Canso considers health-care future amid ongoing staffing issues

Dr. Luke Dobek is exactly what the town of Canso on the eastern tip of Nova Scotia needs. The problem is, there isn't enough of him.

For eight years, Dobek, 44, has worked as part of the medical team that provides primary and emergency care for the residents of the historic fishing community.

"I've worked all over the province and I was just looking for the perfect little place," Dobek said in an interview.

"It's beautiful and the people are wonderful … And now that I'm here, I feel a personal commitment to help the place out, even if conditions are becoming less favourable."

In some ways, those less favourable conditions were inevitable. Like most rural communities, Canso has struggled to attract and retain health-care professionals.

A recent doctor departure has left just Dobek and Dr. Chris Milburn to provide complete care for the community when each is working. Without a third doctor, it means 10 days of each month have no emergency or primary care coverage.

It's not only doctor availability that's created problems. The community is awaiting the arrival of a family practice nurse and Dobek and other nurses in the community say they've watched over time as the availability of paramedics has also decreased.

"It's difficult to get [an ambulance] and usually the patients have to be more critically ill, otherwise you're waiting sometimes six hours, sometimes eight hours," said Dobek.

It's with all of this in mind that officials with Nova Scotia Health held a community meeting in Canso Tuesday to discuss potential options to provide more sustainable service as recruitment efforts continue.

The three-part plan would include the establishment of a collaborative care clinic, an urgent/emergency clinic and enhanced paramedic coverage for times when the emergency department and urgent/emergency clinic are closed. The latter scenario could also include video access for nurses to an emergency department doctor associated with EHS, something nurses at the meeting and Dobek said is necessary.

Those options require help, however. The family practice nurse will need to be in place, a full-time nurse practitioner is required and recruitment efforts would need to continue for another doctor, even if it's one that focuses only on primary care and doesn't provide emergency department coverage.

Brett MacDougall, vice-president of operations for the health authority's eastern zone, said the proposal is about finding alternative models that provide more sustainable access to care, while continuing recruitment efforts.

MacDougall said he and his colleagues would review the feedback they received Tuesday from the community and staff at Eastern Memorial Hospital and determine what is possible.

"We're going to try and have to make the best use of the limited resources that we have and ensure that we're maximizing the care that we can deliver in these communities," he said in an interview.