Last week’s headlines were dominated by the number of doctors fleeing Nova Scotia. Some are leaving for professional development denied to them here, some for competitive pay or better working conditions and/or access to operating rooms and equipment.
The Friday highlight was the loss of Kentville obstetrician/gynecologist Dr. Charles Hamm who has a 5,000-name patient list and could only get 2.5 days of OR time a month at Valley Regional Hospital!
With an existing shortage of rural-based doctors, where are these 5,000 women going to find physicians?
Sadly, Dr. Hamm is just one of the parade of medical professionals scrambling to get out of Nova Scotia.
What is fascinating is that this doctor is so frustrated and fed up that he actually speaks truth to power saying, “I feel like I'm beating my head against the wall in Nova Scotia.” If more of the province’s medical professionals embraced Dr. Hamm’s candor the house of cards which our system is would come crashing down.
After his initial interview, Janet Knox, the new president and CEO of the Nova Scotia Health Authority (and former president and CEO of the Annapolis Valley District Health Authority which employed Dr. Hamm) and Dr. Pater Vaughan, deputy minister of health gave an interview. Their appearance couldn’t actually be called a response to Dr. Hamm’s comments. Just more of the ‘we-re-trying-as-hard-as-we-can-and-it-takes-time’ PR speak. On a live radio interview it is akin to running out the clock in the final minutes of overtime. After these executives spoke, Hamm was asked for his thoughts.
He said, “This is a great example of people not answering our questions. They may come up with a solution, but it’s like putting a screen door on a submarine … They dance around the issue. There is a problem in women’s health care … and these guys aren’t listening. They don’t get it or they don’t want to get it … There’s no new model, there’s no plan … There is no mandate for women’s health care.”
And so he’s going someplace that has a mandate.
You can hear these comments here:http://www.cbc.ca/player/News/Canada/NS/Audio/ID/2670512609/
Let’s do a quick scorecard of departing doctors.
On Monday, June 29th, in response to what she heard on radio, a Yarmouth OBGYN called CBC to say that her senior partner in obstetrics, with no new doctors coming to Yarmouth, is leaving.
Also on June 25th it was announced that researcher Dr. Rob Brownstone, who teaches at Dalhousie and practices at Queen Elizabeth Health Sciences Centre, is leaving for the University College London. He has been one of the country’s top researchers and we’re losing his skills, vision and ability as well as the ten-person team accompanying him to England.
On June 17 two geriatric specialists in Cape Breton announced they were leaving. The next day an OBGYN in Antigonish announced he was closing his office and The Coastnewspaper reported that a French-trained neurosurgeon, Mahmoud Alkhatib, who could only get work in blood collection here, decided to give up trying to get a license to practice medicine in Nova Scotia and leave Canada.
We also learned that none of the six current obstetric grads from Dal are planning to practice in the province.
In April CBC reported that nine of the province’s 40 OBGYN’s were thinking of leaving the province. That’s 25 percent of the province’s obstetrical specialists!
In July 2014, a doctor recruited to practice in Digby left after a month in the community. His initial practice list was for 400 people. No explanation.
In January 2013 Pictou lost an orthopedic surgeon because he couldn’t get OR time, so he and his wife, a general practitioner, moved to Florida. The next month, with no money to pay her, orthopedic surgeon Dr. Andrea Veljkovic, who specialized in foot and ankles, left the province, taking her radiologist husband with her. She was an itinerant surgeon based in Kentville who travelled all over southwest Nova to operate on patients. Meanwhile, Halifax-based orthopedic surgeon Dr. Mark Glazebrook has patients waiting – and suffering and using the health care system – for 10-to-13 years before he can operate! In spite of this suffering and waste, the Province decided we didn’t need more orthopedic surgeons.
February 2013 was a big month for loss. In addition to Dr. Veljkovic, two top neuroscientists, Drs. Donald Weaver and Ivar Mendez, announced their departures. Dr. Weaver took his ten-person medical chemistry team to Toronto. Dr. Mendez, who is credited with bringing $72 million in research funds to Halifax, left for the Brain Repair Centre in Saskatoon. Other researchers who left the province include Dr. Michael Esser, who worked in Pediatric Epilepsy Research, and Dr. Ryan D’Arcy, who was a leading brain researcher.
In 2012 a Cape Breton doctor told me she was one of 28 who left her hospital in 23 months. No one from the health authority or ministry asked any of these departing doctors why they were leaving and what could be done to alter their decision. At the same time Yarmouth lost six doctors in 13 months.
In 2009 three other geriatric doctors quit Cape Breton over what two said was “a lack of support from the local health authority.”
These are just some of the higher profile departures. They don’t include those who simply got fed up and left without saying anything or those who retired. And then there are all those who wouldn’t apply to practice here because of the departures.
In all professions, people gossip. If you’re a young doctor looking to launch a career and pay off student debt, are you going to consider a place where established and leading professionals say is impossible to work?
It’s a truism that the most highly educated are the most mobile because of the numerous career options. Obviously, top professionals both need to be courted and catered to. Where Nova Scotia is obviously failing is human resource management. We’re not working hard enough to keep those doctors we have. Instead we hear a lot about recruiting new doctors for rural communities. This is a diversionary tactic to deflective attention away from the on-going problems with management of our system.
In business you learn that staff turn over is costly. You have to pay off the departing people, it costs to recruit and interview new staff, then when new people are hired they are less productive during their training or orientation period. And in business when an employer has a reputation for high staff turnover, the corporate stars avoid them because they know something is wrong and they can do better. Well, we have seen a growing exodus of top professionals. That’s one sign of a problem. Now we have departing stars actually telling us there is a problem.
We’ve changed the system, so all that is left is management. Management was an issue under the former silo system and according the departing doctors continues to a problem under the new unified system. With the same people in charge, how can positive change come about? Their ways of working and thinking seem to too entrenched in the past.
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Monday, 29 June 2015
A parade of professionals quitting the province
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