N.S. doctor recruitment strategy doesn't bode well for N.L., says NLMA president

Dr. Susan MacDonald, president of the Newfoundland and Labrador Medical Association, is applauding Nova Scotia's newly elected provincial government for its commitment to spend over $55 million on physician recruitment in that province.

But she says it will make recruiting doctors to Newfoundland and Labrador even more difficult.

Health Minister John Haggie countered MacDonald's claim last week, saying Nova Scotia is actually "mirroring" many of Newfoundland and Labrador's current doctor recruitment strategies.

But  MacDonald said that isn't the case.

"They've done some really amazing things, and they're clearly taking doctor shortages as a very serious issue," MacDonald said.

Under that new strategy, Nova Scotia plans to:

• Establish clinical health service plans for each region, which will determine the right number and types of doctors needed. 
• Match new graduates with physician mentors.
• Provide succession planning when doctors retire.
• Provide funding to local leadership teams to implement clinical service plans and recruit doctors at the community level. 
• Support foreign-trained doctors to prepare for work in the province in exchange for a return of service agreement.
• Increase medical residency seats by targeting areas of need. 
• Remove the disincentives for family doctors to work in a community practice compared to hospital work.
• Create a pension plan for fee-for-service physicians who practise patient-centred care.

"Here in Newfoundland, the NLMA has never seen a government prepared human resources plan or a recruitment or retention strategy," said MacDonald.

"The RHAs have been focused on local recruitment to fill critical unstaffed positions, and they've got little or no resources to focus on our medical students or on other Canadian provinces."

MacDonald said the province also let funding lapse for the provincial physician signing bonus program in 2018, and the provincial recruitment office closed when the recruiter retired in 2016. 

She was also critical of the province's position on creating more residency seats, saying Haggie hasn't made a similar announcement for Newfoundland and Labrador.

Recruitment and pay gap

For supporting foreign-trained doctors, MacDonald said Newfoundland and Labrador used to have a training program but now has a practice-readiness assessment program with no return of service agreement associated with it.

She said six other provinces have a similar assessment program — with some paying the program fees for prospective doctors, with more competitive compensation than this province. 

"That's not going to help Newfoundland," she said. 

As for pay inequity, MacDonald said Nova Scotia is going to increase the rate for billing codes for family doctors. Since the contract between the NLMA and the province expired in 2017, she said, pay in family medicine has fallen below the Atlantic Canadian average. She said Nova Scotia's billing code increase is going to drive Newfoundland and Labrador even further below the average for wages. 

"I see the fact that we have 90,000 people without a family physician, [that] really indicates that we are not doing a great job of recruiting and retaining our family physicians," she said. 

"We also have problems in specialties as well, but our main concern is in family medicine at this point in time."

MacDonald said Newfoundland and Labrador needs a comprehensive human resources strategy to find the health-care system's shortfalls, including a need for physicians in both the short and long term and a competitive recruitment and retention strategy. 

"How do we make it comfortable and make the jobs such that people are happy to be able to do it, feeling that they're respected and valued? That's what I think we need to be doing," she said. 

"Waiting for the Health Accord, which is a 10-year process, I think is not going to help the dire crisis we're in right now."

Read more from CBC Newfoundland and Labrador