Nova Scotia

Nova Scotia doctor wait-list hits record high, topping 81,000

An undesirable record was set this month, again, on Nova Scotia’s wait-list for primary care. More than 81,000 people have now joined a registry of patients looking for a doctor or nurse practitioner.

In-migration and doctor retirement are the main drivers of the growing wait-list

30,000 people on the list were recently offered virtual care while they wait. About 25 per cent have signed up. (Cryptographer/Shutterstock)

An undesirable record was set this month, again, on Nova Scotia's wait-list for a family doctor or nurse practitioner.

As of Nov. 1, more than 81,000 people were on the list, up by more than 60 per cent from the same time last year.

The figure has been rising steadily since last summer, with several thousand people joining each month. Names come off the list each month, too, but at a much slower rate.

In October, 5,262 people added their names to the registry, while 2,334 names dropped off.

Premier Tim Houston told reporters Thursday he is "of course" concerned by the size of the wait-list for primary care, but is confident his government's plans to improve access to care will pay off, eventually.

"I'd also remind people that we've always been very clear that things were probably going to get worse before they got better," said Houston.

"We know the issues in the health-care system. We're concerned about it but we're focused on it."

Premier Tim Houston speaks to health-care workers at roundtable discussions in Bridgewater, N.S., in September 2021. (Robert Short/CBC)

Houston's PC government won a majority in the summer election on a platform largely focused on health care. He has since opened a new office dedicated to the recruitment of health-care workers to fill major gaps across the system.

A spokesperson for the provincial health authority said as of last week, between Nova Scotia Health and the IWK Health Centre, the province was looking for about 85 new family doctors and 25 nurse practitioners.

Drivers of growth

Matthew Murphy, who monitors and analyzes the wait-list data for the health authority, said the numbers typically increase for three reasons.

The two main drivers are in-migration to the province, and physician retirements or relocations. Together those two factors accounted for about 90 per cent of the growth in October. The remaining 10 per cent of people who joined the wait-list said they hadn't needed a health-care provider until now.

Matthew Murphy is the director of performance analytics and accountability for Nova Scotia Health. (Submitted by Nova Scotia Health)

Murphy said the share of people joining because they didn't previously need a provider ticked up slightly last month. He's exploring the possibility that the province's new virtual health-care program is the cause.

So far, the program has been offered to about 30,000 people on the wait-list in the northern and western health zones and is expected to roll out to the rest of the people on the list by the end of this year. The offering is to connect those people with a virtual care provider for as long as they're on the wait-list.

"We have a hypothesis that people may not have added their names if they felt that it could be a year or two before they got a provider," Murphy said.

"Knowing now that there will be a virtual care option to provide more continuous care, we think may be driving some people who had previously not put their name up for attachment."

Murphy said he's in the early stages of testing that hypothesis.

Virtual care uptake

Since it launched in September, about 25 per cent of those who have been offered the virtual care option have taken it.

Health Minister Michelle Thompson said she knows virtual care won't be appealing to everyone, but she thinks it's worth making available. 

"We will continue to talk to people about making sure they're on the registry if they need primary care, ensuring that we are asking people if there are any barriers to them accessing that service, and also increasing access to primary care in communities, in person, where we can," Thompson said following a cabinet meeting Thursday.

Minister of Health and Wellness Michelle Thompson. (Robert Short/CBC)

Names come off the list as people find doctors or nurse practitioners to take them on as patients, or when people leave the province. But it falls on the individual to remove their name, which not everyone thinks to do immediately. 

Murphy said data quality checks are done regularly by sending emails or making phone calls to people on the list to see if their need for a practitioner has changed. Recently, emails were sent to everyone on the list who had provided one (about 38,000 people) and 1,300 names were removed.

Murphy said the number on the province's registry might actually be an underestimate, based on figures collected by Statistics Canada.

In 2019, Statistics Canada reported 14.4 per cent of Nova Scotians did not have a primary care provider, or about 139,000 people based on that year's census population. That's significantly higher than the number of people on the province's registry that year — the 12-month average was just over 51,000.

"There's a gap between what we have for people who have registered and are looking versus those who maybe just are unattached and not looking," said Murphy.

Statistics Canada's numbers come from a national health survey. That survey shows primary care access is a countrywide problem. The survey found 14.5 per cent of Canadians did not have a regular health-care provider. Ontario had the lowest percentage of unattached patients at 9.4 per cent and Quebec had the highest, at 21.5 per cent.

ABOUT THE AUTHOR

Taryn Grant

Reporter

Taryn Grant is a Halifax-based reporter and web writer for CBC Nova Scotia. You can email her with tips and feedback at taryn.grant@cbc.ca

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