A cancer survivor lost her family doctor. Now she's pushing for better access to care
P.E.I. has no Practice-Ready Assessment program to license foreign-trained doctors
The Cure is a CBC News series examining strategies that provinces and territories are using to tackle the primary-care crisis across Canada.
Barb Broome was diagnosed with thyroid cancer nine years ago.
The western P.E.I. woman had her thyroid gland and all four parathyroid glands removed, leaving her body unable to regulate the amount of calcium in her system. Without correction, that could be fatal.
For nine years, Broome had a family doctor to help her navigate her changing calcium levels through regular blood tests and intravenous infusions.
She had no idea how difficult that would be to manage after her doctor retired last November.
"I really didn't know what to expect... or how this was going to work, or how to use the Maple system," she said, referring to the private online medical service she's able to access at government expense, as one of 38,006 Prince Edward Islanders with no primary-care provider as of Feb. 28 of this year.
"It was all new to me. And I thought, 'Oh God, you know, it can't be that bad. There's got to be a nurse practitioner. There's got to be somewhere to go.'
"There isn't, you know. There really isn't."
Her own health-care advocate
Broome has been forced to become her own health-care manager and advocate. She has to request her own copies of blood work results, then provide those every two weeks to an internist in Summerside who reviews them.
But Broome says her internist has made it clear that she really needs a family doctor.
"Where do I go from here? Like, where am I getting the results?" Broome said. "Who's gonna follow up with this if there is more to be done? And that's the question that would normally go to your family doctor and you would go from there. And I have nowhere for that to go."
I wouldn't have to be at that emergency department or taking up space in that hospital if I had a family doctor.— Barb Broome
In the nine years that she was managing her condition with the help of her family doctor, Broome was hospitalized three times. In the first four months after losing her doctor, she said, she was hospitalized four times.
"That kind of, to me, speaks volumes on what the need is here," she said.
"I wouldn't have to be at that emergency department or taking up space in that hospital if I had a family doctor and we could work this out to be a little bit better."
Practice-Ready Assessments a possibility?
Here's one thing Broome says would help her and thousands of other Islanders waiting for a family doctor: The province streamlining the process of accrediting physicians from other jurisdictions, including those trained internationally.
One way to do that could be through what's called a Practice-Ready Assessment program. These provide internationally trained physicians with an assessment period of about three months while they are evaluated by a supervising physician. Then, if the review goes well, they become licensed to practice on their own.
New Brunswick recently graduated the first 10 doctors through its program, after more than 100 people applied to take part.
That leaves P.E.I. as the only province in Canada not using Practice-Ready Assessment to accredit foreign-trained doctors.
Broome said she would like less red tape getting in the way of more doctors practising on the Island.
"They're now talking about interprovincial trade and that's great. So let's do interprovincial everything," she said.
"If you can work in the medical field in Alberta and you want to work … you should be able to just come to Prince Edward Island and go to work. It's probably not going to be quite that simple, but it's got to be easier than it is right now."
"We've had discussions a few times with the department and with the health authority talking about whether a Practice-Ready Assessment is right for P.E.I.," said Dr. George Carruthers, registrar and C.E.O. of the College of Physicians and Surgeons of Prince Edward Island.
"Do we have the resources with the medical school, with the teaching? It's very heavy supervision for those physicians."
He said those discussions around a possible program were continuing this week.
Associate physicians have begun to work
In the meantime, P.E.I. has taken a different route to incorporate foreign-trained physicians into its medical workforce.
The province's associate physician designation allows a foreign-trained doctor to work under the supervised of a licensed physician.
"There are already APs working collaboratively with supervising physicians in P.E.I., improving access to care for Islanders," Health P.E.I. told CBC News in a written statement.
The agency said it "continues to explore pathways to getting internationally trained doctors licensed to practise on P.E.I."
But Green MLA Matt MacFarlane said his party keeps hearing from patients, families and medical professionals that P.E.I.'s accreditation process is too slow.
"We are losing professionals because of the system that we have in this province that doesn't match or align with other provinces when it comes to accrediting foreign-trained physicians," he said.
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With files from Laura Chapin and Connor Lamont