Environmental Scan - Government of Nova Scotia

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Physician Resource PlanningAn Environmental ScanCONSULTANT NOTATION – Because of the volume, detail, and timing of the information a summary only isprovided in the Appendix under ‘Detailed Submissions’.Figure 204 DFM – Department of Medicine – FTE Summary 2000 to 2010/11 by DivisionInterview - Chief of Division of CardiologyPOPULATION NEED• Emergency Care• Lower threshold for intervention significant utilization driverHealth System Design• Historically, PRP has simply tracked the term of the extant AFP• Wait lists improved since 2009/2010, due in part to NP clinic managing propriety of consultations –new consultations decreased from 1,200 annually to 700-800Infrastructure• No cardiac catheterization other than CDHA• Echocardiography limited to hospitals – without a change, recruitment will be impeded• Echocardiography, and stress tests are provided in CDHA, Dartmouth, and Cobequid256 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
Physician Resource PlanningAn Environmental Scan• CVSNS is more a monitoring program than an operational program – this needs to change and be aDepartment of Health and Wellness programSocial-economic• Cardiovascular disease is the number one cause of mortality in Nova Scotia• Service provider from PE, as well – look at reciprocal billing data• Aging population is a significant utilization driverPHYSICIAN SUPPLY• Critical mass−−Growing need for interventional careUsing billings, ECG numbers, and catheterizations as proxies for service, the Cardiology workloadhas increased by 20% since 2005• Specific Disciplines−−−−−−Currently 18.0 FTE Cardiologists constituted by 30 Cardiologists in totalEight (8) of the Cardiologists are interventionalists who work 1 in 8 and steadily when on callAverage age of interventionalist group is 45 years – usually stop at 55 yearsRequire one additional interventionalist now and another two over the next five yearsCoronary incidents had mortality rate of 20% in the 1980s – fell to 12% in the 1990s with the use ofthrombolytics – fell to 4% in 2005 with lower intervention thresholds and improved techniques forangioplasty and stentsTwo Cardiologists in Dartmouth – most communities are served by Internists with an interest inCardiologySUPPLEMENTARY DOCUMENTS1. Department of Medicine Survey Committee – Report from Cardiology 20102. Department of Medicine Quarterly Report, Division of Cardiology March 20113. Universal Access, but When? Wait time benchmarks for cardiovascular services and procedures4. Nova Scotia Manpower Resource Plan for Physicians 2011SubmissionSummary• Division provides primary and secondary cardiology to CDHA and the Province• Division provides tertiary cardiology to the Province and PEI.• Provide quaternary care services in highly specialized areas such as advanced Electrophysiology,congenital heart disease, structural heart disease, heart transplantation and ventricular assist devicesfor the entire Atlantic Provinces.• MSI requires all advanced cardiac electrodiagnostics such as echocardiography and stress testing needto be provided within the walls of a recognized hospital institution.• Open heart surgery wait times remain within standard; however, wait times for cardiac catheterizationand PCI have drifted above standard.• The addition of the NP Clinic has had a substantial impact on the wait times for new Cardiologyconsults.• The situation in Nova Scotia is accentuated by the lack of qualified general internists or Cardiologysubspecialists working in the community and dealing with everyday bread and butter patients withcardiovascular disease.• Specific recruitment requirements by subspecialty are identified in the Detailed Submission.257 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
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Physician Resource PlanningAn Envir
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3 KEY OBSERVATIONS3.1 IntroductionP
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KEY OBSERVATIONSPhysician Resource
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7 CONCEPTUAL MODELS7.1 Methodologie
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Figure 23 Population per Physician
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INCIDENCEPhysician Resource Plannin
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PHYSICIAN SERVICESPhysician Resourc
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12.5 Renal DiseasePhysician Resourc
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PRIMARY CARE NETWORK - COORDINATED
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Environmental Scan - Government of Nova Scotia

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