Family doctor shortage affecting 'entire department of surgery,' says specialist

A vascular surgeon in Halifax says the province's family physician shortage is forcing specialists to pick up the slack and write prescriptions for ailments outside their expertise.

Dr. Gerry MacKean recently attended a meeting with other surgical leaders, and all of them were facing the same challenges.

"This is not about politics, this is about fixing a crisis in the province for patients who don't have a doctor who can't get a doctor," he said.

"Because the patients are coming through the door with no family doctor, we have nobody to quarterback their care. A football team with no quarterback doesn't win many games."

'A specialist is a specialist'

On Wednesday morning, MacKean saw a dozen patients, two of whom asked him to refill prescriptions that had nothing to do with the reason he was seeing them. He said he felt compelled to help them.

"I wrote a lot of prescriptions for drugs that I'm not an expert in," he said.

"Quite frankly, a specialist is a specialist. They know a lot about this one little area. They don't know a lot of other things. I'm not the guy to have control your diabetes. That's your family doctor's job."

MacKean said it's an uncomfortable position, but he's quick to clarify that specialists who choose to do this are not putting patients at risk.

"They are just acting within their abilities," said MacKean.

MacKean said his opinions of the crisis are measured compared to those of many of his colleagues, but he said this is a problem that needs an urgent fix.

"It's affecting the entire department of surgery, it's affecting physicians across the province."

Focus on recruitment

The Health Department and the Nova Scotia Health Authority have repeatedly said they are focusing on recruitment, but are facing a national doctor shortage.

They're also dealing with an aging physician workforce that is trying to retire. In the case of Dartmouth, 40 per cent of the family physicians in the community intend to retire in the next five years.

As of December, 26 family doctors and 66 specialists have been hired in this fiscal year.

But none of the excuses add up for MacKean, who is baffled that more isn't being done to keep the physicians who are being trained here in the province.

"We make 90 to 100 doctors a year, fresh, coming right off the doctor tree," he said. "Where are they all going? What are they doing? 

While he said it's not his job to create solutions, he believes physician salaries are a good place to start.

Nova Scotia family physicians are some of the lowest paid in the country, with neighbouring New Brunswick and P.E.I. offering higher salaries.

"I think we should show them we appreciate what they do. We should pay them adequately and we should value them. Because they are our backbone."

Readers who wish to share their story about searching for a physician can contact Carolyn.Ray@cbc.ca.