The town and district councils got together in December to talk about doctor recruitment.
The main issue on the table: South West Health wants them each to set aside $60,000 for doctor recruitment for the next four years or more.
Representatives of the district health authority were in Digby on Dec. 18 and made their case before both councils for the $240,000 commitment.
“This money could be used for return of service contracts with medical students, family medicine residents or physicians, payment of recruitment firm fees, office set-up, forgiveness of overhead payments, recruitment initiatives such as job fairs and meetings with medical students and residents,” said Hubert d’Entremont, site manager at Digby General hospital as he read from South West Health’s proposal to the councils.
d’Entremont said they preference could be given to doctors with a connection to Digby and to those are able to most quickly set up practice here.
d’Entremont said they could also sign contracts with medical students “before they select other communities.”
The municipality currently has a standing offer of $20,000 per doctor per year. The town withdrew their standing offer when they agreed to fund ten per cent of the new collaborative clinic up to $177,000.
d’Entremont and Shirley Watson-Poole, the physician recruiter with South West Health want the municipalities to make the commitment to a recruiting fund to save SWH coming back to council every time a potential doctor comes knocking.
“We have been successful with long term recruitment to Yarmouth County by partnering with their three municipal units,” said d’Entremont. “They budget funds every year and because the district is aware of the amount of funding available we are able to immediately discuss with candidates the incentives available in that area.”
d’Entremont said the initiative has attracted one medical student and three family medicine residents to Yarmouth, the first of whom will begin work this year.
Deputy mayor Jean Brittain said more doctors go to Yarmouth because it is a bigger centre and spouses have more opportunities and she wondered if more financial incentive would really overcome that disadvantage.
Deputy warden Jimmy MacAlpine wondered why South West Health’s funding proposal did not include the province who is technically responsible for health care.
“And more than that, Nova Scotia has the second highest ratio of doctors in Canada but they all go to the city,” said MacAlpine. “We’re doing what we can but what I’d like to know is where is the province in all this? Besides your salary?”
d’Entremont and Watson-Poole listed a few ways the Department of Health and Wellness is helping: their debt assistance plan offers up to $45,000 to Nova Scotia residents who choose areas of the province with physician shortages; they offer return of service programs for international medical graduates, as well as clinical assessment for practice programs and payment for site visits and relocation allowances.
MacAlpine also asked if pay scales were the same across the province.
Hubert said they were different and that South West Health was pushing the province to make them the same.
MacAlpine summed up his feelings with one sentence:
“We need equality or we are never going to draw doctors here.”
District councillor David Tudor asked for specifics about the pay differences.
d’Entremont said emergency department doctors in Yarmouth get $190 an hour and in Digby only $100.
“I wonder why the Yarmouth ER is consistently open and ours isn’t,” said Tudor. “I don’t think it’s the whole problem but it’s a clear example of the problems that are all through this. It’s a clear example of what’s wrong and it’d be a great place to start if you want to fix things.”
d’Entremont said the health authority’s focus was on attracting family doctors and those doctors might pick up the shifts needed to keep the Digby emergency open.
Councillor Mike Bartlett asked about ways to take some of the load off the doctors we do have or end up attracting.
He suggested limiting shifts available to new doctors to keep them from burning out, he suggested using nurse practitioners to keep the emergency open and he suggested stationing an ambulance and paramedics at the hospital when the emergency is closed.
The South West Health representatives said those kinds of decisions were provincial and “complicated.”
Mayor Ben Cleveland told the meeting he feels it’s important to put together a consistent package so we’re ready when doctors come along.
“We have to remember, we can’t force doctors to come here,” said the mayor. “I don’t know if we can support the kind of money you’re talking but I do know it’s a numbers game. Put a good package together, show it to a thousand and maybe we’ll land a couple.”
Cleveland says is it’s the number one concern on everyone’s mind these days.
He says even though health care is a provincial responsibility, “the community is telling us, a municipal government, to find them doctors.”
“I’d be very uncomfortable if we just shrugged it off and said ‘It’s not our responsibility,” he said.
“I don’t think any of the communities can really afford this,” says Cleveland. “But Yarmouth will soon be looking for doctors, Shelburne is looking and they all have packages.”
The mayor wants to see the Nova Scotia task force of 35 towns have a serious discussion about this issue.
“We’re pitting community against community for doctors,” he says. “It’s a bidding war, a war we could lose just because we don’t have a lot of money.”
Neither council has made a decision on the health authority’s request. Town council was to meet next on Monday, Jan. 7 and the municipality’s committee of the whole on Monday, Jan. 14.
Cleveland says he’d like to see his council make a decision by the end of the month.