More than six years since Nova Scotia Health began reporting on improving patient access to primary care, the number of Nova Scotians who say they’re in need of a family doctor or nurse practitioner has more than quintupled. As of the latest Need a Family Practice Registry report, released on April 14, there are now 142,262 Nova Scotians actively looking for a primary care provider—a population that would form the province’s second-largest municipality, if it were its own region. That figure was just 25,210 when the province’s health authority shared its first Need a Family Practice update on March 7, 2017.
While Nova Scotia Health’s latest report shows some signs of progress—West Hants’ primary care waitlist has shrunk for the second month in a row—the overall trend points toward a worsening situation across the province.
Population growth or burnout behind care shortage?
It might be tempting—as some pundits have done—to point toward Nova Scotia’s population surge as the reason for the province’s primary care predicament, but there’s a problem with that explanation: The numbers don’t quite add up. Per the province’s Finance and Treasury Board, Nova Scotia’s population has grown by roughly 6.9% since July 1, 2017, when it was estimated to be 953,869. In that same time span, the number of Nova Scotians on the province’s Need a Family Practice Registry has climbed a staggering 464%. And while, sure, it stands to reason that new—or recently relocated—Nova Scotians are likely to form a higher proportion of those on the province’s waitlist, there’s a larger trend at play: Nova Scotia’s doctors and nurses are burning out—and it’s leading them to retire or close their practices in greater numbers.
More than half of the 142,262 Nova Scotians currently on the province’s primary care waitlist say they joined the Need a Family Practice Registry because their current provider either closed their practice, moved, retired or plans to retire soon.
That’s the case for 4,000 Halifax patients after four doctors at the South End Family Practice on Spring Garden Road announced last month that they would be closing up shop at the end of August. As SaltWire’s Francis Campbell reports, the clinic had been asking the province for an additional doctor to help carry its current patient load—but Nova Scotia Health wanted to see the clinic take on more patients if it was going to receive more resources.
“I regret and understand the stress this will cause for you,” reads a letter to patients from Dr. Maria Sampson, dated Feb. 6, 2023, which The Coast obtained. “The current state of health care in Nova Scotia and the lack of support for primary care providers has accelerated this closure.”
Province, doctors negotiate new round of contracts
Nova Scotia’s Department of Health and Wellness is currently negotiating a new round of contracts with Doctors Nova Scotia, which represents some 3,500 active and retired physicians and medical students across the province. Both the 2019 Master Agreement—which stipulates pay rates for physician appointments, health benefits and targeted investments—and the Clinical/Academic Funding Plan (C/AFP) contracts expired on March 31, 2023.
While Nova Scotia’s per capita spending on its physicians is among the highest in Canada (the province spent $1,056.09 per person on physicians in 2022-23, behind only BC, Alberta and Newfoundland and Labrador), the average physician in Nova Scotia—regardless of specialty—earns just shy of $40,000 less per year compared to their Canadian peers, according to an environmental scan by Doctors Nova Scotia.
Last March, Nova Scotia’s government announced a suite of incentives to recruit family physicians, including up to a $10,000 relocation allowance, mileage and per diem spending for doctors who provided backup coverage in rural areas and up to $125,000 in potential bonuses over a five-year period.
Province rolls out online dashboard for primary care reporting
For the first time, Nova Scotia’s Need a Family Practice Registry report arrived in April via a newly-unveiled online dashboard on its Action for Health website. The dashboard offers the same information as prior PDF updates, but in a more readily-searchable format.
“Nova Scotians want and deserve to see the whole picture when it comes to accessing primary care options,” health and wellness minister Michelle Thompson said in a release. “This new data will help Nova Scotians see there are many ways to get the care they need, when and where they need it.”