Nova Scotia using Mayo Clinic stateside to meet testing needs; predicted to last until fee deal reached

HALIFAX | Staffing shortages have forced Nova Scotia to spend $1 million over the past 12 months to send hematological pathology samples for testing to the Mayo Clinic in Minnesota, the province's health minister revealed earlier this week.And he doesn't expect the situation to end until the ongoing, months-long negotiations with the province's doctors over a master fee agreement are successfully concluded.“We need a short turnaround, and this is what the Mayo Clinic is providing," Leo Glavine told the Chronicle Herald on Jan. 5. "We will have to look at a number of options for the future, realizing the current challenge.”According to Glavine, Nova Scotia has long sent pathology samples out of province when highly specialized or uncommon testing is required in various medical specialties.But he said the 5.8 full time equivalent (or FTE) hematologists here have been unable to keep up with the "dramatic" demand for testing in the past year, and suggested the situation was due in part to the province's inability to attract and retain new blood because of the stalled contract talks with doctors.“I’ve decided to have a very, very significant distance from the master agreement (talks)," Glavine said. ("But) at the current time, there are indeed unknowns.”The comments came just three weeks after Nova Scotia Liberal Premier Stephen McNeil floored doctors when he publicly rebuked what he called the "unconscionable" salary proposals made on their behalf by Doctors Nova Scotia.The premier blamed those demands for his decision to table a highly controversial wage bill in the provincial legislature.A spokesperson for Doctors Nova Scotia downplayed the out-of-province testing, but agreed on the need for an agreement between doctors and government."Referral of this kind of work in the short term is not uncommon," Kim Bottomley said in an email to the Medical Post today. "However, when referral of work is needed for a lengthy period of time there is likely a recruitment issue."In the long term, that recruitment issue should really be addressed directly. This is exactly why negotiations are so important."Physician recruitment is an ongoing challenge in Nova Scotia, one which we are trying to address at the negotiations table," added Bottomley."Our priority is to continue to negotiate with government and work with the province to reach a deal that improves our health-care system for both patients and physicians."For his part, Dr. Andrew Warren, a pediatric cardiologist and associate dean in charge of postgraduate training at the medical school at Dalhousie University, which supplies English-language physician training for Canada's three Maritime provinces, said recent government cuts in both manpower forecasts and related funding will make it hard for his institution to maintain its four-year hematology program, which is one of only five in Canada."We have four people in training right now, but we will fewer because the latest physician resource plan, which was last updated in 2014, forecasts 1.1 hematologists are needed over the next 10 years," Dr. Warren told the Medical Post.As a result, he added, his school now plans to open up only one position every three years.It seems however that Nova Scotia is not alone when it comes to soliciting testing assistance from the world-famous Mayo Clinic.In an email to the Medical Post, clinic spokesperson Dusanka Anastasijevic said her facility has been providing "highly esoteric laboratory testing services" for Canadian healthcare professionals and patients for more than 40 years."As one of the largest reference laboratories in the world, Mayo Medical Laboratories supports more than 5,000 healthcare organizations in more than 60 countries, one of which is Canada," wrote Anastasijevic."Each week, more than 100 Canadian health care organizations located in every province send very specialized testing to (us) for testing. Most of these tests are accompanied with a clinical algorithm that prevents over-ordering of additional tests, or the ordering of needless tests, and thereby saves significant financial resources in the Canadian health care system."Without specifically referring to Nova Scotia, Anastasijevic said hematological pathology samples normally involve "bone marrow for leukemia phenotyping followed by a pathology consult."

Nova Scotia using Mayo Clinic stateside to meet testing needs; predicted to last until fee deal reached

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