Program stabilized health-care services for Nova Scotians

Dear editor,

An article appeared this week in the Chronicle Herald about the income stability program that was put in place for physicians at the beginning of the COVID-19 pandemic in 2020. Some doctors have received phone calls from their patients and members of the public expressing concerns about the program.

It’s important for Nova Scotians to know that the program was created to stabilize health-care services in the province and minimize the risk of medical practices closing and doctors leaving Nova Scotia to work in provinces where income stabilization programs were on offer and COVID-19 response needs were far greater. 

This program helped to establish a reputation for Nova Scotia as a province that supports doctors, which is a significant boost for physician recruitment and retention. The program also allowed doctors who couldn’t provide direct patient care due to service shutdowns to shift their focus to training and preparations for worst-case scenario COVID-19 response, just as we were seeing in other jurisdictions.

Most doctors are paid only for the services they provide directly to patients, but doctors also do a lot of critically important work outside of direct patient care – work that is often unpaid. This was particularly true at the beginning of the pandemic, when doctors were deeply involved in planning and preparing for COVID-19 and participating in training and simulations to ensure they were ready to provide the services deemed most essential.

During this time, many doctors were struggling to keep their practices running. They had to continue to support their families and to pay office staff and overhead expenses such as rent and utilities, but because they couldn’t see patients, they were covering those expenses without a source of income. We heard from physicians who were happy to support the COVID-19 response, but were concerned about how they would manage without being paid.

Our province acted quickly to create the income stability program to provide a source of income for physicians at 80% of what they typically bill for the care they provide directly to patients. It saved doctors from having to lay off staff in their practices, which meant that they could continue to provide health-care services as much as possible during the first wave, and that they were able to quickly ramp up their services again once it was safe to do so. The program also allowed doctors to deliver health-care services that were the highest priority in the system, whether that work was typically paid or not.

Doctors tracked the services they provided that they would typically bill for, so that a funding reconciliation could take place. At the end of the program, 190 doctors repaid some of the funds they received from the program.

Our province moved quickly and appropriately in the early days of the pandemic and the income stability program was successful: it kept health-care services available to Nova Scotians and physicians ready to be deployed when they were needed.

I am grateful to every doctor in this province for their commitment, sacrifice and the exceptional care they provide to the people of Nova Scotia. I am grateful to every nurse, paramedic, health-care provider, administrative staff member, cleaner and everyone who is working tirelessly to support Nova Scotians during this incredibly difficult and unprecedented time. Everyone is doing the best they can in the face of great fatigue and low resilience.

Thank you for everything you do,

Nancy MacCready-Williams
CEO