Counting Sheep, not Docs

Counting sheep helps some people sleep.

Counting docs keeps people awake across Canada because there aren’t enough of them to go around.

In Nova Scotia, it seems, the government wants people to rest a little easier – to stop fretting about doctor-shortages and start counting on the broader health care system.

On April 14, Health Minister Michelle Thompson said the waiting list for family doctors in Nova Scotia (now at 140,000+ people) continues to grow.

This she said by way of introducing a new health dashboard listing other points of health care access – including telemedicine, mobile clinics, urgent care centres, urgent treatment centres, and primary care clinics.

Thompson also underlined her government’s commitment to providing primary care inside a system that is “transforming and evolving”.

There are unstated subtexts here – one, not everyone looking for a family doc will find one. Two, government is looking for a new way to define primary care success, because the idea of finding a doc for all is doomed to failure.

The Minister’s department will try to fill gaps in the primary care system by triaging people on the waiting list – the elderly and the infirm will presumably get first access to family doctors. 

In a sense, the Covid-19 pandemic prepared people for this kind of adaptation in health care delivery.  Telemedicine appointments were easier to manage for many patients than visits to a doctor’s office. Pharmacists, now licenced to prescribe medication for a narrow range of ailments, ably stepped in to administer vaccines.

Still, Thompson faces two major challenges as she tries to nudge the health care system towards a better future.

One, many Nova Scotians expect to have a close relationship with a family doctor they trust to manage their care inside a complex system.

In this context, her new dashboard is designed to test the public appetite (or tolerance) for a new model of primary care that relies less on docs-that-can’t-be-found.

Watching this saga unfold from the CrowNest, we think her tougher task is turning around the giant vessel known as the health care system.  

Triaging patients on a waiting list of 140,000 people is both a sound idea and a daunting challenge.

Thompson, a Registered Nurse herself, knows she will be judged not for conceiving of good public policy, but for delivering on its promise.

Still, you’d have to be churlish to wish her anything but Godspeed in her mission.