Why we are leav­ing

Digby doc­tors share per­spec­tives of their work in Digby and ex­plain why they are leav­ing the area at the end of November

Tri-County Vanguard - - NEWS - DIG­BY­COURIER.CA

“We deeply en­joyed get­ting to know our pa­tients and work­ing with them to sort through their med­i­cal is­sues one by one. We are sad to leave them.”

“Much of this work was done above and be­yond our con­tracted hours. We have taken on many ex­tra nights and week­ends with­out pay and sac­ri­ficed time away from our fam­i­lies to serve the pop­u­la­tion of Digby. All of this work has been dif­fi­cult and busy yet re­ward­ing be­cause we un­der­stand that the com­mu­nity greatly needs bet­ter ac­cess to health­care ser­vices.”

Doc­tors JEN­NIFER CHANG and GENNA BOURGET have been part of a col­lab­o­ra­tive prac­tice in Digby op­er­at­ing out of the Digby and Area Health Ser­vices Cen­tre. The two doc­tors are leav­ing the area at the end of November. They have shared this per­sonal re­flec­tion on be­ing doc­tors in Digby, on re­cruit­ment and on leav­ing.

It is with mixed emo­tions that we will be leav­ing Digby at the end of November. We felt com­pelled to share a few things that we have learned from our time in Digby and to give our per­spec­tive on why we chose to leave.

First, Digby is a great place in which to work and live for providers who can come with their fam­i­lies. This is a beau­ti­ful com­mu­nity with ocean­side liv­ing and in­cred­i­ble sun­sets. Many of the peo­ple we have met are gen­uinely warm and friendly. The hos­pi­tal and clinic staff are top-notch and won­der­ful to work with.

We’ve also re­ceived strong sup­port from our col­leagues in Yar­mouth, An­napo­lis, and Kentville. As fam­ily physi­cians, we en­joy a scope of prac­tice here that would be dif­fi­cult to have in a larger city. We have been warmly wel­comed and strongly sup­ported by the lo­cal Digby Hos­pi­tal Foun­da­tion, a lo­cal char­i­ta­ble or­ga­ni­za­tion. They have part­nered with us on re­cruit­ment ef­forts and con­tinue to do great work.

The Nova Sco­tia Health Au­thor­ity (NSHA) has also worked closely with us to try to main­tain bet­ter work-life con­di­tions de­spite the heavy work­load and too few providers.

We have worked tire­lessly for this com­mu­nity since ar­riv­ing last Septem­ber. We have spent long hours work­ing in clinic, cov­er­ing the large ma­jor­ity of the hos­pi­tal in­pa­tient ser­vice in or­der to keep it open, pro­vid­ing ob­stet­ri­cal cov­er­age which in­cludes Digby pa­tients, and work­ing mul­ti­ple shifts in the emer­gency depart­ment ev­ery week.

Much of this work was done above and be­yond our con­tracted hours. We have taken on many ex­tra nights and week­ends with­out pay and sac­ri­ficed time away from our fam­i­lies to serve the pop­u­la­tion of Digby. All of this work has been dif­fi­cult and busy yet re­ward­ing be­cause we un­der­stand the com­mu­nity greatly needs bet­ter ac­cess to health-care ser­vices.

The pop­u­la­tion in Digby in­cludes a large el­derly pop­u­la­tion with com­plex med­i­cal prob­lems that re­quire ex­ten­sive and thor­ough care. We deeply en­joyed get­ting to know our pa­tients and work­ing with them to sort through their med­i­cal is­sues one by one. We are sad to leave them.

Although we have en­coun­tered many positive as­pects of work­ing in Digby, we feel com­pelled to ad­dress some of the re­cent mis­con­cep­tions that have been thrown about, both pub­licly and pri­vately, re­lated to our leav­ing.

Many peo­ple may not un­der­stand that we were never re­cruited to Digby. Both of us com­pleted med­i­cal school in Dublin, Ire­land, and were sub­se­quently re­quired to sign a re­turn of ser­vice con­tract to Nova Sco­tia when we en­tered res­i­dency train­ing through Dal­housie. We were given a list of six un­der­ser­viced towns to choose from and we chose Digby be­cause of the un­der­stand­ing that there would be four physi­cians start­ing to­gether, which no other com­mu­nity of­fered.

