Retention efforts crucial in 'fragile' physician environment, says doctors group

Doctors Nova Scotia says it's giving credit to the Nova Scotia Health Authority and Health Department for ongoing doctor recruitment efforts, but tackling the shortage will continue to be an uphill battle unless more attention is paid to retaining current physicians.

"This is a looming situation," said Nancy MacCready-Williams, the CEO of Doctors Nova Scotia, a professional and advocacy association that represents more than 3,500 physicians.

Fifty-five per cent of the organization's actively working members are over the age of 50, and she said retirements will continue to grow, especially if physicians are feeling disenfranchised.

• 40% of Dartmouth family physicians to retire in 5 years

There are physicians willing to practiseinto their senior years, she said,"if some of the issues that prevent them from feeling supported and engaged on the ground were addressed."

'Fragile and at risk'

MacCready-Williams made the comments after provincial health officials updated MLAsat a legislature committee Wednesday on their recruiting efforts.

She pointed to a recent Doctors Nova Scotia report thatdescribed province's physician workforce as "fragile and at risk," and which found doctors are feelingburned out just two years into their careers.

"Instead of adding physicians, Nova Scotia is struggling just to retain its current complement of physicians," the report said. "It is challenging to recruit new physicians to the province, and increasingly difficult to get them to stay."

Officials withthe health authority and Health Department have stressedthe importance of strong community support when recruiting new doctors to the area. But the Doctors Nova Scotiareport said health officials also need to rebuild trust so that new doctors won't face frustrated colleagues when they arrive.

So far this fiscal year, 26 new family physicians have started working in Nova Scotia, along with 66 new specialists. There are also 44 pending offers that the Nova Scotia Health Authority says just need to be ironed out.

The issue of physician compensation also came up during Wednesday's meeting.Liberal MLA Gordon Wilson wanted to know if it was the only factor when it comes to recruiting and retaining staff.

Dr. Lynne Harrigan of the Nova Scotia Health Authority was quick to say it was not at the top of the list.

"When they've done national surveys, the first thing that comes up on the survey is the quality of the place where you're living," said Harrigan.

"The second thing that comes up is the community of physicians that you're working with. Compensation is way down the list. So in spite of it always being focused upon from physicians themselves, it is not the primary thing."

MacCready-Williams disagrees. She said compensation isa significant factor in retention and family physicians in Nova Scotia are some of the lowest paid in the country.

"If they went to New Brunswick or P.E.I. they would make more, so that is a problem," she said. "That is a problem when we are trying to be competitive in having a warm and welcoming environment, and we're competing with other provinces."

'We're at a tipping point'

She also noted comments Harrigan made in an online video just a week earlier where she discussed an announcement aboutpay for hospitalists,one that will increase the disparity with family doctors.

"We have a system of payment that is inequitable," Harrigan said in the video. "We have the lowest payment for psychiatrists in the country. It's no surprise that we have trouble recruiting psychiatrists in rural areas because of that issue. Our family physicians are amongst the lowest paid in the country."

MacCready-Williams said that confirms a systemic issue that needs to be addressed.

"Right now we're at a tipping point, because many physicians' work-life environment right now is incredibly stressful. We have record rates of burnout and professional dissatisfaction," she said.

"In my six years in this role, I've never seen morale of our community at its lowest as it is right now."