If current trends continue, by next June the family doctor shortage in the Halifax area — at least as measured by the Nova Scotia Health Authority’s Need a Family Practice (NAFP) registry — could be a thing of the past.
That’s projecting the success of the last year forward, so there’s no guarantee. But the data are clear — the number of so-called orphaned patients in the NSHA’s central zone plummeted between Nov. 1, 2018 and Nov. 1, 2019.
On the flip side, the number of people looking for a family physician rose sharply in Nova Scotia’s western and northern zones over the same period.
It’s a tale of two Nova Scotias. Those living in or close to the province’s largest city are, more often than not, finding family doctors. Those in small-town or rural Nova Scotia too often aren’t as lucky.
That’s a big problem. The age of our province’s population is unevenly distributed. Halifax tends to be relatively younger, the rest of the province older. Since people often require health-care services more frequently as they age, the lack of primary-care physicians in southwestern and northern Nova Scotia means many who most need a family doctor can’t find one.
A quick look at the numbers tells the story. On Nov. 1, 2018, there were 59,225 people on the NAFP list. The greatest number, nearly half, 29,544 (49.9 per cent) were in central zone. Meanwhile, 24,711 (41.7 per cent) were in western (17,384) and northern (7,327) zones.
A year later, the registry’s overall total was down to 49,340. Central zone’s total had fallen to just 11,697 (23.7 per cent), now below both western (20,606, 41.8 per cent) and northern (12,387, 25.1 per cent) zones. Those latter zones now accounted for 66.9 per cent of Nova Scotia’s orphaned patients.
The situation in southwestern and northern Nova Scotia is even worse than these dismal numbers suggest. Since fewer people live there, as compared to the Halifax area, a much higher percentage are without family doctors.
The worst example is around Middleton, where 4,381 people — nearly 21 per cent of that area's NSHA listed population — are registered as needing a family physician. In Halifax peninsula/Chebucto, just 3.4 per cent of the population is on the list.
Check out the map that shows where the need for family doctors is greatest.
The NSHA’s doctor recruitment and vacancy statistics also reflect success in attracting new family doctors to metro, along with difficulty in doing so in smaller communities.
Of the 80 family doctor vacancies currently listed on the NSHA’s website, 53 (66.25 per cent) are for western and northern zones. Just 11 (13.75 per cent) are in central zone.
On the recruiting side, 56 per cent of family doctors (50 of 89) brought to Nova Scotia between April 1, 2018 and Sept. 30, 2019 chose to locate in central zone. Just 23 chose western (14) or northern (9) zones.
Responding to my query, an emailed statement attributed to the NSHA’s director of recruitment, Katrina Philopoulos, said it’s a national trend that health-care workers, including doctors, choose more urban centres to practise.
“In the past two years, we have focused on recruitment to fill as many of the vacancies as possible, and in this context, the province has allowed physicians to choose where they want to practise,” Philopoulos said in the statement. “Our goal is to recruit and retain as many physicians as we can to the province of Nova Scotia. A doctor in one region is a win for the province.”
NSHA statement from Katrina Philopoulos, director of recruitment
To help bolster rural recruitment, the following have been implemented:
o Increased residency opportunities to include rural areas of NS.
o The provincial government offers incentives that are specific to rural practice that help an individual chose to practice in rural NS.
o NS Practice Ready Assessment Program has been launched and will bring more physicians to rural Nova Scotia.
o Increased our recruitment team presence in the rural communities.
o Hired a recruiter whose focus is on residents and medical learners.