Nova Scotia family doctor graduates see value in walk-in clinics

New doctors who want to practice family medicine in Nova Scotia often depend on work in walk-in clinics to begin their careers, but are being limited by the the Nova Scotia Health Authority's recent decision to restrict new doctors from working at walk-in clinics, say two Dalhousie University family medicine residents.

Walk-in clinics can help doctors get a feel for the type of work they want to do, as well as provide extra shifts to help with expenses, say Dr. Kristian Lobban and Dr. Joseph Phillips, the co-chief family medicine residents at Dalhousie.

Phillips's goal is to work in a collaborative family medicine clinic. He and his partner, also a doctor, plan to live in Halifax but also work in rural locations providing locum coverage.

"For instance, if we're spending six weeks in Cape Breton, four weeks in Yarmouth, and in between, what we were going to do was to come back to Halifax and live in our home and potentially work shifts in a walk-in clinic," Phillips told CBC's Information Morning.

Income opportunities

The Nova Scotia Health Authority's decision to limit new doctors from working at walk-in clinics — part of a strategy that would see the development of collaborative family medicine clinics — limits new graduates' options, he said.

"The problem right now, in all of Halifax, I only know of two collaborative practices that have been backed up and set up with the health authority," Phillips said.

"That's an issue."

He says starting a new medical practice is a huge investment.

"You are essentially working as a private business and the income you make from seeing a patient in your clinic has to go toward paying rent, has to go toward paying utilities, has to go toward paying your front staff, your nurses, everything. And my student debt," said Phillips.

New graduates need to know there are opportunities to make an income, said Lobban.

Going down the road?

"We've been contacted by numerous medical students who are interested in family medicine. They are concerned about the job market and staying in Nova Scotia. They're thinking about going elsewhere for their training," he told CBC's Information Morning.

The health authority currently lists 20 positions available in the central zone — which includes the Halifax area — and more in the rural area.

Other provinces 'more flexible'

Last month, Dr. Lynne Harrigan, the authority's vice-president of medicine and integrated health services, told CBC News the province is changing the direction of primary care, from "boutique" care that includes walk-in clinics to full-service family practices. She acknowledged the transition will take time.

Lobban says communication from the health authority to residents has been poor.

​'We don't feel we have great information to pass on to medical students," he said.

Meanwhile, Phillips says he hopes to stay in Nova Scotia.

"My future wife and I, neither of us are from this province, neither of us have family here. We came here because we love working here, we love the patient population, people are very nice, collegial, it is a great place to live and work," he said.

"We're planning on working here for a year. If things go well, we may end up staying. But if they don't, other provinces are definitely much more flexible at this point in time and can definitely be appealing."