Antigonish surgeon loses privileges at one hospital after resigning from another

Dr. Jeannie MacGillivray wanted help improving her work-life balance and that of her colleagues in Nova Scotia.

Now the veteran surgeonfinds herself without a job, and two rural hospitals face the prospect of even fewer services.

For several years, the Antigonish-basedphysicianproposed ideas that could reduce on-call demands for the three surgeons at St. Martha's Regional Hospital.When her concerns continued to go unaddressed last spring, MacGillivray went on leave from the facility.

In the meantime, she continued working up to six days a month at Inverness Consolidated Memorial Hospital, where for the last three years she did surgical consults, performed colonoscopies and gastroscopies, and worked with the colon cancer prevention program.

Patients told of changein letter

But while on leave from St. Martha's, and without notice, she was placed back on the call schedule in November, according to Dr. Stephanie Langley, a friend and fellow physician.

Unawareshe had been put into the rotation, MacGillivray was out of town when she received a call from the hospital and could not fill the shift. The situation led toher resignation from St. Martha's, which then affected her standing at Inverness though why remains unclear.

"I have been informed that I will no longer be able to provide services at the Inverness Consolidated Memorial Hospital," MacGillivray wrote in a letter to patients advising them of the developments.

MacGillivray declined an interview during a brief telephone conversation last month, citing efforts to finalize her future plans for work.

Concerns identified early on

But Langley, a North Sydney-based family doctor who has known MacGillivray since high school and is familiar with the details of her situation, has attempted to draw attention to the matter.

In late December, Langley tweeted a photo of the letter MacGillivray sent patients. Langley said MacGillivray worked inOntario after completing medical school but was eventually recruited back home to work in Antigonish, where she's practised for the last 12 years.

She said MacGillivray identified burnout concerns with what she viewed as an unsustainable on-call schedule several years ago and the need to bring in another person to help.She met with health authority officials and Health Minister RandyDeloreyin an effort to improve the situation.

One of MacGillivray's colleagues in Antigonish raised similar concerns during an interview with CBC News last summer.

Lack of support

But Langley said staff there resisted MacGillivray's efforts to bring in another surgeon who would split her time they'd each work part time while helping the on-call rotations.

"There'd still be just three full-time surgeons, but there could be one-in-four call, so that would improve things for everybody," said Langley.

Langley said her friend was butting up against people whoweren't interested in MacGillivray's suggestions and a lack of support from the Nova Scotia Health Authority.

"There just doesn't seem to be support for physicians' plights when it comes to their jobs and issues that are going on."

Things at St. Martha's are about to become even more strained, she said, because one of the two remaining surgeons has given notice he will take a six-month leave beginning in February.

'Not entirely factual'

No one from the health authority was available for an interview Thursday.

In a statement, spokesperson Kristen Lipscombe said urgent or emergency cases on MacGillivray's roster are being referred directly to other surgeons, while less urgent matters are being sent back to family doctors for referral to another surgeon. Recruitment efforts are ongoing to fill MacGillivray's slot.

The statement did not address questions about why MacGillivray would be placed on the call schedule during a leave, or why her resignation from St. Martha's would prevent her from working in Inverness.

On Friday, the health authority said Langley's accounts are "different than what we know and understand in relation to the situation. In some cases what is being claimed is not entirely factual/accurate."

Lipscombe said it would not be appropriate to discuss specific details of the "numerous discussions between physician leaders" andMacGillivrayabout work-life balance.

MLA calls on Deloreyto get involved

Allan MacMaster, the Progressive Conservative MLA for Inverness,said he's talked with MacGillivray and fielded many calls to his office about her departure.

Losing her will have a significant effect on services for the community and surrounding area where some residents are more than two hours away from the closest regional hospital, he said.

"The obvious question is why would you be discouraging somebody who wants to be in a rural area practising surgery?"

MacMaster called on the health minister to get more involved in the matter and broker a solution so people in his region don't lose an important service.

'Tip of the iceberg' for burnout

Delorey declined comment, saying through a spokesperson he could not speak about individual conversations or personnel matters. The minister's office referred operational questions to the health authority.

Langley said she believes what's happening with MacGillivray and other doctors who have either recently left the province or are planning to leave is "the tip of the iceberg with physician burnout."

"It's not so much the patient care that we provide, but it's the bureaucracy and the lack of support within the health authority that really leads to frustrations, and you feel like you can't really be doing your best job," she said.

"It's incredibly frustrating."