Last week, Nova Scotia’s doctors accepted two new four-year agreements with the provincial government. The new physician contracts represent a significant investment in the province’s health-care system and are a meaningful start toward improving patient care and physician retention and recruitment – in other words, keeping the doctors we already have, and enticing others to come work here.

Better support for essential work
Physicians provide a wide variety of care in a wide variety of settings, and some of that work, such as paperwork and other administrative tasks, often happens in their off-hours. The new contract delivers a 10% wage increase (spread over the next four years) as well as new payments for work such as consulting with other doctors about patient care, travelling to work in other health-care facilities and doing administrative work. Physicians in private practice will also receive payments (based on the number of patients they care for) to help cover overhead costs.

Addressing the burden that overhead places on small-town family physicians will be a meaningful way to make community family practice more attractive, says Dr. Alison Wellwood, a family physician in Wolfville. Overhead costs and the responsibility of running a business can push new medical graduates away from community family practice, but having help covering those costs makes family practice more attractive. At a time when more than 150,000 Nova Scotians are on the Need a Family Practice waitlist, this is an important way to help get more physicians practising in small-town Nova Scotia.

Care across the lifespan
Another part of the new contracts is a new payment model. The Longitudinal Family Medicine model emphasizes the importance of providing patient care across the lifespan, no matter how simple or complex the patient’s needs might be. It’s another way of helping to retain and recruit much-needed family physicians in Nova Scotia, while ensuring Nova Scotians get the care they deserve.

Training the physicians of tomorrow
The new contracts also include increased remuneration for physician preceptors – that is, the payments that physicians receive when they supervise medical students and residents. This important work is crucial to both properly training physicians of the future and to recruiting physicians to Nova Scotia’s smaller communities. It means that you might be more likely to see medical learners in your doctor’s office in the future – and more likely to see new physicians settling in and working in your community.

Planning for the future
The new Physician Agreement also includes three big changes that will help physicians plan for their futures and those of their patients. A new locum program will take steps to ensure that physicians who must leave their practices for additional training or medical or other leave will have someone to step in and care for their patients while they are gone. A major investment in parental leave ensures that physicians will be able to take longer to care for their newborn babies – which should make practising in Nova Scotia more appealing to young physicians with new families.

The third investment is a program that allows soon-to-retire physicians to overlap their work with new-to-practice physicians. This allows the retiring physician time to train their replacement, giving the younger physician time to learn more about the patients and the practice.

The crossover approach doesn’t just benefit patients – it also helps both the outgoing and the incoming physician. Receiving support and mentorship from the outgoing physician helps a new physician adjust to the patients and the practice community, retaining them long term, says Dr. Cathy Connell, a recently semi-retired family physician in Halifax. “We are there as ongoing support, so we can help them with referrals in the city and answer any questions that come up.”

Looking ahead
Although the new contracts can’t solve every issue with the provincial health-care system at once, they do represent a big step forward on many of the issues that affect us all. These contracts are good for physicians, good for patients and good for the health-care system.

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