Time's up: Minister falls far short of target to eliminate doctor wait list

It was six months ago that Health Minister Dorothy Shephard said her department was taking over recruitment from the regional health authorities, and focusing on the elimination of the wait list for primary care.

Shephard told CBC on April 12, 2021, that her "100 per cent goal is to give every New Brunswicker a primary caregiver" within six months.

Unfortunately, the number of patients on the wait list for a family doctor or nurse practitioner remains over 40,000 people, with at least two family doctors in Fredericton leaving with no one to replace them. 

At the end of last year, 44,226 people were registered with Patient Connect New Brunswick, which pairs residents with a family doctor or nurse practitioner. Now that number sits at 40,304.

Shephard was not available for an interview.

In a statement a spokesperson said the Department of Health is "actively working…on an innovative solution to connect all patients who are waiting for a primary care provider," but no details were given.

The decrease of 3,922 patients comes despite the fact that 22,508 people have been matched with a primary caregiver between January and August, according to the Department of Health.

In May, the department said more than 2,000 new names are added each month to the wait list. 

Doctors leaving, patients added to list

Dawn Mockler of Fredericton isn't surprised the numbers aren't budging much.

She recently contributed five names to the Patient Connect list — herself, her husband and her three children — after a letter arrived in her mailbox explaining that their family doctor was leaving the city, and a replacement hadn't been found.

"On top of everything else going on it was kind of like a punch to the gut," she said. "You realize you've become part of the orphans that are kind of lost and floating and having to rely on clinics or after-hours emergency rooms for just routine things."

Mockler, who had thyroid cancer a few years ago, isn't sure how she will manage her prescriptions when her doctor leaves in December.

She discovered a small lump in her neck that turned out to be cancer, and said she might not have gotten it checked if she had to go to an after-hours clinic.

"My thing is always thinking, 'Oh no — I don't want to go sit at the after-hours clinic, I might catch something worse than what I'm going for.'" 

As a physiotherapist, Mockler has also seen her patients ignore health concerns because they don't have a primary caregiver.

"I think there are people now that are doing that, that are just putting things off and waiting until the signs and symptoms are more severe. And that's not a good place to be, that's not a healthy population."

In Fredericton alone, at least three family physicians are planning to close their practices by December and according to letters provided to CBC News, only one has a replacement.

New Brunswick as a whole has 130 vacancies for doctors, according to the medical society.

Mockler's doctor, Mohammad Khaleduzzaman, said in his letter to patients that he will close on Dec. 20, 2021.

"Regrettably, I have been unable to find a replacement," he writes. In the meantime, Khaleduzzaman suggests patients add their names to the Patient Connect wait list.

In a letter to patients dated July 19, 2021, Dr. Aaron Digby said his Fredericton practice would close on Oct. 22, 2021,  because he wants to "pursue work in another area."

He too has been unable to find someone to take over.

"I have truly enjoyed working here since 2009, and I have developed strong connections with many of you over that time. That makes leaving especially difficult."

CBC News contacted the offices of Digby and Khaleduzzaman to ask about their reasons for leaving, and the challenges of finding replacements but was unable to reach them.

Question of who leads recruitment mired in tension

Back in April, Shephard said she had heard complaints from family doctors who wanted to come to New Brunswick to practise but didn't "even get a call back" from the regional health authorities.

"That's why we've taken recruitment into the Department of Health to lead it, working with our partners at the [regional health authorities] and the medical society and our associations. I have not been satisfied with our recruitment process," the minister said at the time.

Those comments spurred criticism from then chair of Horizon Health Network, John McGarry. He said he was "perturbed" by Shephard's suggestion the Health Department could do a better job at recruiting doctors to New Brunswick.

McGarry was fired by Shephard two weeks later and in an interview afterwards called Shephard's criticism of recruitment efforts by Horizon a "cheap shot."

• Health minister fires vocal chair of Horizon Health board 
• Former Horizon chair takes firing in stride — but not health minister's 'cheap shot'

Despite the tension between Horizon and the Department of Health, Dr. Jeff Steeves hoped Shephard's commitment to eliminate the Patient Connect wait list within six months would lead to positive changes.

'We haven't had meetings about recruitment at all'

In April, Steeves, who was then president of the New Brunswick Medical Society, said doctors in the province were ready to start working "immediately" with Shephard to achieve her target.

At the time, he said it was encouraging to hear a "hard goal" with measurable outcomes.

"I think it's fantastic that there's a line in the sand now and that there's a time frame," he said. "I think it is ambitious but that's what we need at this point."

Six months later, however, his cautious optimism has turned to concern.

"In terms of recruitment, not much has happened at all," Steeves said, explaining his hope was that officials from the Health Department, the regional health authorities, family doctors and community leaders would get together to talk about how to attract primary caregivers.

"That is what we were envisioning — a table of concerned parties that can … say, 'This is why people left, let's address that.' We don't have that.

"We haven't had meetings about recruitment at all."

In a statement, a spokesperson for Shephard said the Department of Health is "actively working with physicians and the New Brunswick Medical Society on an innovative solution" to solve the doctor shortage, but no details were provided.

Steeves wouldn't comment on what that solution is, saying he expects it will be released by the government in its upcoming health plan.

In the meantime, work to come up with long-term solutions to prevent doctors from leaving, and to lure new doctors is, in his opinion, lacking. Steeves points to Montreal, Toronto and Vancouver as some of the most attractive cities for doctors.

"There, if you're a patient, you can go to a clinic, you can be referred to a specialist and get seen very readily because the proportion of physicians to population is much, much higher than in rural areas," he said.

"In that sense, we are entirely rural. So the Maritimes really should get together to come up with a plan to say, 'How can we get physicians here globally?' And try to sell our area better — both as New Brunswick but also as a Maritime province."

When asked whether any progress or gains have been made when it comes to recruitment in the past six months Steeves said, "No, we haven't moved that forward at all," and added it is up to government to lead those efforts.