TRURO, N.S. – There may be no quick fix for this province’s doctor shortage but the newly elected president of Doctors Nova Scotia believes a solution is possible.
“My main reason for taking on this position was to work towards a world where every Nova Scotian can have access to a family physician,” Dr. Tim Holland told the Truro Daily News following his election.
“Obviously we are not going to get there in a year,” he said. “But if we can set ourselves up well through the upcoming negotiations, the relationships with government and through proper retention and recruitment strategies, I think we can get at least on the trajectory where we can see a world where every Nova Scotian has access to a family physician.”
Holland graduated from Dalhousie Medical School in 2011 and completed his family medicine residency in 2013. Following his residency, he worked in multiple locations throughout the province as part of the Rural Emergency Locum Program, before coming to work at Colchester East Hants Health Centre.
Solving the province’s doctor shortage situation will require efforts from several fronts, he said. This includes creating a payment model “that makes more sense for the way doctors practice today.”
Instead of paying doctors for each patient visit, Holland said he believes they should be compensated through a “blended model in which doctors are paid for each patient in their roster. That allows them to really focus in on the individual themselves. And that’s how family physicians practice today,” he said.
“People have complex health needs and you need to look at the whole person.”
Holland said the model would also provide an incentive for both attracting and retaining family physicans.
Despite this year’s commitment by the provincial government to increase the primary health care budget by $39.6 million, Nova Scotia’s doctors remain the lowest paid in the country.
And Holland said that is another area that needs to be addressed if the government is serious about attracting more family doctors.
“We’re in last place by a significant margin.”
Nonetheless, Holland said he remains hopeful that positive change is possible.
“I am cautiously optimistic that all the partners have the same goal in mind and that we’re really starting to see the problem with the same glasses,” he said. “We have to be able to sit down with the department and look at the nuts and bolts of the model. But we both recognize that we need to pay family doctors in a way that allows them to focus on the patient rather than the problem of the day.”
Another area that requires attention, he added, is to figure out ways to better support rural specialists, especially those who are required to work 36-hour shifts every other day.
“It’s not all about family doctors either,” he said. “The rural specialists, especially in the Truro area, are being worked to the bone as well.”
That prevents them from participating in clinics and from consulting with family doctors on their patients’ issues, which ultimately results in more “downloading” to those practices.
And Holland said he is also aware of the additional challenge he’ll face in his new role this year in the wake of upcoming contract negotiations between doctors and the government.
“There’s a lot at stake,” he said, in a news release announcing his presidency. “While we are all struggling, some of us are struggling more than others. We need to be able to look beyond our personal challenges and frustrations and consider the hardship our colleagues are facing as well.”
And ultimately, ensuring that all Nova Scotians are able to access health care “is a matter of focusing on the end game,” he said.
“For Doctors Nova Scotia, we achieve that goal by supporting physicians to thrive. For the Department of Health and Wellness, it’s through careful application of resources. For the Nova Scotia Health Authority, it’s through care delivery, and so on. However, we each get caught up in the means and forget our end. If we keep our common ‘end’ in mind, we’ll be able to align our disparate ‘means.’”
Holland replaces fellow Truro physician Dr. Manoj Vohra in the one-year term as president of Doctors Nova Scotia.