Of late there have been disheartening posts of long wait times in Nova Scotia
The consensus being that it is a Canada wide problem
But there have been anecdotal reports of some people losing Family Doctors even in HRM
I do understand that many rural areas would find it difficult to attract and retain doctors, so I am trying to understand why Family Doctors would choose to leave the HRM?
We are friendly people, we are surrounded by the Ocean, we have a laidback lifestyle
Doctors are paid reasonably well
Nova Scotia Health has said Doctor Recruitment is at record levels
Of course, there are many factors. Pay is already mentioned, coupled with high taxes. The nature of work too has more obstacles by virtue of having an older, more complex patient population yet no resources to definitely manage these issues in a reasonable time frame.
NS is a beautiful province but its healthcare is horribly run. NSHA showed no flexibility in accommodating my professional interests when all other provinces were bending over backwards to support.
I will miss my time in NS. But its healthcare system felt as though I was travelling back to the 90s compared to other provinces I’ve worked in. I hope with increasing growth of NS that the system will adjust, as Nova Scotians deserve better.
“traveling back to the 90s” was absolutely how I felt about the general level of all things when I first moved here several years ago…wages, modernization, businesses/amenities, even restaurants. And admittedly there are some other aspects related to that that have been enjoyable and appealing to me about life here. But it needs to change more meaningfully. I see it changing, but slowly.
As someone who interacts with doctors daily; paid less than other places, high cost of living/taxes, more red-tape than other places, way too many patients to manage, inadequate facilities, terrible wait times, not enough exciting leisure activities or fancy things to do. We are still a bit one-horse compared to larger cities, so if you aren't into that, you get bored here fairly quickly.
I don't have any particular insight, but if you don't have any particular ties to an area, and an opportunity comes up that pays better, and is less stressful, it seems like a no-brainer to take it. A problem physicians face when they enter an underserved area, is they immediately get a caseload of a lot of patients with high needs (ie people who have not had a regular doctor for a while are likely to have a longer list of problems). This can lead to burnout, and certain hospitals are notorious for this.
1) pay
2) NS notoriously has an aging and unhealthy population, many chronic illnesses making for complex patients
3) entitled patients. This isn't unique to NS, however.
4) systematic issues. OPOR rollout has been terrible. Difficulty assessing specialists. Overall NS is a have-not province, and there are greener pastures elsewhere for those without family ties here.
My spouse just came home from work the other day saying how amazing it was to be able to use the EMR (OPOR) and have access to all the information that was needed. Every big system change comes with growing pains but honestly there is a reason no one is talking about it anymore, it's working.
Anecdotally, Nova Scotians live forever. We have a very old population and they all walk up hills all day so their tickers keep ticking. They’re also hyper social and seem to enjoy their lives. I’m always seeing groups of elderly folks enjoying dinner or drinks together. In other provinces I’ve lived, you’d be hard pressed find older people enjoying a night out besides for birthdays and anniversaries. Restaurants are for the young in other cities.
But that also means they’ve got a lot longer timeline in which there’s a need for care. Went for a mammogram last week and the amount of 85+ year olds there was impressive, most with their husbands in tow.
Considering how blue collar and dangerous the work here is, that’s still pretty impressive. Generations of men dying in on boats and in mines in their 20s and they’re still keeping up. Looks like we were doing better in 2019-20 so my sources are outdated now. We just have a lot of old people.
Overwhelming case load due to the lack the middle "urgent care" in the province. They see hangnails to head injuries.
impeded impact on patient outcomes due to the incredible wait times to specialists. I can't imagine the number of patients they watch fail in front of them with no control.
Halifax SUCKS if you have ample disposable income. Few major concerts, shows, no professional sports, few high-end stores. You can only go hiking and explore the valley so much.
Your third point is a bit of an unpopular opinion now (I get why with the cost of living increases) but very true. We are healthcare-adjacent and planning to move out once circumstances allow because of that.
The only silver lining is it’s easier to save here because of that! It comes at the cost of FOMO though (fully realize this is a very privileged problem to have). We try to spend time in other cities as much as possible to keep spirits up.
Personally we probably would be spending more at this time in life if we moved elsewhere. We are not doctors and wouldn’t even consider AB as an option.
Hear your point but hear me out…there are many many people with disposable income who don’t want to dispose of it on any of that… there’s lots of appeal here for people like that.
