Anger mounts as Sheet Harbour's ER closed 9 days and counting this month

This week, Tanya Malay will drive her 84-year-old mother from Sheet Harbour, N.S., to a walk-in clinic in Bayers Lake 130 kilometres away because she has no doctor and needs blood work.

"It weighs on my mind that there's no place for her to go that's within an hour," Malay said during an interview last week.

She's far from the only one with concerns. When word got out a reporter from theCBCwas on the way to Sheet Harbour to interview a few people last week, 65 people showed up at the agreed meeting place.

TerryHavlikhas been dealing with a heart condition for 12 years that requires regular hospital visits. It's not uncommon for him to be transported from the Eastern Shore Memorial Hospital in Sheet Harbour to the Dartmouth General Hospital,112 kilometresaway, when his needs are more pressing.

Havlikneeds regular doctor visits, but with no doctor, it can be weeks before he's able to see someone. Last year, he had a heart attack.

"We are facing a crisis in our community, but the whole province is having problems with health care and I've seen it first hand."

The challenges Malay,Havlik, their families and others are facing are due to a doctor shortage in the area, which has led to closures of the Eastern Shore Memorial emergency department with strikingregularity. When it's closed, the closest major emergency servicesare Dartmouth General or the Aberdeen Regional Hospital in New Glasgow.

There are also hospitals in the Musquodoboitarea:Musquodoboit Valley Memorial Hospital in Middle Musquodoboitwhich is about 45-minute drive from Sheet Harbour and provides emergency services from 8 a.m. to 8 p.m. daily. While Twin Oaks Memorial Hospital in Musquodoboit Harbour is 55 minutes away by car, its emergency department is open 24 hours a day, seven days a week.

This month, the emergency department in Sheet Harbour has beenclosed for a total of ninedays so far. On Wednesday, the provincial health authority announced it would also be closed beginningat 8 a.m. on Thursday until 8 a.m. on May 1.

Suspended medical licence

What's different about this doctor shortage, however, is there is a physicianin the community waiting to work.

Dr. Brad Atkinson has served the area for 25 years, but he's been unable to practise since June 2016, when the College of Physicians and Surgeons of Nova Scotia placed an interim suspension on his licence.

While the college's website provides no explanation for the suspension, a decision the year before notes Atkinson was flagged in 2014 for prescribing Tylenol 3 to a patient with knee pain and ordering morphine in 2015 for a long-term care patient he said was "actively dying." He was notpermitted to prescribe those medications.

He'd previously been ordered toimprove his knowledge of and skills in treating patients with narcotics, but the college determined Atkinson hadn't fulfilled that requirement.

An audit of Atkinson's practice found he needed to improve his recordkeeping, however a practice assessment "did not find that there were concerns with the clinical care being provided.His competence and knowledge were appropriate but he needed to properly document his care."

Attempts to reach Atkinson were unsuccessful.

Case not yet resolved

In a telephone interview Wednesday, Dr. Gus Grant, the college's registrar, said until the matter is resolved, the college cannot discuss what's happening.

Speaking in general, Grant said the college guarantees confidentiality to anyone who might file a complaint. That confidentiality is also extended to a doctor facing a complaint in the sense that unless an allegation is proved, it is not made public. The college publicizes all findings requiring discipline.

"A complaint is just an allegation, and until it's been investigated and adjudicated, it's just an allegation," said Grant. "Our legislation says that we shouldn't share that."

Remaining doctors busy

Meanwhile, the two full-time doctors in the area have had to pick up the slack. And while they've had help in the past froma nurse practitioner and another doctor, botheventually decided to go elsewhere.Right now the emergency department closures are necessary to give the two doctorstime off. Residents fear they're headed for burnout and perhaps even early retirement.

Catherine MacNeil said the situation is especially worrisome for the predominantly senior population in the area, many of whom simply don't have the means to travel more than an hour to seek medical care.

"They're stuck with what we have out there. And if it doesn't exist out here, what do they do? Why do we have to be made to feel like we're less than, or why do we have to worry about the 'what if' out here?"

And while there is frustration, there is also anger anger at the lack of explanations for what's happening and anger toward the College of Physicians and Surgeons of Nova Scotia, which some people here believe has been heavy-handedin Atkinson's case at the expense of those left without their doctor and a community with less emergency department access.

Annie Carver notes Atkinson's office started scheduling appointments again last month, only to have to call people back to cancel.

"Why isn't he here? We need him and he is a good, professional, caring doctor."

Understanding the frustration

Grant, the college's registrar, said he understands why people in the community might be upset and want answers, but the process the college follows prevents it from providing any information until things are complete.

The college "is not blind to the consequences"of taking a doctor out of a placesuch as Sheet Habour, he said,but Grant added that can't get in the way of the college's mandate to protect the public and maintain the standards of the medical profession.

"The college has not been drawn into the temptation to lower the standards or have a different lens as to what the appropriate standard of quality is for the profession in an underservicedarea as compared to a fully-serviced area," he said.

"We're aware of the pressures on these communities, but at the same time we have to protect the public."

Looking for more staff

Dr. Maria Alexiadis, the Nova Scotia Health Authority's head of family practice medicine for the central zone, said the expectation was Atkinson would be returning to work at the end of March. The health authority is now waiting for more information, she said.

"When the college has something, they will communicate it to us."

In the meantime, Alexiadis said the health authority is working on finding the right mix of health-care professionals for the community both for the short and long term.