STELLARTON – Ehab Soliman is often a tired man.
A typical day for him sees about 35 patients knocking on his door with complaints of high blood pressure, diabetes, breathing problems, mental illnesses and age-related conditions, among others.
All told, the Pictou County-based family doctor has about 4,000 patients on his books, pretty typical for physicians like him.
“It’s really, really mentally tiring,” Soliman told The News.
By contrast, doctors who work in new collaborative practices only have 1,500 to 2,000 patients signed up. They also enjoy back-up from nurse practitioners, nurses, mental health specialists, social workers and other professionals.
Collaborative care doctors are paid a salary, whereas doctors working in traditional practices are paid a fee for service, which Soliman prefers despite his long hours.
However, spouses of newly recruited doctors in New Glasgow and Pictou County often cannot find jobs. This forces many physicians to pack up and leave.
“I would say more than 50 per cent of the people who moved did so because their spouses were not happy,” said Soliman.
He said his situation was not helped by the 2015 centralization of local health authorities into the central Nova Scotia Health Authority.
For Soliman, this means extra layers of bureaucracy and “a total disconnect between what the physician wants and needs and central services in Halifax.”
Under the previous local authority in Pictou, Soliman and his fellow doctors could raise concerns with a CEO who then took them to board meetings.
Now, any concerns raised with an NSHA representative are passed on to Halifax.
Another issue rankling Soliman is that doctors cannot choose where they wish to practise but must go to ‘clusters’ designated by the NSHA. For example, two doctors may be assigned to New Glasgow.
When asked how this state of affairs made him feel, his response was blunt.
“Resentful. Disconnected. Unvalued,” said Soliman. “They don’t care about us. Our opinion doesn’t really matter.”
Dr. Manoj Vohra, president of Doctors Nova Scotia, said that Soliman’s situation was fairly typical of doctors across the province.
“We need to make sure our physicians don’t get worse burnout,” said Vohra.
Nova Scotian doctors already rank as Canada’s lowest-paid and proposed federal tax reforms may put a further dent in their pockets, making recruitment even more difficult.
Vohra said that putting doctor recruitment back in the hands of local communities was key, adding that physicians had to feel “that they’re part of the system.”
This formed part of the recommendations for physician workforce reform released by Doctors NS in a report last month.
“We appreciate the challenges of setting up a new system, but patients have to be a priority and getting them access to care has to be our number-one priority,” said Vohra.
Minister of Health and Wellness Randy Delorey said that he has taken on board the concerns of doctors he had met face-to-face, including those in Pictou County, when he travelled across the province in August.
Delorey discussed with doctors how best to work together and improve communications between physicians and the province.
“We agree more needs to be done and look forward to continue working with the NSHA, physicians, and health care professionals on improvements,” said Delorey in a statement to The News Wednesday.
NSHA spokesperson Kristen Lipscombe said her department is listening to family physicians and newer doctors wanting a better work-life balance.
“That is part of what’s informed our planning to expand collaborative family practice teams care around Nova Scotia. It not only benefits patients by providing access to comprehensive care from a team of health professionals, but offers doctors a way to practise as part of a team, working together with colleagues, to share in patient care,” said Lipscombe in an email Wednesday.
The NSHA is also recruiting more foreign physicians to Nova Scotia, despite the challenges faced by those currently working in the province.
The health authority is attending the British Medical Journal Careers Fair on Oct. 20-21 in London and has asked both Nova Scotia Immigration and the College of Physicians and Surgeons of Nova Scotia for assistance.
The BMJ Careers Fair is one of Europe’s most prominent and promises access to more than 1,800 doctors.
“We've had success with recruitment and retention of physicians from the UK,” said Dr. Lynne Harrigan, NSHA vice-president of medicine and integrated health, in a release Wednesday. “Nova Scotia has a lot to offer doctors – the opportunity to practise medicine on collaborative teams, enjoy the balanced pace of the East Coast, and be a key part of their community.”