Setting DNS’s priorities
Doctors Nova Scotia prepared an extensive member outreach strategy, which included a member-wide survey, targeted group meetings, 15 meetings with physicians in academic departments in Halifax and a series of meetings in communities across the province throughout October and November 2022. The information you provided and the experiences you shared were critical to building the DNS Board of Directors and your negotiating team’s understanding of your top priorities and the most pressing issues facing physicians, as well as how best to support physicians in delivering exceptional patient care.
Key themes
A few themes came up in almost every consultation session. These concerns were reflected in physicians’ negotiation priorities, no matter where the physicians practised or their specialty or payment model.
Retention and recruitment
The retention and recruitment of physicians to Nova Scotia—especially family physicians—is top of mind for NS physicians. More physicians are needed to address the volume of patient care required in the province today.
Retention is more complex, and requires the health system to deliver on promises made about practice environment and pay during recruitment. Successful physician retention is grounded in flexible policies and practices that meet the needs of all different types of physicians, regardless of career stage, patient community or personal circumstances. Physicians who do not feel adequately supported may leave for other regions or may leave practice altogether.
Recruitment requires attractive options for practice with competitive remuneration, opportunities for collaborative practice and the promise of work-life balance (including supports for spouses and children in the community). It hinges on proactive, responsive communication with potential recruits – whether they are new graduates from residency programs or licensed physicians from other provinces or countries.
There should be clear lines of communication between physicians and health system administration.
Remuneration models
Physicians in Nova Scotia need a variety of different payment models to choose from. Different payment models work best for different forms of care, and physicians need access to the model that will best support care for their patients.
Overhead
Physicians need financial supports outside of remuneration for the services they provide to patients. Physicians who practise in community clinics outside hospital settings are responsible for paying their overhead costs out-of-pocket. This represents a significant financial burden and professional responsibility, and a deterrent to office-based practice.
Physician and system burnout
Nearly three years of managing the COVID-19 pandemic have left health-care providers burnt out and facing depleted resources, mounting system issues and ever-more-complex patients. In addition, the past few years have also seen longstanding health system inequities acknowledged, revealing the extent of provider and patient discrimination in health care.
Member survey
The first step to getting your input was a member-wide survey. The survey, conducted by Narrative Research, closed on Nov. 3, 2022. More than 775 members responded to the survey, representing 23% of the membership.
Read the survey report here.
Virtual roadshow
DNS hosted virtual community meetings to hear directly from Nova Scotia’s doctors about their priorities for negotiations. The virtual roadshow consisted of targeted group meetings, 15 meetings with physicians in academic departments in Halifax and a series of meetings in communities across the province. A report called, What we heard: Negotiations 2023 – Member consultation report, summarizes the ideas, feedback and input shared by Nova Scotia’s doctors during the roadshow.
Read the full report here.
Economic forecast
Doctors Nova Scotia developed an environmental scan of the economic factors that influence Nova Scotia’s health-care system. Among other things, this report analyzes Nova Scotia’s physician compensation relative to that of other provinces using each of the following separate approaches for verification:
- Provincial physician services budgets on a per capita basis
- Fee schedule increases
- Physician funding as reported through MSI data
- Physician funding as reported by CIHI’s fee-for-service data
- Top five billing codes by specialty
The analysis in each case confirms that physician compensation in Nova Scotia lags behind most provinces, with Nova Scotia firmly in the bottom third on most comparative metrics.
Click here to read the report.
Have questions?
Contact your physician advisor to discuss issues that important to you.
Noelle Moulaison (Zone 1-Western)
noelle.moulaison@doctorsns.com
Ryan Brown (Zones 2-Northern and 3-Eastern)
ryan.brown@doctorsns.com
Jennifer Girard (Zone 4-Central)
jennifer.girard@doctorsns.com
Kim Oakley (team lead)
kim.oakley@doctorsns.com