A Cape Breton doctor says the next government needs to better determine who and where health resources are to be deployed throughout the province.
Nova Scotia Health Authority has muddied the waters
The shortage of health-care professionals in rural communities is a global problem that poses a serious challenge to equitable health-care delivery.
The lack of enough physicians in rural areas and in some regional centres has become the prime focus of this election campaign. All party leaders have vowed to recruit more for the province.
The details are skimpy, but the desire is strong. People have a right to be skeptical after decades of failures.
In Nova Scotia, we are told we have more physicians per capita compared to the rest of Canada, but many recent publications dispute this.
This frustrates the 100,000 Nova Scotians without a family physician. Where is the health human resource plan to address this issue?
Nova Scotia is competing for health human resources with all other provinces. Throwing money at the problem is a failed global strategy, a fact that has apparently escaped the notice of both the politicians and the Nova Scotia Health Authority (NSHA).
In a well documented study by the Canadian Society of Rural Physicians, financial incentives ranked fifth in a list of 10 factors affecting recruitment and retention of rural health-care professionals, behind these simple observations: Medical students from rural areas are more likely to return to their rural roots.
Marital partners of those physicians, whose own roots are rural, enhance the chance of rural retention.
Spouse employment, collegial support and group practice are powerful enablers of both recruitment and retention. To solve the problem of access to timely care, it is necessary to look at the real issue:
physiciancentric care models. Today a different reality exists and evidence has shown that physicians are not always the most appropriate care providers for all health problems.
It is a fact that people still want to live in rural Nova Scotia. Indeed, the desire for baby boomers to retire to ancestral lands is on the increase.
Baby boomers bring three things with them when they move back: high expectations, significant financial resources and critical analytical skills.
They are prepared to use all of these to leverage services, as was in evidence in Sydney Mines and in Digby in recent weeks. Vocal, educated, networked and technologically savvy, this will be a formidable group to placate with the usual platitudes.
As medicine has become more complex, team-driven and technologically advanced, the struggle to provide timely, evidenced based, cost-effective and appropriate health care has become more the expected paradigm than it was in the past. Why propose 1980s solutions for 2017 problems?
The NSHA has muddied the waters by moving the dial to a collaborative
model of care for family practice, ironically without collaborating with either the consumer of health care or the frontline provider.
They have failed to communicate the message and their singlemindedness around who and where health resources are to be deployed has alienated the very champions they need to bring about this transformational change in health-care delivery. In addition, they have failed to share the evidence that this model is cost-effective.
It cannot be left to current providers to come up with a plan to improve access to health care. They are too invested in legacy practice to be successful on their own.
But neither can their input be devalued as it has by the Health Authority.
“Why propose 1980s solutions for 2017 problems?”
Rural residents of Nova Scotia want access to evidencedbased medicine and they care not who provides it, as long as it is up to date, timely and has positive outcomes.
Somebody has got to get out of the way.
Let’s start by government providing the environment and letting non-government content experts develop a business plan to make it happen.