As a doctor, Kirk Magee doesn’t like to tell people he can’t help them.
But as an emergency care specialist at the Halifax Infirmary, that’s a situation he faces more and more amid Nova Scotia’s family doctor shortage.
“People who are looking for primary care, they’re often surprised and very disappointedthat’s not what we do,” Magee said in an interview Wednesday. “I have no training at all in family medicine.”
Magee, who is the interim head of emergency medicine at the Queen Elizabeth II Health Sciences Centre, called family doctors the backbone of the health system.
“They’re the first point of access. They direct (patients) to the most appropriate place to get their care. With the decreased access to GPs in Nova Scotia, particularly in Halifax, we’re seeing the fallout from that in the emergency department.”
He figures the number of people without a family doctor seeking care at the Halifax Infirmary ER has doubled in the past five years “and, if anything, we’re probably underestimating that problem.”
Besides those seeking primary care in the wrong place, Magee pointed to another set of patients, the ones who do need emergency care and should be in the ER.
“Emergency care is very episodic care,” said Magee, who has worked in emergency medicine for 17 years. “Emerg physicians are there to see patients with urgent or emergent problems. They’re there to quickly investigate that and form a treatment plan. And a lot of the times, the treatment plan is contingent on the patient being able to follow up with their family doctor for reassessment. And when patients don’t have a family doctor, that poses a unique challenge.”
Emergency rooms are usually more crowded in January after the schedule disruptions of the holiday period. If predictions of a severe flu season are borne out, obviously that will make things even busier in the coming months.
Magee said he doesn’t like to see people waiting “three, four, five hours” in a packed ER for nothing when they could have gone to a walk-in clinic.
“I want patients to understand what we can do for them in the emergency department,”
he said. “We want to provide good care. And how you define that is really up to the patient because everyone’s going to define that in a different way. We are more than happy to see them and assess them. We will use our skill set to rule out things that are life- or limb-threatening, we’ll do our best to treat things that are acute.
“But what patients need to understand is thatwe are not family physicians. Family medicine is a specialty different from emergency medicine and if they’re looking to
have their prescriptions refilled, if they’re looking for chronic care for a chronic problem, the emergency department is not really the place for that.”
It’s estimated that about 100,000 Nova Scotians don’t have a family doctor.
Besides emergency clinicians, Doctors Nova Scotia has said the shortage has forced other specialists into inappropriate primary care roles such as monitoring and renewing prescriptions.
