Tuesday , June 15 2021

Atlantic Canada needs more doctors: Where are they? | Doctor Depth In-Depth

Here for a time there was a shortage of a doctor. How does this affect people? Marginalized? Families? Doctors? Other health professionals? You? Over the next four Fridays we dive deep into the problem, outlining the challenges and trying to find solutions.

Add estimates to those waiting for a family doctor in Atlantic Canada and the sum is just shy of 175,000 people.

The deficiency of a doctor on the east coast dates back at least a quarter century, even longer in some provinces.

The Atlantic Provinces will have to attract 146 new doctors, ready to see 1,200 patients to clear the Waiting List.

Source: PF, Newfoundland and Labrador governments, Nova Scotia

Everest Hoose was abandoned by the health system.
Everest Hoose was abandoned by the health system.

The shortage of family doctor is a threat to health care in Atlantic Canada

Your family doctor is withdrawing or continuing. Suddenly, unexpectedly, you feel alone and unprotected.

Calls to family medical clinics are mixed with conversations with other people like you. The answer is always: "Sorry, but we do not take new patients."

Weeks turn into months. Anxiety is worrying. Visits to clinics or emergency rooms are often disappointing experiences.

62-year-old Everest Hoose knows this feeling.

In 2016, Howse, who lives in Steady Brook, N.L., was the first time in his life without a family doctor.

And he needed a family doctor more than ever with complications arising from previous health conditions – two aneurysms, heart surgery, and back injuries.

Hoose says he contacted about 20 family doctors in his area, visited clinics, and had hundreds of calls, but no result.

Finally, in desperation, he made a double cardboard sign showing his displeasure, attached him to his shoulders with a clear wrapping tape and started a protest from a man at the West Memorial Hospital in nearby Corn Brooke.

The protest drew the attention of the hospital staff and the local health authority and was eventually linked to a new family doctor.

Not everyone can or does not want to accept their disappointment and direct it in the way that Jose.

In Atlantic Canada, it is estimated that between nine and 13 percent of the population does not have a family doctor.

Dr. Lynn Dwyer
Dr. Lynn Dwyer

While the issue is not limited to the Atlantic Provinces – there is also an international shortage – Nova Scotia, PJ, New Brunswick and Newfoundland and Labrador have a particularly difficult struggle with aging and a problem with family doctors recruiting for rural areas.

In New Brunswick, according to the medical community in this province, there are about 50,000 people without a family doctor.

"The recruitment of new family doctors is more difficult than ever," the public said. "We need a flexible strategy for recruiting and retaining doctors in the province."

According to P.E.I. 12 January had 12,213 people on the January 12th patient register who were looking for a new family doctor since January.

The Nova Scotia Patient Register as of January 1, 2019 registered 52,680 people waiting to be placed in a family doctor, accounting for about 5.7% of the province's population.

Newfoundland and Labrador do not have a patient registry in the province, but it is estimated that up to 13% of the population has no family doctor – more than 60,000 people.

Because if these numbers were not challenging enough for the health system, family doctors in all provinces manage older patients who have more complex medical conditions.

This means that more time is needed for each patient, which further limits the number of patients the doctor can take.

Dr Lynn Dwyer, a family doctor at St Johns, says she has seen the workload increase for over 31 years.

She believes the government needs a human resources plan to determine how many family doctors are needed and where.

"Family doctors know that the current system is not sustainable," she says.


According to the Canadian Medical Association data of 2018, how many doctors were 65 years and over in Atlantic Canada, with 40 in PI, 172 in N.L., 235 in N.B. and 387 in N.S.

Average weekly hours worked by general practitioner or P.I.I. specialist according to CMA data for 2017. The numbers for the other Atlantic provinces are 52.7 for N.L., 49.18 for N.S. and 48.1 for N.B.

Percentage of general practitioners or specialists in the CMA survey for 2017 who feel overwhelmed in their student at the National Assembly. The number is 39.3 for N.L., 34.3 for P.E.I. and 34.1 for N.B.

Source: Canadian Medical Association

Who feels the impact?

The shortage of doctors affects everyone involved in the healthcare system, from patients to practitioners, causing difficult decisions, both personal and professional.




