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Physician recruitment and retention

March 22, 2017

Dear editor:

Janet Knox, CEO of Nova Scotia Health Authority and Denise Perret, Deputy Minister of Health and Wellness have both recently stated that Nova Scotia has the highest rate of physicians to patients in the country.

This means we have more physicians per patient population than any other province. But with news reports of a doctor shortage, you might wonder how this could be so.

Nova Scotia’s doctors provide specialized services – things like organ transplants, complex maternal care and some cancer treatments – to people across the Maritime and Atlantic provinces, not just Nova Scotia residents.

Dalhousie Medical School in Halifax, which trains medical students and residents, also has family medicine residency training sites in Yarmouth, Sydney and Kentville. Physicians across the province teach the next generation of both family doctors and specialists, which means they must balance their academic duties with patient care.

Nova Scotia also has a robust medical research program. Physician-researchers work to improve understanding of disease and prevention/treatment. It's important work and it takes them away from treating patients.

Nova Scotia has an aging, unhealthy population, which creates increased demand for doctors. Aging patients with complex conditions require more care. Physicians are a vital part of a health-care system that seeks not only to treat disease, but also prevent it.

As you can see, the doctor-to-patient ratio isn’t as simple as having enough doctors for everyone in the province. The ratio changes significantly when you remember that Nova Scotia's doctors provide care for people from four provinces, not just one, and factor in doctors who are teaching the next generation of physicians and leading important research.

So, while it may be true that Nova Scotia has a high number of doctors we have people who don’t have a family doctor.

Statistics Canada indicates that as many as 90,000 Nova Scotians – about 10 percent of our population – don’t have a family doctor.

Government’s own Physician Resource Plan indicates the province needs to hire more than 1,000 physicians (both family physicians and specialists) over the next 10 years.

So, let’s stop the debate about the physician to patient ratio.

Let’s make Nova Scotia an attractive place to practice medicine. Physicians are supportive of a move to collaborative care or team-based care, some physicians have been practicing that way for years. But to fully make the shift, it’s going to take time and our patients need good access to care in the meantime.

I encourage the NSHA and DHW to be flexible and concentrate first on recruiting doctors, family doctors in particular. Once we have them working in our province, we can help them transition into the new model of care.


Michelle Dow, BSc, MD, CCFP