Would you work for the Nova Scotia Health Authority?
Doctors Nova Scotia have issued a position paper on the value of family physicians. It is an unprecedented paper. The fact that the organization which represents family physicians felt the need to do so illustrates the adversarial situation which exists between front-line physicians, the Nova Scotia Health Authority and Nova Scotia Department of Health and Wellness.
One point which jumps out is this:
Research has shown that patients with access to care over the years from the same physician have fewer hospitalizations and better health outcomes, based in part on the relationship and trust that patients and their family physician have established over time.
Read the paper here:
This website has been and is a promoter of a single, merged health care system. The theory is that it should standardize care, streamline decision-making, redirect administrative costs to the front line and allow for better coordination of skills, assets and needs. Unfortunately, in selecting the right system for Nova Scotia health care the government installed the wrong/weak leadership. The job went to someone who had been the head of a health authority, but on reflection, other than climbing the corporate ladder, it’s a stretch to find any history of innovation and success in delivery of care.
The impediments to practice in Nova Scotia include:
At $259,378, Nova Scotia has the lowest pay for family physicians in Canada. A doctor in New Brunswick can average $293,636 and in Prince Edward Island that rises to $305,091. Nova Scotia pays 13-17 percent less than neighbouring, less prosperous provinces. Even Newfoundland pays doctors 5 percent more. In 2017 a Halifax-based family physician told me that after deducting practice costs, their taxable income was $60,000!
There has long been a trust issue in health care in Nova Scotia. CIHI accreditation reports have shown a low of 48 percent and a high of 52 percent when staff are asked if they trust their managers.
The way this executive have acted as the NSHA and in predecessor authorities doesn’t show much respect for medical professionals. In 2013 Dr. Andrea Veljkovic, who was an orthopedic surgeon specializing in diabetes-related foot and ankle care in South West Nova, quit the province when the Annapolis Valley District Health Authority headed by Janet Knox (now NSHA CEO) refused to find funds to pay her. The authority’s explanation was that Valley Regional Hospital had five orthopedic surgeons and that was enough. Dr. Veljkovic travelled the region performing surgeries in Kentville, Yarmouth and Bridgewater.
Then we had the on-going litigation against Dr. Gabrielle Horne. Dr. Horne was a rising medical star who had her hospital privileges reduced and research thwarted after a manufactured dispute with a hospital director at the former Capital Health Health Authority. Dr. Horne’s professional standing was harmed by the manager’s claims. The result was 16 years of litigation in which Dr. Horne prevailed. Capital Health, continued by NSHA, spent over $10 million of taxpayer money to avoid taking responsibility for the actions of their management team. In the end the courts found for Dr. Horne. All that NSHA did was spend several millions more to cut a $1.4 million damage award to $800,000. The managers who caused this problem remained at work and rose in the organization.
Last month, NSHA showed their on-going disrespect when they cancelled hospital privileges of Dr. Jennie MacGillivary. Dr. MacGillivary is a surgeon who performed surgeries at two provincial hospitals. She asked for help to deal with professional burn out caused by her workload and lack of support. She lost her job. So much for a NSHA being a compassionate employer.
Another example of the NSHA disrespect for medical professionals was a meeting called by a NSHA provincial health zone manager where the 42 doctors in attendance were told they had no concept of realty and “were living off the fat of the land”. Really?
- Practice Restrictions
The NSHA has been careful not to say a doctor can’t practice wherever they wish. They know those cases limiting practice have been lost in the Supreme Court. However, the NSHA has used credentialing as the club preventing doctors from establishing practices wherever they wish and to drive new doctors to join a collaborative care practice. Without “credentials” doctors can’t bill for services, can’t order tests, prescribe drugs or even admit a patient to hospital. I have been told of a physician who was prevented from opening a practice in a suburb of Halifax, another was prevented from taking over his parent’s city practice, another city-based doctor couldn’t turn his existing practice over to a new doctor. Two young doctors were prevented from establishing a rural practice because it was within the 100-km catchment area of a community care practice.
Here are some unedited NSHA employee ratings posted on-line in connection to a job competition in October 2018:
Very little room for advancement / Allied Health (Current Employee) – Sydney, NS – 15 May 2018
Advancement is only given either by seniority but more commonly by nepotism. System is failing due to ineffective management who are not above asking illegal requests. Union violations occur frequently, but the union has no teeth in protecting the employees and retribution within the rules of the contract does occur.
Salaries are fair for the region and job security is very high, but individuals who should never work within healthcare are never removed.
Pros Decent wages, secure job
Cons Poor management, overworked, understaffed, not interested in changing / 2 stars
Good place if you’re looking for a good job / Senior Systems Analyst (Former Employee) – Halifax, NS – 25 March 2018
Steady work, low expectations. Organization has low technical competence and fear of technology, relying on external consultants to make decisions. Internal expertise is not fostered, nor welcome.
Take your job, do your hours, for interesting stuff, find a side project.
Pros Not concerned with IP constraints
Cons System change not welcome / 3 stars
Fun work place / Utility Worker (Current Employee) – Halifax, NS – 14 March 2018
Great company and all co workers are treating respect to each other. Company giving good benifits loke medical dental and pension plans. Also we have vactions and sickness time.
Pros Free Uniforms
Cons Long hours / 5 stars
sexist managers / Registered Nurse (RN) (Current Employee) – Halifax Regional Municipality, NS – 28 February 2018
if you are male, you wont (for the most part) get hired here. they have the odd token male but it is a non-male dominated workforce and they arent letting go.
i have seen qualified male candidates declined over new grads. managers will look for someone that kowtows to them. these same managers are unbelievably rude and condescending to male staff called in from local agencies.
i have been watching this for years and it is disheartening to see so many (but not all) men head elsewhere as soon as they can.
Pros that the men get to escape
Cons everything / 1 star
is a stressful environment / Mental Health Nurse (Former Employee) – Halifax, NS – 13 February 2018
There is a divide between management and staff, trust is a huge issue. When issues are brought to their attention nothing is done. it can be a toxic work environment.
Pros great staff / 3 stars
It seems the only solution to make the Nova Scotia Health Authority a welcoming place for professionals to work is a change at the top. The executives are entrenched in their “rightness”, believe the rest of us don’t understand the issues, and maintain their comfortable status quo. Other places have to be more welcoming to new talent than this crowd.
The Nova Scotia Health Authority embraces all the words and phrases du jour, but by their actions we see they don’t implement them. Beware.