Dear Doctor,

What’s new?

Providing virtual care – fees coming!
We’ve worked closely with government on a solution to enable physicians to provide care to patients using the telephone. We are finalizing the details and expect to make an announcement in the next few days. We know that many of you are already providing care virtually in response to the province’s social distancing protocol. We encourage you to keep track of any virtual visits that you’re doing this week until we have more details for you.

We are also working with government to enable other virtual care tools to support physicians in providing telemedicine services and asynchronous communication with patients. We expect this announcement to follow closely.

Compensation
Many physicians are worried about what to do if they are unable to work in their normal capacity during the pandemic. With health services being cancelled, physicians are concerned about income loss, loss of clinical work, supporting their employees and maintaining business as usual. We want you to know that DNS is having those conversations with government as well. An update on this will follow. 

• The Tuesday, March 17, the province announced one confirmed and six presumptive cases of COVID-19.  There are additional measures under the authority of the Health Protection Act, which include:
  • Organizations and businesses must practise social distancing of two metres (six feet) and keep gatherings below 50 people or less. This applies to restaurants, bars, movie theatres and other gathering spots
• Key information from Dr. Nicole Boutilier, vice-president of medicine, Nova Scotia Health Authority (NSHA) includes:
  • In addition to all non-urgent ambulatory clinic visits and group sessions being cancelled, beginning Wednesday, March 18 (tomorrow):
    • All elective outpatient visits in NSHA clinics are cancelled. Individual services will contact patients whose appointments are proceeding. Dialysis, chemotherapy and radiation treatments, and mental health and addictions appointments will continue.
    • All non-urgent diagnostic imaging appointments will be rescheduled and walk-in X-ray services will be closed.
    • All same-day admission and elective surgical procedures are postponed. Cancer and urgent/emergency procedures will continue.
    • As currently occupied inpatient beds become available, they will be held open to create capacity to establish COVID-19 units in designated hospitals.
    • Service interruptions are being posted on the NSHA website at www.nshealth.ca/temporaryclosures and will be updated regularly.
  • March 15 - Fax Referral Form for Coronavirus Assessment Clinics (PDF)
  • March 16 - Family Practice COVID Screening Guide (PDF)
  • Infection Prevention and Control (IPAC) Guidance Document
  • March 15 - Link to OP3 Resources on Primary Care Referrals to Coronavirus Assessment Centres
• Dr. Krista Jangaard, CEO, IWK Health Centre announced today:
  • As of Wednesday, March 18 all non-urgent services will be suspended. All outpatient, ambulatory clinic appointments and community visits will be limited to urgent care visits only. All elective surgeries will be cancelled and rescheduled to a later date. Surgical procedures will be limited to urgent or emergent cases only.

Join the COVID-19 webinar
Doctors Nova Scotia is hosting two information webinars from 6:30 to 8:00 p.m. on COVID-19 with Dr. Claudia Sarbu, medical officer of health (MOH), and her NSHA colleagues: one on Wednesday, March 18  and one on Monday, March, 23. Dr. Sarbu will share the latest information and address your questions and concerns. Unable to attend any of the sessions? Download the March 16 session recording.

Special thanks to Dr. Claudia Sarbu, MOH, Dr. Ryan Sommers, MOH, Northern Zone and Dr. Mark McKelvie, public health preventative medicine at Queens University for the development and presentation of the webinar.

Register here for a webinar.

Sick notes

Sick notes requests from employers are inappropriate. Dr. Strang has provided a form letter for employers.

Posters, public education
Self-monitoring vs. self-isolation vs. isolation for COVID-19
How to care for person with COVID-19 at home, advice for caregivers

Personal protective equipment
The OMA has created an infographic to show the recommendations for this pandemic. Check out the infographic.

Keeping yourself healthy
During this difficult time, physicians may encounter heightened stress and challenges. You may feel fatigue, worry or anxiety. If in distress, please contact the DNS’s Professional Support Program for CONFIDENTIAL help 24 hours a day/7 days a week/365 days a year. Call: 902-468-8215 or 1-855-275-8215 (toll-free) or email.

DNS Meetings & Events
Your health and safety are our priority. To ensure we’re respecting the protocol for social distancing, while creating space in your schedule to focus your attention on clinical practice and family time, we’ve made the decision to cancel, postpone or move to a virtual platform many upcoming events and meetings that were planned to take place over the next three months.

Our decisions were guided by Public Health’s Matrix for Risk-Informed Decision-Making for Mass Gathering and considered our business continuity planning

• All Board of Director meetings, eHealth Committee meetings, section meetings or other meetings scheduled between March 18 and June 30 will be conducted virtually, supported by the Go To Meeting or Go To Webinar platform.
• Physician Leadership Institute (PLIs) and the Section of Physician Leader activities scheduled for April and May are cancelled. Anyone who has registered for PLI courses will receive a full refund from DNS by the end of March 2020. If you’ve made a hotel reservation, please cancel that as soon as possible.
• DNS’s Annual Conference at Digby Pines Golf Resort and Spa is cancelled. The business meeting (annual general meeting) and members’ forum will be held virtually on June 6 from 9:00 a.m. to 12:00 p.m. Members can register to attend this meeting virtually at no cost. All social events related to the conference will be cancelled.
  • If you’ve already registered, you will receive a full refund.
  • If you’ve made a hotel reservation, please cancel that as soon as possible.
  • Register here for the free virtual annual general meeting and members’ forum on June 6, 2020.
• Doctors Nova Scotia staff will not be visiting physicians in clinics and hospital facilities on Doctors Day. We will send you some uplifting messages from your patients, via DNS email, on May 1 to help lift your spirits during this difficult time.

If you have any questions about an upcoming meeting with DNS, please reach out to the meeting organizer for more details.

DNS staff and organizational preparedness
Doctors Nova Scotia is committed to providing members with exceptional service. During this uncertain and evolving time, DNS will do its best to maintain business as usual. In an effort to be cautious and responsible, as of March 18 we are transitioning all employees to work from home, consistent with our business continuity plan and measures that many public institutions are taking to facilitate social distancing.

Instead of visiting our office, please reach us by phone or email. For physicians who have upcoming meetings scheduled, staff will be in touch to offer alternative ways to participate in meetings.

Our main line will be closely monitored during regular business hours. If you call, please leave a message and someone will get back to you as soon as possible.

You may reach us by email or by phone 902-468-1866 or toll free at 1-800-563-3427.

REMINDERS

Insurance for lost time
Doctors Nova Scotia benefits with Canada Life (formerly Great-West Life) cover health and dental only. A notice previously posted by Canada Life about short-term disability is not applicable to members. To the 1,600 members who have private disability insurance through OMA, your coverage has at least a 30-day (and in most cases a 60-day) waiting period. If you have coverage through other plans, please consult your plan providers about things like waiting periods and eligibility for quarantine versus illness.

Travel
Nova Scotia Public Health issued a directive, effective noon on Friday, March 13, that any physician (and any Canadian) who has travelled outside of Canada must self-isolate for 14 days upon returning to the country, even if symptom free. Physicians who returned before noon on Friday, March 13 should monitor their condition closely.

Additional Resources:
Department of Health and Wellness (public)
Nova Scotia Health Authority (physician and provider hub)
811 assessment – when to call (advice for patients)
The Public Health Agency of Canada maintains a list of affected areas
Government of Canada
Nova Scotia Public Health offices
Canadian Medical Association

Cases in Canada
As of 10:30 a.m. (EST) on March 17, 2020, there were 424 confirmed cases in Canada. There have been five deaths in Canada – four in BC and one in Ontario. The virus continues to expand globally.