Environmental Scan - Government of Nova Scotia

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PHYSICIAN SUPPLY• Medical EducationPhysician Resource PlanningAn Environmental Scan− Child and adolescent services all linked to the department – available resource pool limited withone (1) new Child Psychiatrist completing training every 4 years− Clinical: Academic ratio is currently 81:19 with a goal of 70:30− Dalhousie the Atlantic training centre for seniors, children, and forensic• Research−−The addition of excellent younger faculty with a keen interest in research and education, both inCDHA and at the IWK Health Centre, has had a positive effect. This cadre of younger faculty isbeginning to develop independent and joint research activities that hold great promise for thefuture, if the Department can help develop their potential with mentorship from senior clinicianresearchers,protected research time, and the space and facilities needed to develop their researchprograms.The Brain Repair Centre initiative, in which Department faculty members have been activeparticipants, has the potential to transform research and clinical care in the Department. But futureprogress in this initiative for the Department depends on having nationally recognized researchersand clinician-researchers with sufficient time committed to research.• Specific Disciplines− Implemented 6 or 7 new positions over past 5 years− Six (6) new Psychiatrists scheduled to arrive over next six months− Ratio analyses would support a cohort of 40-50 Child Psychiatrists in Nova Scotia – they have 19 –IWK and CDHA funding is AFP – none in Yarmouth and 0.5 in Sydney− Forensic Psychiatry all in CDHA with 5.0 FTE – this is about the correct number – these five alsohandle the Psychiatry ICU− Geriatric – would like to expand to 8− Three (3) acute care units (7.0 Psychiatrists) – one (1) short stay unit – one (1) ED Psychiatry service– one (1) mobile crisis teamThe Department AFP reports 74.97 FTE at July, 2011 in CDHA (59.92) and IWK (15.05). The Consultant analysisprovided earlier calculated 86.5 FTE at March 31, 2010. The difference may be attributable to a combination ofthree causes; timing, members in/out of the AFP, and some, usually community-based, psychiatrists notassociated with the DFM.Figure 205 Psychiatrist FTEs – CDHA and IWK at July, 2011SUPPLEMENTARY DOCUMENTS1. Hub and spoke Psychiatry service diagram264 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
Physician Resource PlanningAn Environmental Scan2. A Framework for a Mental Health Strategy for Canada3. Child Psychiatry in Canada: Physician Resources4. Issues for Recruiting Psychiatrists to NS DHAs Outside Capital Health5. Other: Psychiatry Complement 2011, CDHA Seniors' Mental Health Program 2011, Department ofPsychiatry: Notes on Programs and Services 2011, suggestions from DFM Department of Psychiatry onDeveloping a Physician Resource Plan for Nova Scotia, and Funding Mental Health in Europe26.3 Diagnostic Services26.3.1 PathologyInterview DFM Chair Department of PathologyPOPULATION NEED• Health System Design−Starting from a position of scepticism founded in past history and inertia in planning laboratoryservices in the province• Infrastructure−IWK and CDHA had engaged earlier regarding a shared services model and unified laboratoryinfrastructure and governance – planning process was unsuccessful and discussions concluded –makes contemplating the specialty as a provincial resource even more challengingPHYSICIAN SUPPLY• Specific Disciplines−One key issue is a single Pathologist in Dartmouth doing 9,000 surgical cases annually, mostly inisolation – not logical and makes succession planning difficult – why isn't there an integration withCDHA?Submission (Document) - Chair of Department, Approach to PRP (August, 2011)Provided by Godfrey Heathcote as a collective submission on behalf of colleagues who head anatomicpathology (Laurette Geldenhuys), haematopathology (Irene Sadak), medical biochemistry (Bassam A.Nassar), medical microbiology (Kevin Forward), &paediatric pathology (Tim Mailman).Principles1. In the current fiscal climate some degree of rationalization of laboratory services within the provinceseems advisable in order to promote long-term sustainability.2. Participation by all pathologists and laboratory physicians in appropriate internal and external qualityassurance schemes is necessary to guarantee high quality services.3. There should be transparency about workload and remuneration.4. The number of adult tissue pathologists in any site should be based on workload figures, the simplestof which are derived from the Royal College of Pathologists UK:• 1800-2400 surgical pathology cases per annum for a teaching-hospital pathologist;• 3000-3500 surgical pathology cases per annum for a community pathologist.265 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011
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INCIDENCEPhysician Resource Plannin
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Environmental Scan - Government of Nova Scotia

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