participate in something that was hobbling family medicine moving forward."

'A slap in the face'

Doctors in North Sydney have asked repeatedly over the past two decades for a stipend for time spent on call — something paid to their counterparts in most other parts of the province, she said.

"To find out that we kept asking and were being told no when other places were getting it really felt ... I guess like a slap in the face."

The model of in-patient care moving forward is part of ongoing negotiations between Doctors Nova Scotia and the province. (Robert Short/CBC)

It's a situation that's hampering doctor recruitment, said Salah. She said residents who have incurred about $200,000 worth of debt won't be drawn to the area.

"You're not going to go to a place that is under-serviced, has high burnout levels, people backing out of inpatient care all the time, and gets paid less than everybody else," she said.

Physician compensation, and the model of inpatient care moving forward, are both part of ongoing negotiations between Doctors Nova Scotia and the province.

Response from the province

In a written statement, Department of Labour Relations spokesperson Heather Fairbairn said the province has provided Doctors Nova Scotia with a proposal that would give Glace Bay doctors who have continued to provide inpatient care an extra $51,000 a year per doctor.

"The proposal includes an on-call stipend as part of the model. We would be willing to pay this now before negotiations wrap up," said Fairbairn.

In the meantime, the Nova Scotia Health Authority said the withdrawal of inpatient services at community hospitals in Cape Breton is affecting the regional hospital by limiting the number of available beds and causing congestion in the ER.


About the Author

Holly Conners is a reporter and current affairs producer who has been with CBC Cape Breton since 1998. Contact her at


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