Doctor shortages by the numbers

A new poll by Corporate Research Associates says 13 percent of Nova Scotians (approximately 122,000 people) don’t have a family doctor. That’s probably an optimistic number.

Statistically, Nova Scotia appears to almost qualify as a medical nirvana, with one of the highest doctor-population ratios in Canada.

However, some suggest the ratios are skewed by the medical mix. Of the 177 new hires NSHA claimed between April 1, 2015 and March 20, 2017, 71 are family physicians and 106 are specialists. That leaves a significant portion of the population waiting years for a family physician.

Figures for orphaned patients range from 25,000 to 95,000, but could be well in excess of 150,000.

The 25,000 figure represents the number of people who, in the first five months it was available, called a doctor registry hotline instituted by the Nova Scotia Health Authority (NSHA). Later the NSHA adjusted that to 33,000 people looking for a doctor. Doctors Nova Scotia (DNS) says a freedom of information request filed by the Progressive Conservatives found that a study done in October 2016 “was quite startling. We’ve always run on a premise of as many as 10 per cent of Nova Scotians don’t have a family doctor (95,000). This survey indicated in the Halifax Regional Municipality (HRM) about 20 percent of residents and in rural Nova Scotia about 14 percent (didn’t have a family physician) so both of those numbers are higher than what we expected.”

Using the October percentages, that means 155,415 Nova Scotians (78,019 in HRM and 77,396 rural residents) don’t have a family physician. The orphaned patient numbers grow even worse if the projections from a 2012 Physician Resource Plan are used. The Plan predicts that by 2021, the population health services needs will be equivalent to a population of 1,100,000.

That 1.1 million population figure is based on our current aging population, not an influx of new residents. In other words, it is adding the needs of 60,000 more people to the system. That’s basically the population of Kings County to squeeze into our existing system.

One of the problems in attempting to quantify the doctor shortage is the NSHA’s inability to say how many doctors there are in the province. In April, a NSHA representative said, “Given daily changes with retirements, deaths, relocations, etc. and the complex roles that family doctors play, this number fluctuates regularly. On any given day in Nova Scotia there are more than 1000 doctors seeing patients in a family practice.

“If you include specialists, there are more than 2600 doctors in Nova Scotia.
“The best source for these numbers are CIHI Physician Migration Studies.

“Family physicians are independent contractors; they are not employees of NSHA. NSHA does maintain a list of vacant positions by zone and positions that are coming vacant when a physician has given notice that they will be leaving or relocating.

“NSHA does not maintain a centralized list of physicians.  We do work with family physicians to better understand when they are planning to retire or leave the province.”

Since the NSHA doesn’t know how many doctors are in practice in the province, they can’t guess at how many Nova Scotians don’t have a doctor.

Physicians complain about the age of data and methodology used to make guestimates. The Physician Resource Plan, which is the guiding document for the NSHA, was published in 2012 using data gathered in 2008. So the Resource Plan was launched with old numbers and five years later relies on what front-line doctors feel are unrealistic numbers.

How can you fix a problem you can’t quantify?




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2 Responses to Doctor shortages by the numbers

  1. virtually every doc in the province is either on FFS or has to shadow bill ( possibly not full time academics in Halifax). MSI know exactly how many docs they pay every two weeks, and how much., and the list get updated every two weeks. Its beyond me why the NSHA doesn’t use this info

    • I believe we give the NSHA too much credit for what they know and can handle. It seems whenever a problem arises that’s when we learn what they don’t know or don’t track.

      For example, remember in the spring of 2015 when surgeries were cancelled in Halifax because of a problem with hospital sterilizers? Instead of springing in to action with replacement sterilizers, the NSHA in their plodding, measured, comfortable way considered the situation. Two weeks after the problem was identified and surgeries cancelled, the VP responsible for this equipment told Don Connolly on CBC Information Morning that they had formed a group to investigate and find out what other equipment was available!

      How did the NSHA not have that in the database? Or how did the person in charge not have that information in her head? At most it should have taken them two hours to identify every hospital, clinic, lab and research facility in the province with sterilizers.

      As for how many doctors in the province, why wouldn’t they know it? It seems one of the basic pieces of information about health care in the province. I think they don’t want to know. It gives them deniability. Another chance to delay having to do anything. Remember, the top two people in the NSHA are zeroing in on retirement. Three/four more years and they can get away from the demands of their day jobs to become highly paid consultants.

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