N.S. losing doctors on moonlighting contracts

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HALIFAX - Nova Scotia physicians are concerned that other provinces, including Ontario, are luring emergency room doctors away on lucrative short-term contracts.

HALIFAX - Nova Scotia physicians are concerned that other provinces, including Ontario, are luring emergency room doctors away on lucrative short-term contracts.

In the last year, emergency room doctors in such centres as Halifax and Truro have left for varying periods of time to work in hospitals in Ontario, New Brunswick and Prince Edward Island.

Better pay and extra incentives - including free accommodation - is partly what's creating this new class of travelling physicians. But at least one emergency room head says better working conditions are also drawing doctors away.

"We're still not dealing with our overcrowding and wait times as well,' said John Ross, head of emergency medicine at Halifax's QEII Health Sciences Centre.

"From a competitiveness point of view, Nova Scotia has fallen behind," Ross said, who called the emergence of the itinerant doctors a new trend as physicians shop around to find hospitals that aren't overcrowded, backed-up and where they may not have to work all night for lower pay.

He said if the discrepancy in pay remains between provinces, it will cause more doctors to say, "I can go for a week to Ontario and that would be the equivalent of working two or three weeks here. Well, why wouldn't I do that?"

The rate of remuneration among other provinces, "pretty well every province west of here," is significantly different, said Ross. "Certainly for people who have fewer attachments and are a little bit more mobile, it's easier for them to go away for a short period of time and get compensated significantly better."

Frank Lussing, executive director of physician and pharmaceutical services with Nova Scotia Health, said doctors travelling out of province on short-term contracts wasn't anything new and had been going on for a long time.

"I'm not sure in fact whether it's a major issue or problem," Lussing said. "I'm not sure about the extent of the problem, if you can characterize it that way."

Lussing acknowledged other provinces are paying more for emergency doctors than Nova Scotia, but called reports he'd heard of physicians going elsewhere to work "isolated."

However, Lussing said such incidents are not ideal and that the province would prefer that physicians to connect with a community and a hospital and make a commitment. "That, I think, describes the vast majority of physicians."

Lussing said if a public policy problem emerges that needs handling, the province would act. "For the moment, I'm not convinced based on what I'm hearing that it's a generalized problem. But it's not a problem you want to be complacent about."

Mike Howlett, head of the emergency room at the Colchester Regional Hospital in Truro, called the short-term contracts a large and chronic problem that's causing ongoing staffing shortages. "It's just gradually ramping up over the last year and now with the rural closures in Nova Scotia it's become more of a prominent issue."

Howlett estimated New Brunswick and Ontario's rates are 20 per cent higher for emergency room staff. An emergency room physician in Nova Scotia earns about $130 an hour. In contrast, front-line staff in Saint John, New Brunswick get about $160 an hour, Howlett said.

Incentives for out-of-province doctors include payment of licensing fees, travel, and accommodation. "They make it attractive for people to come and help them out," Howlett said.

Howlett said Nova Scotia needs to make its doctors' pay competitive with others in Canada and that working conditions need to improve. "That doesn't mean we want to be the highest paid in the country, because we don't think that's realistic. But somewhere in the middle of the pack is where we need to be to be competitive."

Organizations: HALIFAX, QEII Health Sciences Centre, Nova Scotia Health Colchester Regional Hospital

Geographic location: Nova Scotia, Ontario, New Brunswick Truro Prince Edward Island Saint John Canada

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