Why put a plan in place?
We are facing a number of challenges. Nova Scotians need timely access to family doctors, and some just don't have that. In some cases, there are long waits for specialty services, and like most provinces, we have issues with recruitment and retention.
With an annual investment of $720 million in physician services annually, it makes sense to look at improved planning and coordination across the province given the significant difference in mix and distribution of physicians compared to the needs of the population. And, it's part of our Better Care Sooner plan, based on the recommendations of Dr. John Ross to take a coordinated and more strategic approach to physician training and recruitment.
What are the objectives in adopting a provincial plan?
It's really a recognition that we really need to better plan for the future. By 2021, we know that 31 per cent of the physicians in Nova Scotia can retire. So, we are looking at what the needs of Nova Scotians will be for the next number of years within the national context. We know that there’s a shift towards more general practitioners who provide comprehensive primary care services and that collaborative interdisciplinary primary health care teams are foundational. So, we're planning on how we build to best meet the health care needs of our population.
What data will shape the plan?
This is a dynamic planning tool, so the data we use is updated regularly. The current data we have reflects the 2011/12 workforce, versus the data from 2009/10 which was provided by the consultants (Social Sector Metrics Inc. and Health Intelligence Inc.) who created the original plan.
Isn't the formula for future physicians already decided?
It's important to remember that this is a planning tool. It's comprehensive, flexible and relevant. It's evidence based and it considers key workforce variables, as well as variables of healthy system planning, such as the changing role of physicians and other health care providers, new technologies, updated plans for clinical services such as mental health, critical, palliative and home care.
What's the difference between core district and provincial services?
All Nova Scotians should have timely access to a defined range of core services at the district level. Yet, with nearly 60 per cent of physicians located in Halifax, it’s clear that some regions don’t have that access. Provincial services encompass specialty-services that should be offered on a provincial level so they can be better planned and coordinated for more consistent and sustainable services.
Your forecast projections have some pretty broad ranges, why is that?
The key word is projections. We're using planning ranges, not fixed numbers.
Aren't we really dealing with a national market?
There's no question we are dealing with a mobile workforce. A province of our size must look to the national pool to recruit, and with the medical school in our backyard, other provinces come here to recruit resources. That's why it’s critical we're part of the national strategy that better plans and coordinates planning for the workforce of the future.
Isn't it true that Nova Scotia has more doctors per capita than any other province?
Yes, we do have a generous supply of physicians, but as the consultants found, many are concentrated here in metro Halifax. There are many Nova Scotians around the province that have difficulty finding a family doctor, and don’t have timely access to a family doctor or specialty services. Taking a more strategic, coordinated approach means we can better meet the health care needs of the province, ensure that supply and demand are better aligned with population needs and that medical students and residents can make more informed career choices .
What doctors do we need?
The areas of greatest need are family physicians, general surgeons, general internists and anesthesiologists.
Does this mean some doctors will lose their jobs?
It's important to remember that this is a planning tool. With 31 per cent of our current workforce able to retire by 2021, there will be opportunities for change through natural attrition. Some specialists who retire or leave the system can be replaced with doctors practicing in areas of greater need, such as family physicians.