E fforts to shrink Nova Scotia's doctor waitlist are working, but many Nova Scotians still dont have a family practioner.
When Martha Mutale's family doctor's practice closed almost 10 years ago, she wasn't worried. As a student, she had access to on-campus medical and counselling services, and the need for a family doctor never crossed her mind. But when she graduated, that changed. For years, Mutale made do by relying on local clinics for most ailments, but there were some things that could only be prescribed by a family doctor. So she joined the waitlist.
"I had been on the waitlist for over five years before I began to lose optimism about getting a call back. Following that experience, it's not that I don't care about my health, but I definitely have less trust towards the health-care industry," says Mutale. "I want to believe that having a family doctor is a really important thing, but because it took five to six years, it feels like it has lost its meaning."
Atlantic Canada has been experiencing doctor shortages for almost 25 years, with an estimated nine to 13 percent of the population living without a family doctor. As of January 1, there were 47,000 names on Nova Scotia's 811 Need a Family Practice Registry–down 3.7 percent from January last year. This increase in access only applies to central Nova Scotia, leaving rural citizens out in the cold and coming up with alternative ways to obtain health care.
Tanya Eales and her husband had been fighting for treatment of their individual medical issues in rural NS for three years. "When I got the call, I went around in a state of euphoria for almost a month afterwards. I kept telling everyone, 'You know we got a doctor?' It was such a shock that I couldn't believe it," says Eales. "Nothing really beats having your own family doctor. The comfort and lack of stress that comes with that is unbeatable."
While Nova Scotians are taking matters into their own hands, other changes are in the works. In summer 2019, Dalhousie's two-year family medicine residency program expanded from 37 to 46 spots to accept more patients—and, it's easier to get into med school at Dalhousie if you're from NS than out of province. Plus, last month the signing of a new four-year agreement with Doctors Nova Scotia makes NS doctors the highest paid in the Atlantic provinces, giving more incentive for doctors to come to Nova Scotia.
"It's important to keep in mind that family doctors in the province are very aware of the shortage but are bursting at the seams," says Gary Ernest, a family physician who has been in practice in Liverpool for more than 30 years. "Doctors have taken extra patients on because they feel bad and will help in any way that we can. None of us like to see someone without a family physician. The cornerstone of our medical system is people's ability to have access to a family doctor, it's absolutely critical. But it is vital that the importance of creating a system where you can encourage having access to family physicians is on the government so that everyone in the province has access to a family doctor."
In 2019, the government of Nova Scotia also made changes to the prescriptions and services that pharmacists are allowed to offer to accommodate for the lack of family physicians. Pharmacists are now allowed to prescribe birth control, treat routine bladder infections and shingles, renew prescriptions for up to six months, give vaccinations and can offer medical advice about most things surrounding medications and their effects even if an individual is unable to see a family doctor.
"At this point and time, these new changes are about access for Nova Scotians while also allowing pharmacists to use their full skill sets in a positive way. We are educated, trained in and are prepared to use many skills and topics but until now, haven't had the legal authority or funding," said Lisa Woodill, a frontline pharmacist and PANS director of pharmacy practice. "I think right now we're really in a transition period as pharmacies have really started preparing themselves as far as staffing, workflow and how they manage these new changes in their day-to-day practices."
Even with these changes, Nova Scotians still struggle to find health-care services in the province.