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A 'wicked problem': Digby and Area Health Coalition holds event to discuss health care challenges

A community roundtable session to discuss health care was held recently in Digby. SARA LAUREN PHOTO
A community roundtable session to discuss health care was held recently in Digby. SARA LAUREN PHOTO - Contributed
DIGBY, N.S. —

Tony Kelly of the Digby Area Health Coalition. SARA LAUREN PHOTO
Tony Kelly of the Digby Area Health Coalition. SARA LAUREN PHOTO

Members of the Digby community, primary care providers and provincially interested parties recently gathered at the Digby Curling club to deep-dive into the ongoing issues involving the lack of health-care service providers in rural Nova Scotia, specifically in Digby County.

At the March 11 session Tony Kelly, co-ordinator of the Digby and Area Health Coalition, described the challenges ahead as a “wicked problem” that is multifaceted and not easily solved. He posed the question: “What does Digby need?”

On hand to help begin to answer that question were members from Doctors Nova Scotia. Gary Ernest is a family physician in Liverpool and relayed the statistic that, as of now, Nova Scotia has a shortage of 200 family doctors to meet current patient needs.

CEO Nancy MacCready-Williams indicated that Doctors Nova Scotia represents the over 3,500 physicians in Nova Scotia, 2,400 of whom are actively practising. The Department of Health and Wellness has an annual health budget of $4.2 billion, but it is in fact the Nova Scotia Health Authority that is responsible for the recruitment and retention of physicians.

Dalhousie University educates and trains about 100 new doctors every year. However, the Physician’s Resource Plan, created eight years ago as a working document, suggests that Nova Scotia will require 1,000 new doctors in the next 10 years, 500 of them family doctors, just to meet the aging populations needs.

MacCready-Williams spoke of the Recruitment and Retention Advisory Committee that is responsible for providing advice and help to bridge the gap with the Nova Scotia Health Authority, but ultimately the responsibility for hiring physicians lies with them.

There has also been a Medical Education Working Group set up to encourage Nova Scotian students to train and practise at home, through mentorship programs and training physician ambassadors. The final program that has been rolled out as of January is the Nova Scotia Practice Ready Assessment. This helps international medical students get a footing in the province to be able to fast track to practice.

These programs have seen the recruitment of 120 new physicians as of January, but there are still 195 vacancies with 132 physicians retiring, passing away or leaving the province.

Doctors Nova Scotia president Dr. Ernest posed the question: “How could I come to Digby, practise and survive here?” He brought up the fact that family physicians in rural Nova Scotia have a much different job role than family physicians in urban Nova Scotia. He described it as a “cradle to grave” practice and talked about how they are seeing patients from birth, in the hospital, in an office and in nursing homes, and that doctors must be comfortable in all settings.

Dr. Ernest explained that training programs today just do not support doctors with a knowledge base to feel comfortable coming into a rural community and, as a result, they become completely burnt out in a very short amount of time. The prescription: the Nova Scotia Health Authority hiring six doctors for the Digby area to come in and build a practice as a team. There would be a position guarantee for the six doctors for six years but the commitment would mean the doctors are required to stay for six years. Dr. Ernest feels this is the only way rural Nova Scotia will recruit and retain physicians.

A community roundtable session to discuss health care was held recently in Digby. SARA LAUREN PHOTO
A community roundtable session to discuss health care was held recently in Digby. SARA LAUREN PHOTO

Dr. Norah Mogan echoed her colleague’s observations, speaking of the success Liverpool has had with a similar model, advising that they have been successful in recruiting and retaining six doctors who have come to town and stayed, seeing patients in emergency rooms, offices, at home and in senior care facilities. Dr. Mogan indicated that the “secret sauce” is the collegiality of the physicians with programs in place to support them to train in rural Nova Scotia, and she posed the question, “Could this same model come to Digby?” Dr. Mogan said the mentality behind recruiting as a group is that “you can break one but you can’t break five.”

The meeting wrapped up with the tough takeaway that with an increase in the aging population, there needs to be a solution, and fast. The working group with the Digby and Area Health Coalition will take the communal priorities – gathered from the small group breakaway discussions – and will concept map them to build a working manifesto that will be distributed to the community, and another round of discussions will take place before the suggestions are brought to the province for review and anticipated action.

Until then, Digby will continue to beat its drum as loudly as it can in hopes that relevant parties will recognize the problem and rather than find a mere Band-Aid solution, they will join arms with the township to create permanent and lasting change.

(Written by Sara Lauren)

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