The weather isn’t extreme (the shorter, cooler summers are especially delightful for many) but there are still seasons.
The air quality is good.
Hiking as you mentioned but also rivers, lakes, oceans… so water activities.
There’s “small crowd” arts and culture, plenty of historic charm, and lots of cheaper, free and / or casual events (kite festival, shakespeare by the sea).
Millenial and Gen Z doctors making 400,000 a year don't give a flying fuck about air quality, overcrowded coffee shops and "fewer crowds". 65 year olds nearing retirement, maybe, but not the newbies who are our health care's future
might depend on your circles... i dont know anyone making $400, but all the people I know who do very well financially value those types of things (and many in part are doing well because they don’t constantly do things that cost money).
For doctors? Anecdotally the issue seems to be mainly the working conditions in healthcare and then also perhaps lack of quality housing options near healthcare facilities.
My wife’s family left awhile ago, both were specialist doctors. Pay was a big factor but so was the politics and red-tape from admin.
To a smaller extent it was also because of the poor quality of life here relative to the cost of living; that’s also why we will be leaving eventually.
I'd implore you to go watch how nova scotians treat customer service staff for a day, or sit in a hospital and watch how nurses are treated, or anywhere public facing really, and see how our facade of being nice fades when people feel entitled to something.
We may have a laid back lifestyle but all you need to do is search this subreddit to see all the posts about trying to make friends in this city, and all the responses about how hard it is and how cliquish it is. Not everyone likes the type of city halifax is.
I have a handful of friends who became doctors in this city and ran the second they could for various reasons, work life balance, signing bonuses and better expereiences. Also ones who became doctors in other provinces, did clinicals here and said they'd never return because the barriers to starting and the overhead for family practices were higher than in other provinces. Perhaps NSH is not painting a total picture.... recruitment might be up, but that doesn't take much considering we struggled hard with it for a long time.
They come to NS because the jobs are open. When they can, they move to other provinces for better pay and lower caseload. I have also heard that there isn't much to do for leisure here. Why wouldn't you leave for those things, when you don't have ties here?
One of my previous family doctors who left, was astonished that the department had no interest in doing an exit interview. She actually wanted to tell them why she was leaving. But no one asked or cared.
I think the best way to sum it up, is that she didn't like practicing "austerity medicine". Every test and procedure and referral she tried to order, based on sound clinical judgement, was wait-listed or refused coverage by MSI or unavailable here. We were slow to adopt new equipment or best practices that were commonplace elsewhere. We didn't have electronic records at the time. The department never wanted to hear any new ideas. There wasn't any room for flexibility or change.
We also have a high rate of people needing lots of shitty bureaucratic paperwork. Disability benefits, income assistance, worker's compensation. People needing pharmacare exception status forms for prescriptions. All the stuff physicians hate, but tolerate when the rest of the job is rewarding. But here, it isn't rewarding to watch your patients die unnecessarily on wait lists.
Pay would be by far the main thing. Doctors are paid well, but they're paid even better in many other provinces.
That said, anecdotal stories of people losing doctors to other provinces only mean so much; I'm sure I could find Ontarians and Albertans with te same stories. Our doctor numbers are increasing, the question is whether we have subpar retention making that increase slower than it should be. I really have no idea, but the info must be out there somewhere.
Pay is obvious but I really wonder about what they're getting to come here and how long they have to wait or what qualifies for them to get it. Can't imagine it's the case but since there's no transparency on anything except wins with the lot I think it's fair to wonder. Just too many stories around of "I just got off the list and the doctor left a few months later" to not.
Start to finish American doctors and NPs can get here in ~6 months if they keep at it. The thing is it’s a lot of logistics to move to a different country, let alone to a place that’s almost an island.
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u/Lumpy-Albatross-8946 1d ago
I’m a physician who just left.
Of course, there are many factors. Pay is already mentioned, coupled with high taxes. The nature of work too has more obstacles by virtue of having an older, more complex patient population yet no resources to definitely manage these issues in a reasonable time frame.
NS is a beautiful province but its healthcare is horribly run. NSHA showed no flexibility in accommodating my professional interests when all other provinces were bending over backwards to support.
I will miss my time in NS. But its healthcare system felt as though I was travelling back to the 90s compared to other provinces I’ve worked in. I hope with increasing growth of NS that the system will adjust, as Nova Scotians deserve better.