When a heart issue sent Lunenburg’s Leanne Morin to the emergency department while visiting family in Hawaii, the ER staff recommended she follow up with her doctor in Nova Scotia. The only problem? She doesn’t have one.
Leanne and her husband, Joel, have been on the province’s primary care waitlist ever since moving from Montreal last summer. By this point, per Nova Scotia Health’s latest report, they’re two of 133,500 Nova Scotians actively searching for a family doctor or nurse practitioner. It’s a list that has swelled by more than 55% in the last 12 months alone—and, in the past two years, has more than doubled.
The Morins know they’re far from alone—and that many Nova Scotians have been waiting for care for far longer. But they worry, for themselves and others, about what the future holds if the province’s health-care crisis worsens. There are no walk-in clinics in Lunenburg. The nearest options are Bridgewater and Chester—and appointment slots fill up early, Leanne says. That’s not accounting for when the weather makes travel difficult.
“If there’s a snowstorm, good luck,” she tells The Coast.
‘The hole was deep,’ says Nova Scotia Health CEO
Both Leanne and Joel have been following the province’s health-care announcements with acute interest—and also a degree of skepticism. Since October, health minister Michelle Thompson, deputy minister Jeannine Lagassé and Nova Scotia Health interim CEO Karen Oldfield have been hosting community forums across the province to gather input and offer updates on the government’s plans to address Nova Scotia’s ongoing health-care crisis.
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“Every crisis is an opportunity,” Thompson—herself a former nurse—told those gathered at the Halifax forum on Nov. 14. “We know that there are problems in health care, and we have to seize this opportunity of political will [and] significant financial investment … and make it a transformational moment.
“That’s what we’re trying very, very hard to do,” she added.
If Thompson’s message was one of optimism, Oldfield was more blunt in her assessment of the province’s health-care picture. “The hole was deep,” she said. “We’re starting to climb out. It’s going to take some time.” The health authority’s top boss assured those gathered that she was interested in hearing their comments and questions, “and most especially your solutions.”
Morin wonders, if that’s the case, why the province hasn’t heeded public calls to open the door to fully trained and licensed health-care providers from other countries to practise in Nova Scotia. She points to Port Hawkesbury-based physician Michael Mittler, who, despite 25 years of medical experience in his native Germany, says he still can’t work as a doctor in Nova Scotia—even though he would like to. Speaking with the Port Hawkesbury Reporter, Mittler called the situation “extremely hard to understand,” given his community’s need for health-care providers: “The emergency room at Strait Richmond Hospital is closed two or three days per week and I live two kilometres away. I could do shifts there; I could do an orthopaedic practice. I’m sure there is a certain need if you look around.”
That baffles Morin. She emailed the province after its Lunenburg forum in November, asking decision-makers to consider eliminating hurdles and barriers for foreign-trained professionals.
“I never got a reply,” she says.
‘Backwards immigration process’ hindering foreign-trained professionals
Some of that red tape is at the federal level—and it’s causing foreign-born doctors trained in Nova Scotia to leave the country altogether. Under the current immigration rules, only Canadian citizens and permanent residents can apply for medical residencies in Canada. That strikes some physicians who were born elsewhere but studied in Canada as unfair.
Medical resident Dr. Abhinaya Yeddala came to Halifax in 2016 through a partnership between Dalhousie University and the International Medical University in Malaysia, but told Global News that due to Canada’s “backwards immigration process,” it took her two and a half years to obtain permanent resident status. Boston-based physician Taha Khan told CTV News that the same restrictions forced her to leave Nova Scotia in 2019, despite her desire to stay.
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That doesn’t sit right with Morin either.
“It just smacks of protectionism,” she tells The Coast.
The province, for its part, says it’s trying to pull those barriers down. In December, health minister Thompson announced that Nova Scotia was expanding its annual residency capacity for international medical graduates from six positions to 16. And last September, the College of Physicians and Surgeons of Nova Scotia said it was “streamlining” the process for granting foreign-trained professionals the license to practise in Canada.
But there are limitations there, too. Nova Scotia’s expanded residency seats are only for Canadians who have studied abroad and want to return home—not for foreign-born medical students who want to complete their residency in Canada. And for foreign-trained professionals, the college’s assessment process would still take anywhere from six months to two years.
That’s done in the interest of public safety, Dr. Gus Grant, registrar of the College of Physicians and Surgeons of Nova Scotia, told CBC News last September: Licensing health-care providers, he says, requires “rigorous” assessment—no matter their level of experience. Still, he conceded that licensing authorities “may have placed an overreliance on certification exams, particularly for mid-career physicians coming from different parts of the world.”
Provincial waitlist reporting lags
Amid the province’s health-care crisis, both Nova Scotia’s government and its health authority have pledged transparency in their progress and setbacks.
“We want to be very accountable to Nova Scotians,” health minister Thompson told Haligonians at November’s open forum. “We want to tell you how things are going—and we don’t fudge the numbers.”
Part of upholding that promise—at least in principle—has come in the form of Nova Scotia Health’s monthly primary care waitlist reports, which the health authority says it releases “monthly within five working days after the first of the month.” But this month—as The Coast reported on Twitter on Tuesday—the provincial health authority still hadn’t provided an update by February’s midpoint.
We asked Nova Scotia Health about the cause of the delay. Hours after our Twitter post, the health authority updated its primary care waitlist with February’s tally. A Nova Scotia Health spokesperson tells The Coast the tally was delayed because the province was including “additional information … so people understand how they can access care if they don’t have a primary health care provider.”
Those options include calling 811 for “confidential health-care advice from a registered nurse,” 24 hours a day, seven days a week; booking an online appointment through VirtualCareNS if you’re already on the province’s waitlist; accessing prescription renewals, vaccines and other health-care services at area pharmacies; and visiting nshealth.ca/wheretogoforhealthcare for a complete list of available options.
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This article appears in Feb 1-28, 2023.