Due to un­fore­seen per­sonal cir­cum­stances, only the two of us were able to come and stay. We were never given any bonuses or in­cen­tives to come here. Specif­i­cally, we were in­el­i­gi­ble for any ru­ral in­cen­tives from the prov­ince or from the mu­nic­i­pal­ity. Nei­ther of us have fam­ily or a sup­port sys­tem in Digby. Dr. Bourget’s fam­ily lives in Hatchet Lake and Dr. Chang’s hus­band lives be­tween Saint John and Hal­i­fax, with her fam­ily be­ing in Toronto.

For all of th­ese rea­sons, we are grate­ful that we will now be com­plet­ing the re­main­der of our re­turn of ser­vice con­tracts in the Cen­tral Zone. We are not break­ing our con­tracts but in­stead will con­tinue to ad­dress the needs of an un­der­ser­viced pop­u­la­tion there. The ar­eas where we will prac­tice are also in dire need of pri­mary care. We chose to trans­fer in or­der to be closer to our fam­i­lies, and not for any fi­nan­cial rea­sons as our salaries will not be higher in the Cen­tral Zone. We will con­tinue to work in Nova Sco­tia and look for­ward to be­ing re­united with our fam­i­lies, friends and be­ing closer to our sup­port sys­tems.

We truly be­lieve the key to re­cruit­ment and re­ten­tion of pri­mary care providers lies in at­tract­ing locums and physi­cians who have roots in Digby or the sur­round­ing com­mu­ni­ties. Bas­ing res­i­dency pro­grams in more ar­eas of ru­ral Nova Sco­tia is one way to en­cour­age this, as is fa­cil­i­tat­ing men­tor­ship from more es­tab­lished physi­cians lo­cally.

Sup­port for physi­cians with spouses or fam­i­lies is equally im­por­tant as well.

Our nurse prac­ti­tioner col­leagues are also pro­vid­ing high qual­ity pri­mary care to a large num­ber of peo­ple in Digby and the Is­lands, and there are on­go­ing ef­forts to re­cruit more NPs. The Digby Hos­pi­tal Foun­da­tion has made tremen­dous strides to help with re­cruit­ment and rep­re­sent a com­mit­ted group of cit­i­zens work­ing with physi­cians to­wards a com­mon goal of bet­ter ac­cess to qual­ity health care.

While we strongly sup­port cit­i­zens ad­vo­cat­ing for the health care of their com­mu­nity, a mi­nor­ity of peo­ple have un­re­al­is­tic ex­pec­ta­tions and con­tinue to ad­vo­cate in a neg­a­tive way. They have been dis­cour­ag­ing to us and to other health- care providers since our ar­rival and con­tinue to be so as we plan to de­part.

They do not take into ac­count all the chal­lenges in­her­ent in pro­vid­ing qual­ity health care in a re­source lim­ited set­ting, nor what it takes to keep a clinic or a hos­pi­tal open. Their ac­tions and at­ti­tudes have made it dif­fi­cult to at­tract more physi­cians and NPs. Un­re­al­is­tic ex­pec­ta­tions and fail­ure to rec­og­nize the im­por­tance of fam­ily sup­port con­trib­ute to physi­cian burnout. More con­ver­sa­tions need to be had to help them be­come more ef­fec­tive in ad­vo­cat­ing for their com­mu­nity.

We will be leav­ing Digby at the end of November, but we re­main hope­ful for this com­mu­nity. It has been a priv­i­lege to get to know the kind, re­silient, and strong peo­ple who live here and to have had the op­por­tu­nity to serve in Digby.

Sin­cerely,

Dr. Jen­nifer Chang and Dr. Genna Bourget

TINA COMEAU

Doc­tors Genna Bourget and Jen­nifer Chang spoke about what, as new doc­tors to Digby, made them feel at home and part of the com­mu­nity dur­ing a Fe­bru­ary ses­sion held in Digby that was or­ga­nized by the Digby Area Health Coali­tion and Doc­tors Nova Sco­tia.

DIGBY HEALTH SER­VICES CEN­TRE WEB­SITE

Dr. Jen­nifer Chang.

DIGBY HEALTH SER­VICES CEN­TRE WEB­SITE

Dr. Genna Bourget.

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