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You reap what you sow.
If the proverb didn’t spring to mind when the bosses at the Nova Scotia Health Authority perused the dismal results from their survey of doctors, it should have.
The survey, conducted last year but kept under wraps until reporter John McPhee got hold of it and broke the news in The Chronicle Herald this week, confirms that Nova Scotia’s doctors are a discouraged, disaffected and frustrated lot.
They got that way over the past several years, while the NSHA and the provincial government treated them like a problem to be managed, rather than the solution to the medical needs of Nova Scotians.
“The reality is that NSHA and the provincial government systematically set out to create a health organization that alienated and marginalized physicians, ensuring that they were disempowered in as many ways as possible,” said a Nova Scotian doctor, who is making arrangements to relocate his practice to British Columbia where he’ll be paid more, taxed less and treated better.
He’s right. The survey shows that the majority of Nova Scotia’s doctors do not feel valued by the province and empowered in their work, with twice as many docs (55 per cent) saying they aren’t as those who say they are (26 per cent).
At least the survey results serve to negate one of the government’s go-to tactics when a Nova Scotian doctor speaks out publicly about the deterioration of medical services. Such comments can no longer be written off as the isolated grumblings of a few disgruntled docs.
It turns out 72 per cent of the province’s family doctors do not trust the NSHA to effectively manage change. Had the question been shortened, a similar number could be expected to respond that they simply do not trust the health authority.
Why would they?
Many of them were introduced to the NSHA at meetings a few years back where senior officials told the docs not to get too comfortable in their current practices. With breathtaking arrogance, the bureaucrats let it be known that the professional lives of these docs could be dictated by the NSHA.
If you’re looking for a point in time when the shortage of family doctors became a full-blown crisis in primary care, those meetings where bureaucrats from the NSHA flexed new “super agency” muscles would be a good place to start. Retirement notices and rental vans started appearing soon after.
Nova Scotia has one of the oldest populations in Canada. One in five Nova Scotians is on the shady side of 65, the highest rate in the country, and the median age of about 44 is the second oldest in the country. As we age, most of us will require more medical attention.
Why the McNeil government and its creation, the NSHA, would risk alienating doctors, when a glance at the province’s population data would tell them Nova Scotians need those doctors now more than ever, is unfathomable. But they didn’t just risk it. They went ahead and did it.
Yet, there may still be hope. The NSHA is making sounds that suggest it realizes the error of its ways and wants to reset its relationship with docs. A good first step in that direction would be to stop hassling docs who speak out publicly about matters that affect their ability to treat patients.
That would be good advice for Premier Stephen McNeil, too. He hopped up on his bully pulpit not long ago to publicly pummel a doc who’d done just that.
If there’s good news for the NSHA in the survey, it’s that this one sets the benchmark against which physician “engagement” will be measured in the future. It’s next to impossible to do worse, so improvement is almost preordained.
The authority says it planned to communicate the survey’s results to doctors to “help facilitate the beginning of establishing trust,” but sat on the thing too long, for a bunch of reasons that only make sense to the NSHA and, predictably, it leaked out. The survey was shared with the NSHA board in November. That might have been a good time to include the docs, too.
Nova Scotians need their doctors, and the system needs them engaged.
The provincial government and the NSHA broke trust with docs. You break it, you own it. And Nova Scotians expect them to fix it.