This is the first installment in a Global News series called Code Critical, which examines the issues impacting the health-care system in Nova Scotia.
When Brenda MacDonald found out her family doctor was closing her practice back in October 2021, the Halifax-area woman immediately did two things: put herself and her two sons on the province’s family physician waitlist, then held her breath.
Two and a half years later, she and thousands of other Nova Scotians are still waiting.
“You’re always worried. You’re always hoping you don’t get sick,” she said.
MacDonald said she’s particularly anxious because both her children have medical concerns.
Her three-year-old son has a lung disease that kept him in hospital for much of the first year of his life. His disease isn’t always manageable at home, and often results in pneumonia.
“I just pray that my youngest one doesn’t get sick, to tell you the honest truth,” she said.
“When it reaches a pneumonia stage and it’s no longer feasible to try to manage it at home is usually when we end up in the ER.”
MacDonald said they made six ER visits last year; five of which ended with her son being admitted.
Meanwhile, her eldest — who is 15 and just started high school — is waiting for an ADHD assessment. Without a family doctor, MacDonald said she’s been navigating the process herself through private insurance and the school system.
While her son’s school told her they could put in a referral for the assessment, it would take about two to three years before he got an appointment.
“We felt that was too late. So I actually looked into my medical at work and found out I did have some coverage, so we ended up going private,” she said.
“For his learning disabilities and his ADHD, my medical covered the majority of it. But at the end of the day there is still some other pockets. The assessment alone was $2,900.”
But that wasn’t the end of it.
Even with a diagnosis in hand, obtaining the medication necessary presented the next hurdle.
“I had asked the psychologist that did the assessment, ‘We have no family doctor. How can I go about getting him meds?’ She suggested that I call around to the walk-in clinics and see, because some will write the prescriptions and some won’t,” she said.
“Every walk-in clinic I called said because of the nature of the prescription, they didn’t typically do it.”
The result? Another private online service that required another $199 to be re-assessed.
“At that point, I was willing to pay it because I wanted to get my son back on track,” she said.
Juggling the myriad of medical options, private companies and walk-in clinics have been stressful, to say the least.
It’s taken a toll on her well-being as well.
“My biggest fear is with my two boys — I don’t want to think that way — because I want to be around for my two boys, at least until they’re old enough to look after themselves.”
More than 155,000 on the wait list
According to the province’s data dashboard, there are 155,373 people on the Need a Family Practice Registry as of Feb. 1, which represents 15.5 per cent of the population.
Since Jan. 1, the registry has increased by 2.2 per cent — or just over 3,300 people.
Of those who indicated why they’re joining the registry, nearly 35 per cent said they were new to the area. The second most common response at around 25 per cent was, “my provider has moved/closed their practice.”
Katrina Philopoulos, the director of physician recruitment with Nova Scotia Health, said it’s a challenging time for the province because as the population continues to grow, doctors are leaving their practices.
“The reality is we know we’ve had unprecedented increase in immigration and migration from folks coming from other provinces to Nova Scotia,” she said.
“Coupled with we’ve had retirements of physicians who had big practices. And so when they’re retiring, we’re not just replacing with one, we’re replacing with two (doctors).”
She added that the province is “still recruiting as aggressively as possible” and “not leaving any stone unturned.”
“What I can tell you is that our wait list, every month, we are taking patients off that list,” she said.
“We have a number of strategies in place to help support that waitlist and access for patients.”
Those strategies includes expanding collaborative care teams and “clinical onboarding of patients,” which dictates how new patients are registered.
“So those patients that are waiting on the list, when we have a new physician in their community, making sure that there’s expediency for those patients to come off the list,” she said.
But the truth remains, there is a shortage of doctors in the province. To further exacerbate the situation, Dr. Leisha Hawker, the past president of Doctors Nova Scotia, told Global News a quarter of her colleagues are expected to retire in the next five to 10 years.
“We really need to plan for that succession planning. We need to try to retain every resident we’re training and we need to try to train more and recruit more,” said Hawker.
‘Too late by then’
That’s small consolation for patients like Brenda MacDonald, who remain on the waitlist and have no idea how much longer it will take to get off it.
Without a family doctor, she fears she’ll fall through the cracks.
“My biggest fear about not having a family doctor is if there is something really wrong, by the time you get in to see a doctor or somebody who could actually do something for you and then you actually get tested … it will be too late by then.”
Part 2 of Global News’ Code Critical series will take a closer look at what efforts are being made to recruit doctors and why time is of the essence.
