Signs of the times
There were emotionallycharged, poignant moments as the spectre of a mass exodus of doctors from Nova Scotia hung over a sombre meeting in Halifax Saturday.
The spectre of a mass exodus of doctors from Nova Scotia hung over a meeting in Halifax Saturday, not as a threat, but with the grim reality of families driven from their homes by financial necessity.
They met because they believe the proposed federal tax changes will destroy their hopes for the future, but the hundreds of doctors from across Nova Scotia talked as much about the fate of their patients.
There were emotionallycharged, poignant moments. There was greater sadness than anger in the room.
Dr. Lisa Bonang, a family doctor in Musquodoboit for 22 years, watched colleagues leave the area for greener pastures. Her voice cracked when she admitted her patients now wait up to two months to see her.
Like the doctors who left, she’s just making a go of it. Forty-four per cent of her income is consumed by overhead. She believes the tax changes would deny her a decent retirement, but she only broke down when she vowed to “stay and fight for my patients and my community.” Her colleagues, in numbers too large to fit comfortably into the Halifax West High School cafeteria, stood and applauded.
Doctors willingly sacrifice years to get where they are. But then they struggle for more years to pay down massive debts. They have no pensions, no maternity leave, no paid holidays and work extraordinary hours to meet the demands of their jobs. One family physician estimated he nets about $8 per patient visit.
They say the tax changes proposed by the Trudeau Liberals, if adopted, will be the last straw, forcing hundreds of them to leave Nova Scotia, taking the last vestiges of a viable health system with them.
Nova Scotia is in more danger than many provinces, because its health care system is already in a crisis, born of mismanagement and characterized by tens of thousands of people unable to find a doctor.
Two subjects draw the ire of these family doctors and specialists. The first is the toll imposed on their patients by the deterioration of the system. The second is the big lie politicians tell about them – that they are wealthy or greedy fat cats, who don’t pay their fair share.
The realities are very different for the 76-year-old surgeon from Amherst who keeps working because he can’t afford to stop; or the 40-something Halifax specialist who said his net worth is zero despite years of practice when he paid the massive debt incurred during more years of post-secondary education; or the 31-year-old medical resident who’s putting off having kids because her hours and finances won’t allow it.
The large high school parking lot was jammed with mid-level and economy cars. This was a Corolla, not a Cadillac, crowd.
While there were several politicians in attendance, including federal Conservative MP Lisa Raitt, the 11 Nova Scotia Liberal MPs on the government side in parliament were conspicuously absent.
Two members of the provincial government pledged full support for the doctors, and said the province would vigorously oppose the tax changes, a position Premier Stephen McNeil refused to take in the legislature last week, although he did offer a commitment outside the House.
At Saturday’s meeting, Labour Minister Labi Kousoulis said the province is completely supportive of doctors and would do everything in its power to keep them in Nova Scotia.
Doctors Nova Scotia President Manoj Vohra said a survey of members suggests more than half the province’s “exhausted, over-burdened and disrespected” physicians will consider leaving if the federal tax changes are enacted.
The direct consequences of the shortage of family doctors was articulated with clinical clarity by Halifax kidney specialist Ken West.
Conditions like diabetes and hypertension, which could be well managed if patients had a family doctor, are instead becoming life threatening.
Gaps in primary care are increasing health costs by millions of dollars annually, and the government’s efforts to recruit family docs, already difficult, will be fruitless if practice or practical considerations deteriorate further.
The national Liberal party was in power when universal, taxpayer-funded medical care came to Canada. A Liberal government, in 1995, amended tax law to allow doctors to incorporate and staunched the flow of Canadian doctors to the United States.
The doctors who gathered in Halifax Saturday wonder if leaders of the current federal Liberal government – millionaire trustfund brats – are so out-of-touch with reality they will drive a lethal stake through the heart of Medicare.