DIGBY, N.S. – It is with mixed emotions that we will be leaving Digby at the end of November. We felt compelled to share a few things that we have learned from our time in Digby and to give our perspective on why we chose to leave.
First, Digby is a great place in which to work and live for providers who can come with their families. This is a beautiful community with oceanside living and incredible sunsets. Many of the people we have met are genuinely warm and friendly. The hospital and clinic staff are top-notch and wonderful to work with.
We’ve also received strong support from our colleagues in Yarmouth, Annapolis, and Kentville. As family physicians, we enjoy a scope of practice here that would be difficult to have in a larger city. We have been warmly welcomed and strongly supported by the local Digby Hospital Foundation, a local charitable organization. They have partnered with us on recruitment efforts and continue to do great work.
The Nova Scotia Health Authority (NSHA) has also worked closely with us to try to maintain better work life conditions despite the heavy workload and too few providers.
We have worked tirelessly for this community since arriving last September. We have spent long hours working in clinic, covering the large majority of the hospital inpatient service in order to keep it open, providing obstetrical coverage which includes Digby patients, and working multiple shifts in the emergency department every week.
Much of this work was done above and beyond our contracted hours. We have taken on many extra nights and weekends without pay and sacrificed time away from our families to serve the population of Digby.
All of this work has been difficult and busy yet rewarding because we understand that the community greatly needs better access to healthcare services. The population in Digby includes a large elderly population with complex medical problems that require extensive and thorough care. We deeply enjoyed getting to know our patients and working with them to sort through their medical issues one by one. We are sad to leave them.
READ MORE LETTERS TO THE EDITOR:
Although we have encountered many positive aspects of working in Digby, we feel compelled to address some of the recent misconceptions that have been thrown about, both publicly and privately, related to our leaving.
Many people may not understand that we were never recruited to Digby. Both of us completed medical school in Dublin, Ireland, and were subsequently required to sign a return of service contract to Nova Scotia when we entered residency training through Dalhousie. We were given a list of six underserviced towns to choose from and we chose Digby because of the understanding that there would be four physicians starting together, which no other community offered.
Due to unforeseen personal circumstances, only the two of us were able to come and stay. We were never given any bonuses or incentives to come here. Specifically, we were ineligible for any rural incentives from the province or from the municipality. Neither of us have family or a support system in Digby. Dr. Bourget’s family lives in Hatchet Lake and Dr. Chang’s husband lives between Saint John and Halifax, with her family being in Toronto.
For all of these reasons, we are grateful that we will now be completing the remainder of our return of service contracts in the Central Zone. We are not breaking our contracts but instead will continue to address the needs of an underserviced population there. The areas where we will practice are also in dire need of primary care. We chose to transfer in order to be closer to our families, and not for any financial reasons as our salaries will not be higher in the Central Zone. We will continue to work in Nova Scotia and look forward to being reunited with our families, friends and being closer to our support systems.
We truly believe that the key to recruitment and retention of primary care providers lies in attracting locums and physicians who have roots in Digby or the surrounding communities. Basing residency programs in more areas of rural Nova Scotia is one way to encourage this, as is facilitating mentorship from more established physicians locally.
Support for physicians with spouses or families is equally important as well.
Our Nurse Practitioner colleagues are also providing high quality primary care to a large number of people in Digby and the Islands, and there are ongoing efforts to recruit more NPs. The Digby Hospital Foundation has made tremendous strides to help with recruitment and represent a committed group of citizens working with physicians towards a common goal of better access to quality healthcare.
While we strongly support citizens advocating for the healthcare of their community, a minority of people have unrealistic expectations and continue to advocate in a negative way. They have been discouraging to us and to other healthcare providers since our arrival and continue to be so as we plan to depart.
They do not take into account all the challenges inherent in providing quality healthcare in a resource limited setting, nor what it takes to keep a clinic or a hospital open. Their actions and attitudes have made it difficult to attract more physicians and NPs. Unrealistic expectations and failure to recognize the importance of family support contribute to physician burnout. More conversations need to be had to help them become more effective in advocating for their community.
We will be leaving Digby at the end of November, but we remain hopeful for this community. It has been a privilege to get to know the kind, resilient, and strong people that live here and to have had the opportunity to serve in Digby.
Dr. Jennifer Chang and Dr. Genna Bourget