Opening remarks for provincial health committee on physician recruitment

Remarks by Dr. Nicole Boutilier, Vice-President of Medicine
Nova Scotia Health Authority
Health Committee – Physician Recruitment
(check against delivery)

Good afternoon. My colleagues and I are pleased to be here to meet with the committee.

As a physician, I know how important it is to have access to the right care, in the right place, at the right time.

As Dr. Marrie has mentioned, teams and physicians continue to provide quality care across the province but access continues to be a challenge for some Nova Scotians. 

Our population is growing and the demands on our health care system are changing as people in our province are aging and medical problems are becoming increasingly complex.

Additionally, more people are leaving the health workforce through retirement than entering.

These challenges did not evolve overnight and solutions require strategic and measured efforts from all stakeholders. Adapting to these changes across the system takes time to produce results.

Primary health care is the foundation of the health system. For the last few years, we’ve been working to create more collaborative family practice teams and strengthen existing teams across the province.

Today, there are more than 80 collaborative family practice teams. To support these teams, we have hired more than 130 allied health professionals, one of the largest investments in front line care in the history of the province. Collaborative teams offer comprehensive, coordinated and accessible care for their patients.

Many newer doctors, nurse practitioners, and other primary health care providers have been trained in team-based care and look for opportunities to work as part of a team. Evidence and experience agree that this model improves health outcomes and helps us recruit new care providers. 

Working with communities and our partners, we have recruited 130 doctors in the last fiscal year; that’s a 26 per cent increase from the year before. Fifty-eight of these were family doctors. Since 2016, we have recruited 385 doctors to the province. The College of Physicians and  Surgeons has reported a stable number of active licenses since 2015.

While we have seen success in our recruitment efforts, we will continue to focus our efforts and evolve our strategies to overcome identified challenges. Demand for health professionals is increasing globally. 

We are competing nationally and internationally to recruit. It is important to note that the need is not limited to doctors. Nursing and other staff vacancies are challenging to fill, especially in rural areas. 

Today, we are working to fill more than 80 family medicine positions and 90 specialist positions. There is more to this story than the numbers. Unfortunately, it is not as simple as just hiring more doctors. If we were simply able to drop a doctor into every open vacancy tomorrow, it would not guarantee access to care in the right place for all Nova Scotians. 

This underlines the importance for community-level strategies.

Physician recruitment was transferred to Nova Scotia Health Authority in July 2016. 

In 2017, we provided our first recruitment strategy, which set the benchmark. Since then, we have engaged external expertise and built partnerships to extend our presence in Canada and in jurisdictions where we have a competitive advantage. 

We now have a sophisticated brand and a website, tools in place to represent ourselves out on the road, and improved processes and partnerships. In this short time, we have grown our recruitment team from three employees to eleven. 

This includes two recruiters in each zone, two administrative staff members, and a director who ensures strategic focus and evaluation remain a priority. 

Our recruitment and marketing plans are grounded in engagement with physicians and partners.

We market our opportunities with information provided to us from physicians about what they find rewarding. 

Relocating for any career is a huge decision. We are not simply pitching positions or hospitals to doctors, we are working to match them with a community. This is a decision that impacts their whole family. 

We have increased our focus on international recruitment — doctors from abroad account for about 20 per cent of the new doctors who have started practice in last year. 

We have increased our focus on licensing and immigration with our partners at the College and Nova Scotia Office of Immigration. Since 2018, 31 of the doctors entering the province’s Immigration stream were from the UK and Ireland. 

We have also increased our campus visits with residents at medical schools across Canada and doubled our attendance at national and international career fairs. We have created a position to focus specifically on medical students training here in the province, which came about through work with our partners. 

Recruitment is the work of many partners. Our plans are enhanced by the interest in this work by many groups that have value to bring. We must work together as a province, and we are. 

Physicians have always been front and centre in the work to recruit other physicians. We know that peer connection is crucial. We have been working to better embed doctors in our processes and they are key members of our team. 

Physicians travel with recruiters across the country and internationally to events and job fairs. They offer testimonials that we use to promote our province. They host events to welcome new medical staff and physician leaders have been an integral part of the formation of community recruitment groups.

We have a provincial Physician Recruitment and Retention Advisory Committee that is made up of many partners: the Department of Health and Wellness, the College of Physicians and Surgeons, Maritime Resident Doctors, the College of Family Physicians, Nova Scotia’s Office of Immigration, Dalhousie University, Doctors Nova Scotia, the Nova Scotia Federation of Municipalities, as well as representation from community groups and health foundations. 

This committee works together on opportunities to use shared knowledge and resources to improve recruitment efforts. 

Our recruitment team also works closely with community leaders to tour interested doctors around the province. These groups have done great work welcoming physicians and their families for site visits and into the community. 

Hosting a welcome event for new physicians is as important as sharing details on practice opportunities and call schedules.  These actions, large and small, are meaningful. They make an impact.

Our progress with recruitment and establishing more collaborative practice teams has been making a difference for Nova Scotians. More than 110,000 people have found a family doctor or nurse practitioner since we began tracking this information almost three years ago. On average, about 6,300 people have found a family practice each month over the last year.

There is still much more to do, and we continue to recruit every day. As we move forward together, we look forward to sharing future updates on our progress.