N.S. doctors must be paid top in Atlantic Canada and middle of pack nationally
Today, Doctors Nova Scotia, Maritime Resident Doctors and the Dalhousie Medical Students’ Society released a position paper, Road Map to a Stable Physician Workforce, which calls on the provincial government to take immediate action to stabilize the physician workforce in Nova Scotia.
“If Nova Scotia has a hope of improving its ability to retain and recruit doctors, the province must offer physicians competitive compensation and must create a heathier environment to practise medicine,” said Dr. Tim Holland, President of Doctors Nova Scotia.
The paper contains six recommendations to improve physician retention and recruitment, ultimately improving access to care for Nova Scotians:
- Pay physicians competitively
- Introduce a new blended payment model for family medicine
- Invest in succession planning
- Improve physician engagement
- Change the focus of billing audits
- Reduce administrative burden for physicians so they can spend more time with patients.
Nova Scotia physicians are among the lowest paid in the country and are often the lowest paid in Atlantic Canada.
“In order to retain physicians in our province and to recruit new ones, we need a competitive advantage. Nova Scotia must become a leader for physician compensation in Atlantic Canada, with an established path to becoming nationally competitive,” said Dr. Holland.
Paying Nova Scotia physicians competitively and creating a new blended payment model to support comprehensive and collaborative primary care would greatly improve the province’s ability to attract specialists and family doctors. In family medicine, for example, the province’s biggest recruitment competitors are New Brunswick and Prince Edward Island. Both provinces pay more competitively and New Brunswick offers a blended payment model. By offering more attractive compensation and similar funding models as our neighbouring provinces, Nova Scotia will be better positioned to recruit and retain physicians.
“With more than half of our practising physicians over the age of 50, with increasing numbers of people without a family doctor and with many specialty services hanging on by a thread, it’s clear that immediate action is needed to ensure Nova Scotians have access to the care they need,” Dr. Holland said.
Mentorship programs that support physicians as they begin practising in Nova Scotia and allow retiring physicians to gradually phase out of practice would provide a better transition for both physicians and their patients, and set up rural communities for successful long-term recruitment.
There is increasing concern that Dalhousie medical students are not choosing to practice family medicine in Nova Scotia. This year, for example, among the fewest ever number of Dalhousie Medical School graduates chose family medicine in Nova Scotia and as a result, Nova Scotia will train more out-of-province residents in family medicine. Just 14 of 29 seats will be filled by Nova Scotians, with the number on a steady decline since 2014. This comes at a time when government is investing to increase the family medicine residency seats in the province – a critically important investment, but one that must be supported by an ability to retain the physicians we train here.
“This is a wake-up call to our province that our own medical students aren’t choosing to practice family medicine in Nova Scotia. Where students train has a significant influence on their choice of practice location,” said Dr. Caitlin Lees, President, Maritime Resident Doctors.
In addition to low compensation, family medicine and other specialists in Nova Scotia face a challenging work environment and excessive administrative burden. Doctors are experiencing very heavy workloads, filling gaps in services at hospitals across the province, and a significant amount of process and paperwork requiring them to take time away from patient care.
“Whether it’s trying to arrange a locum from another province to fill in for vacation, maternity leave or sick time, or completing paperwork requested by government departments, physicians are spending too much time on paperwork when they could be caring for Nova Scotians,” Dr. Holland said.
Physician audits in Nova Scotia are contributing to low morale and a national reputation as an unattractive province to practise medicine.
“Physicians have the impression that audits are focused solely on punishing them, which differs from other provinces where the purpose of audits is to educate physicians to guide appropriate billing,” said Dr. Holland.
In addition, many physicians feel disconnected from health-care decision-makers in Nova Scotia, despite the fact that they play a critical role in the delivery of health-care services. “When physicians are engaged in decisions that directly affect them and their patients, better decisions are made,” Dr. Holland said.
Acknowledging and understanding these issues is an important step toward improving the recruitment and retention environment in the province. The next step is to take action.
“It is almost impossible to recruit physicians to a work environment that promises excessive hours, inadequate pay, insufficient supports and an inability to meet patient needs within reasonable time frames,” said Dr. Holland. “The good news is, with action from our government, together, we can do something to improve the situation.”
The full report is available here.
Note to editors:
Dr. Tim Holland is available for media interviews between 1:30 and 3:30 p.m. on Wednesday and by phone noon to 1 p.m. on Thursday.
Dr. Caitlin Lees may be available for media interviews around her clinical duties between 10 and 11:30 a.m. on Wednesday and between 1 and 3 p.m. on Thursday, by phone only both days.
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Today, the three organizations that represent physicians across the continuum of their career in Nova Scotia released six recommendations to stabilize the physician workforce in Nova Scotia.
Together, Doctors Nova Scotia, Maritime Resident Doctors and the Dalhousie Medical Students’ Society released a position paper titled, Road Map to a Stable Physician Workforce, which calls on the provincial government to take immediate action.
Dr. Tim Holland, President of Doctors Nova Scotia says that in order to retain physicians in our province and to recruit new ones, Nova Scotia needs a competitive advantage. He says Nova Scotia must become a leader for physician compensation in Atlantic Canada, with an established path to becoming nationally competitive.
The paper contains recommendations to improve physician retention and recruitment, ultimately improving access to care for Nova Scotians:
- Pay physicians competitively
- Introduce a new blended payment model for family medicine
- Invest in succession planning for physicians
- Improve physician engagement in the health-care system
- Change the focus of billing audits
- Reduce administrative burden for physicians so they can spend more time with patients.
Dr. Holland said it’s almost impossible to recruit physicians to a work environment that promises excessive hours, inadequate pay, inadequate supports and an inability to meet patient needs within reasonable time frames.
Acknowledging and understanding these issues is an important step toward improving the recruitment and retention environment in the province.