Nova Scotia walk-in clinics face doctor limits

The Nova Scotia Health Authority is limiting doctors from working at walk-in clinics, a move the opposition calls irresponsible.

A health authority document distributed to doctors at a recent meeting in the Halifax area says "requests for new physicians to work in walk-in clinics will most likely be denied."  

It also said, "while physicians may continue to work in the clinics, doctors new to the province will not be permitted to work only in the clinics."

The move is part of the health authority's decision to transition to collaborative care, according to Dr. Lynne Harrigan, vice president of medicine for the authority.

"Care that's provided in walk-in clinics is not the ideal, so we want to focus our limited resources on team-based care," Harrigan said.

"We know the best care patients can receive is from team-based care with a family doctor, nurse, nurse practitioner, dietitian, psychologist, etc."

Trying to build up that system, she said, is a long-term process that will take five to 10 years.

She said a transition is needed from the current system to the collaborative one and the authority is looking at how to do that without being "draconian."

She said the new model may see walk-in clinics provide after-hours coverage for a clinic, but the authority plans to discuss the issue with doctors. 

Walk-in clinics needed

But NDP health critic and former health minister Dave Wilson said limiting the number of doctors at walk-in clinics doesn't make sense.

"There are huge voids in communities across this province that don't have access to a family physician, and a walk-in clinic really is the only way for many of them, thousands of Nova Scotians, to get the primary care that they need," Wilson said.

He calls the move "irresponsible" because the government does not have an alternative for patients in place.

"I think the government needs to revisit that move and hopefully ensure that people have the access to a family physician or primary care personnel before they restrict the ability of people to practice," he said.

He said the province hasn't opened a collaborative clinic in the past two years. The move to limit doctors from working at walk-in clinics will hinder the province's attempts to recruit and retain physicians, he said.

Walk-in clinics will stay

Health Minister Leo Glavine said there will be changes over time, but walk-in clinics remain part of the health-care system.

He said the goal — a challenging one — is for everyone who wants a family doctor to have one. 

Glavine said Halifax has the second-highest doctor-patient ratio in the country, adding that if one thing is moved out of the delivery of health services it will be replaced by something else. 

He said the government has opened a collaborative practice in Digby, announced another in Shelburne and several other communities are working on developing a team approach.