The Current

He survived a heart attack but still can't get a family doctor. Neither can millions of Canadians

Ronald Hayden had a heart attack last month, but like many Canadians, he doesn't have a family doctor for followup care. The shortage of primary care is putting other aspects of health care, such as emergency rooms, under pressure, say advocates.

Shortage of family doctors drives the sick into overstretched ERs, say advocates

Ronald Hayden and his wife, Lana Wood-Hayden, have been trying to sign up with a family doctor, but to no avail. The couple from Musquodoboit Harbour, N.S., told their story, and why Wood-Hayden thinks her husband is walking around 'like a ticking time bomb' at a forum on health care last week, hosted by CBC's Radio's Matt Galloway. (Chantal Bernard/CBC)

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When Lana Wood-Hayden of Musquodoboit Harbour, N.S., answered the phone on Aug. 13, she heard her husband, Ronald Hayden, croak out two words: "Help me."

She raced to the harbour and took a paddle board out to her husband's anchored boat, where she found him collapsed, having suffered a heart attack.

"I managed to get him up on his hands and knees and up to the side of the boat, and then I chucked him out in the row boat," Wood-Hayden said.

She rowed him to the shore, where paramedics were waiting.

Hayden survived. He recovered in hospital for a few days, until staff told him he was being discharged. 

It's just mind-boggling how our health-care system can be in such messed-up shape in this day and age- Lana Wood-Hayden

"They needed the bed, and they said we could follow up with our family doctor," Wood-Hayden said.

But like many people in Nova Scotia, Hayden hasn't had a family doctor for years, relying on walk-in clinics that cannot offer the care he needs now. 

"It is a little disconcerting just knowing I have nowhere to go right now," he said.

According to Nova Scotia Health figures released this week, 75,180 Nova Scotians are on waiting lists for a primary care provider. The Canadian Medical Association estimates that figure nationally is close to five million Canadians.

Wood-Hayden asked hospital staff what they should do to monitor Hayden's condition, or if he needed treatment.

"They just said, 'Come back to emerge.'"

Emergency rooms are sometimes closed due to staffing shortages, says Chris Parsons, provincial co-ordinator at the Nova Scotia Health Coalition. (Submitted by Chris Parsons)

The shortage in primary care has a domino effect in the health-care system, said Chris Parsons, provincial co-ordinator at the Nova Scotia Health Coalition, a non-partisan public health-care advocacy group.

"[Patients] are forced to put pressure on emergency rooms, or they wait until they're extremely sick to seek medical care, when early intervention could have dealt with the problem very easily," he said.

Emergency rooms are also sometimes closed due to staffing shortages, he said, and "when they are open, they're just so overwhelmed by patients who otherwise should be seeking treatment elsewhere but don't have any other choice."

Since her husband's heart attack, Wood-Hayden has been calling practices every week to try to get him signed up to a family doctor, she said. None have had space for new patients, even though Wood-Hayden says she pleads that her husband is "walking around like a ticking time bomb." 

Hayden is also on the provincial wait list.

"It's just mind-boggling how our health-care system can be in such messed-up shape in this day and age," she said.

LISTEN | Listeners across Canada share their experiences:

Hard to say no to patients: Doctor

Dr. Lisa Bonang, a family doctor for 26 years in Musquodoboit Harbour also works in the local hospital's ER.

"I don't know if [an ER] shift goes by that someone doesn't ask us, 'Are you taking on new patients?'" said Bonang.

It's hard to say no to people seeking care, but she already has a full slate of patients and a two-month wait list for a non-emergency appointment.

"To take on more would be irresponsible for me in terms of giving proper care to those patients that I do have," she said.

Any given day, she could see upward of 30 patients in the ER, as opposed to eight, at most, 10 years ago, she said. Wait times can be three hours at her ER, she said, which leaves patients, and those who care for them, frustrated. 

Dr. Lisa Bonang has been a family doctor for 26 years in Musquodoboit Harbour, N.S. She says it's not a good feeling to have to say no to people who are seeking primary care, but she's at full capacity with her roster of patients. (Chantal Bernard/CBC)

Hours in the ER, waiting

Simone Harker says she waited nearly two hours for her diabetic husband, Keith, to be triaged at a crowded Sackville, N.S., ER in late July.

He had been unwell for a few days, and his condition deteriorated as they waited.

"He died right in the lobby in front of everyone," said Harker, of Bedford, N.S.

Keith was 78. His cause of death was recorded as a cardiac arrest.

Harker says she doesn't blame the hospital staff, who she feels are overworked, but she is heartbroken over how he died.

"I don't know that he really had to die at that point. And if he did, why couldn't he have died with respect, and not in a lobby?"

In an emailed statement, Nova Scotia Health said patients are triaged and assigned priority levels using an internationally recognized process. 

The health authority said the province is experiencing "higher than normal" numbers of emergency visits and demands for hospital beds, as well as staffing shortages, which are "made worse by the pandemic." It expects longer waits into the fall as COVID-19 cases creep up. 

WATCH | 2 widows share their grief in push for reform:

United in grief, these Nova Scotia widows hope to change health care

1 month ago
Anne MacPhee and Simone Harker share a common grief: they are both widows. But through their loss they have found friendship in one another — and they hope to be a force for change in health care. 5:27

'Empowered' to call for change

In the weeks after Keith's death, Harker came across an opinion piece written by Anne MacPhee, whose husband, Kelly, died of a heart attack last year.

She said they waited 40 minutes for an ambulance to reach Kelly in their Halifax home despite the nearest hospital being only three kilometres away.

Reading MacPhee's story "empowered" Harker to tell her own. The two women have formed a bond and are speaking out in the hopes it will help other families.  

"[There's] this overwhelming feeling that you get with grief, but working together and trying to turn our grief into something better for somebody else is helping," MacPhee said.

Harker said she knows speaking out won't help her husband, but she believes "in his own way, he'd be very proud" of her.

"I'm hoping down the road, somebody else may have a life saved because of the voices, or the noise, that we're making."

Simone Harker, left, and Anne MacPhee, right, want to share their experiences with the health-care system in Nova Scotia in the hope it could prompt change. (Dave Irish/CBC)

They want to see more incentives to bring doctors to rural areas, and greater efforts to avoid burnout and retain those doctors already there. They're seeking a meeting with Nova Scotia Health Minister Michelle Thompson.

Speaking to reporters last week, Thompson said the provincial government, elected a month ago, is working on solutions, and "details will be forthcoming."

Parsons, the co-ordinator at the Nova Scotia Health Coalition, called for investments in education to recruit more health-care workers. He wants to see a focus on training new people, and away from huge investments in attracting medical professionals from other provinces or overseas.

There should also be a greater emphasis on team-based care, sharing doctor workloads with nurse practitioners, social workers, psychologists and dieticians, he said.

Speaking to CBC Radio's The Current on Wednesday, Nova Scotia's chief medical officer of health, Dr. Robert Strang, said governments "need to think longer-term and bigger picture on the solutions," including addressing issues such as housing and poverty, which can impact a person's health.

"If all we do is try to meet the demand for care, we will never, ever get out in front of that," he said.

Written by Padraig Moran, with files from Dave Irish. Produced by Mary-Catherine McIntosh and Alison Masemann.

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