Physician recruitment and retention in Digby, N.S.

Dear editor,

I am writing in response to a letter to the editor by Tony Kelly entitled, “Docs leave Digby in lurch. What of duty to care?” published on September 22 in the Chronicle Herald. Unfortunately from our perspective, this letter is a demonstration of blame placed where none exists.

Before addressing the specific issues raised in the letter, I want to acknowledge that Doctors Nova Scotia has met with Mr. Kelly and his colleagues, in fact we addressed a health care meeting held in Digby, and were warmly received by both the organizers and the community. We commend the work of Mr. Kelly and his colleagues in working to try and improve the delivery of health care in the community; community advocacy and support are key in physician retention and recruitment.

That being said, we must strongly disagree with Mr. Kelly’s assertion that the relocation of the two young physicians from Digby constitutes a breach of ‘duty to care’. At the core of every physician’s work is the care that they deliver to their patients, and to suggest that a physician has not provided the care needed, and actively breached their responsibility, is a grave and serious accusation.

The two young physicians in question practiced in Digby pursuant to a return of service agreement with the Nova Scotia Health Authority (NSHA) and the Department of Health and Wellness (DHW). They chose Digby from a list of six potential locations, primarily because there were to be four new physicians (including the two physicians we are speaking of) beginning practice in the community. This would have provided for a sustainable practice to deliver full scope care for their patients, sharing on-call for example, and starting practice with a solid support system. For a variety of reasons two of the four physicians did not begin practice in Digby, leaving the two new physicians. This fundamentally changed the expectation they had with respect to practice.

In spite of this, these physicians have been working tremendously hard to support the community. They have been caring for people with complex health needs, taking part in emergency department shifts and caring for inpatients. They have worked long hours, often much more than contractually obliged, simply because the community needs were so great; far from breaching duty of care these young physicians, in the first years of practice, worked tirelessly to try and provide care.

Naturally, these young doctors want to settle closer to their families and support systems. We give kudos to the NSHA and the DHW for supporting them to do so. They will be closer to their families but still serving under-resourced communities in Nova Scotia. In the meantime, more permanent recruitment to Digby remains a high priority.

We all need to work together to support retention and recruitment, and unfortunately comments such as Mr. Kelly’s can discourage young physicians from practicing in certain communities. It’s equally unfortunate that at the time of his comments, more than one hundred family medicine residents were meeting in Digby for a retreat and recruitment event. We should have used this opportunity to promote the many positive reasons to practice in Digby and surrounding communities; success will come when physicians and other professionals are able to practice in communities that they want to be in, and want to stay in, not having to practice in communities through an administrative obligation.

Sincerely,

Dr. Tim Holland
President, Doctors Nova Scotia