Environmental Scan - Government of Nova Scotia

Submission (email), Chief of DivisionPhysician Resource PlanningAn Environmental Scan• Current counts are 3 in Kentville, 2 in Sydney and 2 in Truro. Sydney had 3 and requires additionalnow. Kentville is fine. The south shore (Shelburne to Bridgewater) flows to Halifax.• Halifax currently 8 adult in Halifax. Previously 9 and requires additional now. 3 paediatrics at IWK.Dartmouth has 2 adult.• Generally 1 to 40-50K of normal population distribution. NS is quite top heavy in the agedistribution. Also the age of the practicing urologists in Halifax is only 4 under 50• Support 3 per centre for call purposes:− Kentville 3− Truro 3− Dartmouth 3− Sydney 3− Halifax• Paediatrics 2-3 (best for call but currently rotating with Paediatric surgery and some crosscoverage from the adult guys)• Adult - 10 FTE to allow some academic commitment26.5.6 Vascular SurgeryInterview Co-Director, Provincial Cardiovascular Health Program−−−−−−−−−−Interventional radiology will not have an impact on vascular surgery (unlike cardiac surgery)Important difference between cardiac and vascular is that cardiac referrals come from onlycardiologists – hence, operative: consultation ratio is much higher for cardiac surgeonsMarket place confusion over who does varicose veinsCurrently, overall numbers are about right:CDHA – 3.0 FTE plus 2.0 cardiac surgeons who do some vascular plus 1.0 locum tenens vascularsurgeon from PEKentville – two 0.75 FTE with balance being general surgery – one of the vascular surgeons still doestravel clinics (Yarmouth and Lunenburg)Sydney – 1.5 FTENeed will change if one or both Kentville surgeons goes full-time vascular (spin-off effect on generalsurgery) plus the provincial impact of agingAVH tends to keep patients with higher acuity rather than transfer to CDHABridgewater vascular work goes to both CDHA and AVH• Need for organizational change (not FTE change until variables above come into play:−−−Dollars follow patientsProvince should have "vascular boundaries" that define who goes where and includes obligationsfor travel clinics for all sites – travel clinic time requires payment for time and mileage as wellTherefore, CDHA. CBDHA, AVHAdvances in technology have also led to increasing overlap between the traditionally distinct specialties ofinterventional radiology, cardiology, cardiac surgery and vascular surgery. Interventional cardiology, cardiacsurgery, vascular surgery, and interventional radiology exhibit an ever-increasing degree of overlap among thetype of patients and conditions treated, and the tools used in diagnosis and treatment.278 | Page Social Sector Metrics Inc. & Health Intelligence Inc. | 12/31/2011