ST. JOHN'S, N.L. — A doctor shortage is threatening to undo years of work turning the Newfoundland town of Bonavista into an internationally lauded example of rural growth and development, the community’s mayor says.
Mayor John Norman said there are several doctors who want to live and work in the seaside community of about 3,200 people. But the high patient volumes and gruelling 24-hour shifts required at the local health centre have turned them away.
Despite numerous meetings and continued appeals, he said health officials won’t budge on working conditions and offer physicians a contract they will accept. In the meantime, locals needing reliable access to health care are moving.
“It is almost surreal for a community volunteer like me and the dozens of others like me in the region that have given our lives — our lives, all of our free waking hours — to strengthening and developing this community and region. And now it is completely being undermined,” Norman said in a recent interview. “I'm devastated, utterly devastated about where we are."
Bonavista sits at the end of a narrow peninsula that juts east from central Newfoundland, and the town is about 300 kilometres away from St. John's by road. Like much of rural Newfoundland, it thrived on fishing until the federal government closed the cod fishery in 1992.
In 2016, Norman launched Bonavista Living and Bonavista Creative, two businesses aimed at restoring the community’s deteriorating heritage homes and turning them into real estate, or renting them as artist studios, restaurants and storefronts for budding businesses.
The town is now a popular summer tourist destination, and many of the new local businesses are owned by young people who have moved there from all over the province and the country. Publications from Maclean’s to the New York Times have written about Bonavista’s unique success and its sharp contrast to the rest of rural Newfoundland, whose communities are dwindling.
Norman said the town is now watching people move away in search of better access to health care. Few in the community have a family doctor and there are no staff doctors left at the town’s health centre, which acts as the hospital and emergency room.
News releases from the Eastern Health authority show that over the past two months, the centre was completely closed for 11 1/2 days due to a lack of medical staff, and for 10 1/2 days, only virtual appointments were possible. The next closest health-care facility is the hospital in Clarenville, about 115 kilometres away.
Dr. Gena Bugden, vice-president of the Eastern Health authority, said recruitment and emergency room closures are an issue across the province. She and her team "plan on continuing the conversation" with the physicians who want to work in Bonavista, she said.
"We offer flexible work arrangements and those are individually negotiated with the physician," Bugden said in an interview, adding that compensation is determined by the rates negotiated by the province's medical association and the province.
Dr. Kristopher Luscombe, president of the Newfoundland and Labrador Medical Association, also emphasized that doctor shortages are provincewide. The province announced last July it would offer more money to doctors in rural emergency rooms, and Luscombe said the effort was an indicator that the province is committed to improving wages for rural emergency room doctors.
"It sounds, obviously, that there's still some distance to go, but there has been considerable focus on trying to figure out these rural emergency departments," he said in an interview.
Reg Durdle lives in the neighbouring community of Birchy Cove. He said there are long lineups of people waiting outside the Bonavista health centre when it reopens after a closure. Few have a family doctor, so the emergency room is their only choice for care, he said. The temporary doctors flown in to work at the facility are "overwhelmed big time," he said in a recent interview.
Durdle, too, said people are moving away. "We know some people who've moved and we know some people who are sort of up in the air," he said. "If you haven't got service here, I mean, what do you do?"
Norman said there are doctors in Bonavista who want to stay there, but they want flexible contracts or better compensation to reflect the workload and 24-hour shifts at the health centre. Health authorities report that it is the third-busiest health centre in the province, with more than 7,700 visits to its emergency room in the 2019-20 fiscal year.
It's more attractive for doctors to work in hospitals, where the shifts are shorter and they have support from a full hospital staff to manage the workload, Norman said. One doctor lives in Bonavista, but works temporary contracts outside the province, he added.
"Why are we scouring the globe for health-care professionals?" he asked, pointing to a recently announced effort to lure doctors from Ireland.
This report by The Canadian Press was first published Jan. 26, 2023.
Sarah Smellie, The Canadian Press