On a warm East Hants spring morning, the doors are about to open at the medical centre in Kennetcook.
Located in a two-storey white siding house adjacent to the United Church cemetery, where some of the headstones date back to the 1800s, it’s a tranquil setting for a medical centre.
As she led visitors up the clinic steps, Dr. Barb O’Neil remarked that its proximity to a place of eternal rest has sparked some jokes over the past year.
Up until April of last year, she and three other family doctors worked out of a 2,500-square-foot clinic closer to the centre of the community. Besides the doctors, the medical team included a nurse, a mental health social worker and a dietitian.
That ideal situation was disrupted by the owner’s decision to turn the building into a restaurant. Now only the doctors are left out of the original collaborative team — they are looking for a nurse to replace the one who recently left for a Truro clinic.
The four physicians work in a roughly 700-square-foot space: a small waiting room with six chairs, an office with two administrative assistants and three
examining rooms.
“It would be a beautiful clinic if it was just for one physician,” O’Neil said of the house, which was a gift shop in its previous incarnation, in an interview as she waited for the first of between 22 and 25 patients expected that day. “It just doesn’t quite work for a larger team.”
The house is owned by a local pharmacist, who also owned the original building.
“It’s a strange situation. It kind of let us down by kicking us out of the old space (but) he did try his best to do what he could and make this into a clinic,” said O’Neil, whose oil and acrylic artwork hangs on the walls. “None of us have a bad relationship with the pharmacist, it’s not on him to be solely responsible to provide space for physicians to work.”
The Nova Scotia Health Authority put out a tender for the construction of a new clinic but there have been no takers, she said. (In an email, a spokeswoman said the authority continues to “explore other opportunities in the community for space options.”) As a result, the doctors have had to stagger their schedules so that one works earlier in the day and the others come in later. Still there have been busy times when patients have had to wait outside or in their cars if it’s a cold day, said O’Neil, a Halifax native and Dalhousie graduate who has practised medicine for 15 years.
The clinic has an official catchment area of 6,500 people from the Kennetcook-Noel-Rawdon region. In previous years, the doctors worked in separate clinics in the various communities. As a group, the team has had to move twice in the past three years.
“I think there always is a challenge in smaller communities to have an adequate space,” O’Neil said, noting that might be a factor the health authority hasn’t adequately considered in pushing the collaborative care model of larger medical teams.
“That has to be thought about. Where are these people going to inhabit for their clinics? Especially when you throw in learners into the mix. I always took medical students and residents . . . now I can’t and that’s something I really miss.”
The clinic serves about 3,500 people, with O’Neil carrying the biggest roster of about 1,150 patients. Officially part time (0.75 of a full-time salaried “alternative payment plan” position), O’Neil nonetheless works 40 hours a week. She drives about an hour and 15 minutes each way from her New Ross home — “That’s a whole other story,” she said with a chuckle.
Long days indeed but O’Neil is comfortable with country roads and bucolic settings.
“I’ve always worked in rural family medicine. I went against the grain, I pretty much knew in residency I was going to work in a rural area.”