ANNAPOLIS VALLEY, NS - Ruby Hyndman breaks into sobs, burying her face in her hands to hide the tears rolling down her cheeks.
Karen Hasler fights to finish her sentence before becoming too overwhelmed to speak.
They don’t know each other, but have something in common: the doctor shortage issue in the Annapolis Valley keeps them both awake at night.
Karen, originally from Hubbards, recently moved back to Nova Scotia with her husband, Mervyn, after spending 10 years in Alberta for work, the desire to be near their children calling them home.
“We came home to be with our girls. All of our girls are here,” says Karen.
They’ve always enjoyed the pace of life in the Annapolis Valley and felt it would be a wonderful place to call home in their retirement years.
Their optimism was short-lived.
Desperate for a doctor
Mervyn was diagnosed with a heart condition before leaving Alberta, where he had regular access to, and frequent check-ups with, his family doctor in Edmonton.
He admits he used to take the quarterly doctor visits for granted at times, even seeing it as a nuisance to have as many appointments as he did. His perspective on that has changed drastically since moving to back to Nova Scotia, where he is now awaiting placement with a family practice through the provincial 811 list.
“It is frustrating. It’s annoying. I still don’t think I’ve really realized the gravity of what’s going on,” says Mervyn.
“You’re put on this list but you don’t have to be on the list to get a family doctor because if a family doctor knows you and wants to take you on, you don’t have to go on the list.”
The couple started searching for a family physician in Nova Scotia before leaving Alberta, but to no avail.
“I was quite worried about him and I wanted to get to see somebody as soon as we could. That’s when we found out (about this) huge backlog of people and that you had to be put on this list,” says Karen.
“Coming from Edmonton, I don’t expect to come here and walk right into something that people have been waiting for a long time. I don’t expect that, but … I’d love to have continuing care.”
‘I get very upset about it’
Mervyn managed to get a referral for a cardiologist after seeing a doctor at the walk-in clinic at Western Kings Memorial Health Centre in Berwick but was disappointed to learn his follow-up appointment with the cardiologist would be scheduled in a year’s time.
Without a family doctor, Mervyn must go to walk-in clinics or the emergency department at Soldier’s Memorial Hospital in Middleton when he has concerns about his chronic heart condition. There are times, he says, it seems his visits are frowned upon because his concerns are ultimately classified as non-urgent.
“If I had of known things were this bad with the health system, we would not have come back when we did. We would have put it off until at least I knew that he was settled,” says Karen.
The uncertainty has left the Haslers worried that their situation will only worsen with time as they wait to be placed with a care provider who can monitor Mervyn’s heart health on a regular basis.
“I get very upset about it,” says Karen, her voice cracking.
Read more about the family doctor crisis in Kings, Annapolis counties:
Thousands of patients waiting
Data compiled by the Nova Scotia Health Authority (NSHA) as of Jan. 1 showed 41,877 Nova Scotians awaiting placement through the provincial Need a Family Practice 811 registry. This figure includes 6,248 residents of Annapolis and Kings counties that had yet to be placed with a family physician at the onset of 2018. The two counties account for the most densely populated area in the health authority’s western zone, with the combined population cited as 78,507 residents in 2011.
“Recruitment is ongoing for all areas of the province. Our recruiters have increased their presence at physician career events across Canada and into the United Kingdom. Recruiters work with doctors who are currently in residency and identify their interests in terms of communities and practice interests,” said Nova Scotia Health Authority (NSHA) spokesperson Kristen Lipscombe.
The Annapolis Valley is viewed as a “beautiful place to live and work,” Lipscombe added.
“Most doctors who are introduced to the area want to stay. For example, the Dalhousie Family Medicine program was introduced in 2012 and, since then, has a 90 per cent retention rate. An additional benefit for the Valley is that local communities have partnered with recruiters and are willing to create a welcoming environment for new doctors.”
NSHA is unable to provide a timeline in which patients on the 811 list will be contacted by a family practice.
“When family practices that are accepting new patients contact NSHA, a list of names, in chronological order from the area where the practice is located, is provided to the family practice. Practices contact people directly,” said Lipscombe.
Left to wonder
An influx of new doctors in Kings County can’t come soon enough as far as Hyndman is concerned. She recently learned her doctor at the Valley Professional Centre in Kentville was retiring.
“When it comes to my normal prescriptions and things like that, I’m basically left to go to the ER or a clinic,” she says, noting that her husband and two children are now without a doctor as well.
It’s her family she worries about the most. Her son requires regular care for mental health and behavioural issues. Her husband takes blood pressure medication he can’t go without. Her aging mother has a number of severe conditions that must be monitored by a primary care provider.
“She’s freaking out because she knows that her health is failing as it is and now she’s got this extra stress because there is no doctor,” says Hyndman, adding that she’s not sure when to take her mother for checkups on “bad days.”
“You can’t just wait and see if you feel better tomorrow because tomorrow might not be here.”
Hyndman doesn’t want to dwell on what could happen if the issues relating to the doctor shortage are not promptly addressed, but she can’t help but get emotional at the thought of her mother, who has been diagnosed with congestive heart failure, not having a family physician.
“As a daughter watching it, it’s awful because I want my mom here,” she says, breaking into sobs.
“It’s scary. It’s something that we should have. We shouldn’t have to wonder.”
Fees for medical records?
Hyndman has heard from many patients who are now learning they might have to pay substantial fees to retrieve their medical records once their family physician retires.
“I know a lot of families that can’t afford that to get their medical history,” she says.
“Our healthcare system may be free, but… we pay for it in a lot of different ways.”
The outgoing doctor chooses how the practice will arrange for patients to access medical files.
“Patient files are the property of the physician. They may choose to work with a third-party vendor to manage their patient files once they leave practice. There is typically a fee associated with this service,” said Lipscombe.
“Physicians may manage how they provide their patients with their medical files on their own.”
The health authority recommends patients awaiting placement with a family practice call 811 to speak with a registered nurse for health information, visit local walk-in clinics, go to the nearest emergency department for urgent health concerns, or call 911 in the case of emergencies.