A bigger bomb for Kings County medicine

In a Facebook discussion about the post A Medical Bomb Drops in Kings County, a contributor who supplies the medical sector, listed the doctors leaving the county. Janet Knox, who worked for years in Berwick and Kentville, would know these physicians professionally, if not personally:

The current list of retiring, sick or departing doctors is this:

1. Dr. Siva is on medical leave and will not be returning to his Kentville practice.
2. Dr. J Seaman/Kentville is retiring Jan 2018
3. Dr. P. McGuire/Kingston is retiring Dec 2017
4. Dr. Ainamo/Kingston retried June 2017
5. Dr. Langille/Berwick retired this year.
6. Dr. George/Berwick closed his practice and is doing other medical work.
7. Dr. Soma/Kentville is relocating to Windsor, NS
8. Dr. Keough/New Minas recently closed his practice and has relocated
9. Dr. Bander/Digby will be retiring in 2018. (Dr. Bander is not in Kings County, but is part of the Valley medical community).
…and there will be more.

Last evening I was told that Dr. Ruddy, an ear, nose and throat specialist in Kentville, is also closing his practice.

Assuming the first eight doctors on this list have an average patient file of 2,000 (several of the longer-practicing doctors, like Dr. Seaman, will have significantly more) it’s fair to say that 16,000-to-18,000 residents of Kings County have, or are about to, become orphaned patients. In seven months 27 percent of the citizens of Kings County have lost or will lose their primary physician. They are added to the thousands of other county residents without a family physician. This could take the count of orphaned patients in Kings Couty to 50 percent of the population!

What will happen to these 30,000 people? The Annapolis Valley District Health Authority has three points of contact: Valley Regional Hospital and clinics in former hospitals in Berwick and Wolfville. Without a family physician the logical place for patients to go is to the ER. How will they cope? VRH is bursting at the seams. It is not uncommon to wait four and five hours to be seen by a doctor in the ER. That’s stressful and wasteful, not to mention, for a true emergency, damaging to a person’s health.

And don’t count on a collaborative care clinic (CCC) to provide medical salvation. Later in the week Helphealthcare will publish the unvarnished thoughts of a long-time, free-speaking physician about these.

Kings County is one of the more dynamic economic contributors to the province and region. There are significant employers here, like Michelin and several large food processors. Kings County is not only the richest agricultural area of Nova Scotia, it is one of the top three agricultural areas in Canada. It has a booming wine sector. It’s also a financial centre. It’s a major retail destination. It’s an academic (Acadia University, NSCC) and regional medical centre. Aside from the angst of not having a family doctor is the economic impact of a lack of medical professionals. The longer it takes for people to be seen by a doctor and receive care translates as time lost at work. Those on a fixed salary are costing their employer. Those paid on an hourly basis could be losing income. Companies, institutions and the overall economy could be losing millions of dollars a week as people sit in waiting rooms to be seen. Could this impact a company’s decision to invest here?

Kings County is an attractive place to live. It’s an easy commute to Halifax and the airport. It has good dining and great social life. For outdoor enthusiasts there is the Bay of Fundy, Minas Basin, Harvest Moon Trail and various lakes to explore and play with. For the intellectually-motivated, there is a rich cultural life. Traditionally there is a strong cluster of other professionals to interact and work with. Property prices are reasonable. So are rents. In other words, if you are a highly trained professional, locating your practice here means you don’t have to put your life on hold. Yet, if Kings County is having such trouble retaining and recruiting doctors, what are more remote countries facing? How desperate are others?

The dirty little reality is that the Nova Scotia Health Authority has failed miserably in keeping a key population – the doctors – happy and healthy. We have a new system, which is, alas, populated by old thinkers. To fill all the empty practices we need a change at the top.

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2 Responses to A bigger bomb for Kings County medicine

  1. Bernie Swain says:

    Ralph Surette offers a logical and well reasoned solution to our health care problems in his article in the Halifax Chronicle Herald, December 2, 2017. He says the government should fire the whole NSHA and start again with new blood, The article is well worth the read. If this government has not got the courage to acknowledge the seriousness of the problem, they should step down and make way for people with more intestinal fortitude.

    • I read Ralph Surette’s piece in Saturday’s Herald. Clearly the public’s exasperation with the NSHA has travelled from the tip of Cape Breton, over to Amherst and down to Yarmouth. People are not happy with how this organization is managed. The question becomes: who do the NSHA executives work for, the people or the government? It’s clear the people are ready for a change.

      The fallacy is thinking that one political party has a better idea than the other. Over and over we see that what parties say in opposition is different from how they act as government. My experience with the health care system under the NDP found them as unresponsive, bureaucratic, bunker-like in their thinking as anyone else. In another Facebook conversation, one poster suggested that for the good of the people and the health care system the political parties agree to stop trying to score points on health and cooperate to share and promote best practices and better ideas. Currently, we can’t do long-range planning because parties always have to consider the next election campaign. What is said now is fodder for 2020 or 2021. So the parties are pitted against each other and the health executives cherry pick who they think will be more malleable for their purposes.

      I hear from a lot of hospital workers – I have had people ring my doorbell or stop to talk when I have been watering the garden or grocery shopping, having a coffee or they call me at home. Overwhelmingly they are frustrated that no one in management is accountable or responsible for their actions. And those who watch health care are infuriated that the NSHA board is basically a group of corporate cheerleaders who act at the bidding of the NSHA executive. There is no transparency and accountability. Look at the IWK expense scandal. Their board and executive tried to downplay that, but it broke through to the public. What doesn’t we know about the NSHA?

      There is a certain defensive groundwork being laid to excuse the failings of the NSHA board and executive and a shifting of blame to the government and Department of Health. The cynical conversation taking place is this: health executives see the Liberals as a “lame duck” government with no chance of winning a third term. So, by delaying and deflecting criticisms, plans and actions, they (the executives) can reach their retirements unhindered. As part of their retirement planning the current executives are positioning their favoured successors to step in and take over from them. Then, as has happened across Canada, the newly hired executives recruit the newly retired executives to return as highly paid consultants. This is better than a lottery win for the retired executives because they collect their severance package and pensions and return to work fewer hours while collecting as much or more in compensation as their full-time salaries. This basically doubles or triples their income overnight. Not only is it a cash windfall for them, but by being back as a consultant they can protect their reputations from damage by stopping anyone from too closely examining their previous performance and decisions, and maintaining their favoured programs in place to prevent any new dynamic idea from being a success and showing them up. It’s all quite Machiavellian, but the distrust for those in charge is such that this is the growing conversation.

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