Canso doctor, 72, calls for better succession planning

After practicing medicine for 47 years in Nova Scotia, Dr. Cathy Felderhof is looking to reduce her workload and take some time off.

But finding someone to replace her was a challenge.

For the past two years, she has been looking for a doctor to take on her role in Canso, on the eastern edge of the mainland of the province. She was unlucky.

She doesn’t want to leave unless a replacement family doctor is hired in the rural community she’s come to love over the past 17 years.

“It would be like leaving your children behind, you took care of them,” Felderhof said. “You’ve taken care of all the generations and you get to know them very well, so you want to be sure they’re taken care of.”

She helped treat the community of approximately 800 people along with two other doctors at Canso Medical Center.

They work on a one-week rotation. During the rotation, they are on call 24/7 as an emergency room doctor at Eastern Memorial Hospital across the street.

“We get calls overnight, not every night,” she said. “It’s hard work in the sense that I’m tired when I leave on the seventh day.”

The shortage of doctors has been a problem for several years in Nova Scotia. As of April 1, there were 88,359 Nova Scotians on the family medicine registry waiting list.

“My job is to take care of the patient”

Felderhof is not ready to retire, but she would like to take some time off this summer to consider the next steps. It’s something she’s never done in her long career.

“I can’t even remember the last time I took a week off to tell you the truth. It’s hard to walk away.”

She would like to see an improved succession planning strategy for physicians.

It’s been a problem for years, she said, and right now no doctors are scheduled to work the second week of May at Canso Family Medicine.

While willing to partner with Nova Scotia Health on community needs, she believes the recruitment model needs to be looked at.

“It’s not my job to do that,” she said. “My job is to take care of the patient, my training is to take care of people and their health concerns.”

She said she informed Nova Scotia Health two years ago that she planned to leave.

The nearest hospital to the fishing community of Canso is Guysborough Memorial Hospital, approximately 50 kilometers away. St. Martha’s Hospital in Antigonish is the nearest regional hospital, approximately 130 kilometers away. (Gareth Hampshire/CBC)

Dr Chris Milburn said moving to two doctors in the rotation creates problems even for a short time. Milburn was recruited from the region by Felderhof about two years ago.

“There’s been a week of patients who haven’t been seen, prescriptions need to be refilled, they might have had an ailment or pain or something major that they need to be seen,” a- he declared.

It’s not realistic for Milburn to work extra weeks. He has commitments in a law firm in Sydney.

He said one of his biggest concerns was the impact on emergency care in Canso.

“If we go down to two doctors, inevitably we’re going to have weeks where there’s no doctor here,” Milburn said.

He said the nearest hospital is in Guysborough and it can be 45 minutes away if the weather is bad.

Dr Chris Milburn is worried about emergency response if no replacement for Felderhof can be found. (Steve Lawrence/CBC)

Some people in the area have worked with local doctors to try to bring more attention to the problem.

“We’re just doing what we can as advocates for our community and this region,” said Bill MacMillan, who wants to see Nova Scotia Health make rural health care a priority.

“We are concerned about other communities similar to ours in the province of Nova Scotia where they have the same needs. Between 50 and 60% of Nova Scotians are served by rural clinics or rural hospitals.

Determine where doctors are most needed

Dr. Kevin Orrell, of the province’s new health professional recruitment office, said he identified succession planning as a key area to pay attention to when he took the job.

He said he was grateful for Felderhof’s commitment to his community. Work is underway, he said, on a strategy to determine which communities need new doctors in the province.

He said efforts are being made on several fronts to try to recruit doctors, including a $125,000 incentive for doctors relocating outside of Halifax.

“We have recognized for some time [that] rural medicine has been tough and replacing these doctors who have worked so hard in these areas is going to be a plan we need to launch moving forward,” Orrell said.

This plan could be similar to the one he helped put in place when he was president of the Canadian Orthopedic Association. This plan provided for experienced surgeons mentoring young doctors for several years.

Dr. Kevin Orrell is shown in September 2021 in a meeting with healthcare workers. (Robert Short/CBC)

Additionally, Orrell said he is in contact with Dalhousie University, in an effort to find medical students who want to train in rural areas. Research is also underway to find physicians across Canada as well as in other countries.

He accepts that these strategies take time but, in the short term, doctors who work as back-ups could also be considered for some places in need.

The healthcare recruiting office aims to hire 100 new physicians each year for the next 10 years.

Nova Scotia Health has posted a family physician position at Canso, but Orrell said two physicians may be needed given that many primary physicians are caring for a large number of patients.

Felderhof suggested that mentoring young doctors on the path to handing over a practice is something she says will work, but hopes new policies will be put in place soon.

“I have stated that I believe the situation is urgent.”