"Sira" of former healthcare

In the medical community, a term is sometimes used for patients who lose or are deprived of a family doctor – orphan.

The word causes feelings of abandonment by the healthcare system. Everest Hoose describes it as "the weirdest feeling".

"If it happened to get sick, there was no one to turn," he said. – It's as if you were suddenly stuck in the cold.

The search for a new family doctor was one of the most frustrating things he had ever done. This is something that he thinks people do not have to do.

"I think the patient should be able to choose his doctor," he said. – I see it.

Hoesie says he is happy to be linked to a new family doctor. He advises people who are still looking for a family doctor to "flaunt around the hospital" as he did. He said governments might have to change their approach to attracting new family doctors.




Patient without a doctor

Alexis McKinn does not have a family doctor and says he scares her to death.

The 60-year-old and her husband retired in their native Cape Breton – in the Albert Bridge community – in October.

"I did not realize it would be this brutal, moving from Ontario," says McKinnon, who has a rare chronic disease called mastocytosis.

Diagnosed in 2016, she says she has received excellent care from Ontario specialists. They've contacted Halifax specialists, but they can not make references outside of the province. A nurse from Nova Scotia must do this on her behalf.

"They've agreed to see me when I turn them over to them … once I get a damned family doctor to direct me. The missing link is zero – there is a family doctor. "

McKinn is registered in 811 and spends part of every day on the internet to look for a doctor or nurse who is ready to see her.




President of Nova Scotia

The Netherlands says his country's family doctors are among the lowest paid in Canada, which is a key harm to recruitment and retention.

His group, along with the naval resident doctors and Dahaouzi's medical students' association, have made recommendations to the Nova Scotia government to deal with the "chronic shortage of doctors" and to deal with physician burnout and stress.

He argues that deficiency is a major threat to Nova Scotia's health system that a patient without a doctor is abandoned.

"It varies from your complex adult patient with multiple chronic diseases such as diabetes, hypertension, COPD (chronic obstructive pulmonary disease) who can not cope with current illnesses, to a younger patient who would prefer his or her own doctor in a clinic). "

The Netherlands suggests that almost every Emergency Cancer in Atlantic Canada can tell a few stories about patients who are diagnosed with diseases like emergency cancers, conditions that would probably have been caught several months ago by a family doctor.




Department of Family Medicine at the Memorial University

Soon the shortage of family doctors may be greater.

Catherine Stringer is President of Family Medicine at the Memorial University, where one of the two medical schools in Atlantic Canada is located.

She says that many family doctors in the region are getting closer to retirement, so the shortage will increase if the recovery and recovery goals are not met.

The College of Family Doctors in Canada (CFPC) suggests that the number of places of residence at each medical school should be 50% for family doctors.

"At present MUN has 80 residences, so the CPDP will advocate that 40 of them have gone to family medicine. We are currently at 34. t




The acute need of a family doctor

Prince Edward Island's Ralf Cauline qualifies for kidney transplantation in the spring of 2018. Even if a kidney is available soon, he may lose the opportunity if he does not find a family doctor.

"I did all my kidney transplant tests, but one of the arrangements the Halifax transplant team requires is that transplant recipients should have a family doctor because there are many follow-up activities after the transplant," says Kauflin, who lives in Borden-Carleton on the south coast of PEI.

– I went to seven clinics now looking for a family doctor and nobody is ready to take me because they're all booked. The word I get is to put your name in the (provincial patient) registry. Well, I put my name in the register and they show that it will wait for two to three years.

He feels "disappointed by the government" that he does not do more to find family doctors.


Number of Canadians in 10 who would benefit from virtual visits to a doctor, according to the Ipsos study of 2018

The number of students admitted to Dalhousie University (112) and the Memorial University (80) in 2018

A percentage of Canadians who could get a meeting the same day or the next day with their family doctor or a regular caregiver, according to a study by the Canadian Institute for Health Information.

Source: Ipsos, Canadian Institute for Health Information, Dalhousi University, Memorial University


Our journalists have told hundreds of stories about a doctor's shortage. Several titles from the past 20 years:








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