Doctor leaving prompts much-needed discussion

Wendy Elliott Column

Published on February 26, 2013

The departure of a talented surgeon, Dr. Andrea Veljkovic, has prompted much discussion locally and provincially of late. And that is a very good thing.

Veljkovic is leaving for a new job in Toronto at the end of February. Her patients in western Nova Scotia, where she has been practicing orthopedic surgery, have been speaking out against her loss.

Dr. Andy, as she’s known, has a unique specialization in the foot and ankle. Only two other surgeons in the province have this focus and one is close to retirement.

“I’m sad that we’re losing her,” said patient Lolita Crosby of Avonport. “We can’t afford to lose her.”

Patients who seek this kind of surgery, who are often diabetic, can wait an entire decade to see a specialist.

Veljkovic came to Kentville temporarily to fill in for another surgeon, but folks found out how good she was. Veljkovic was unwilling to speak to the media, but I understand the couple had wanted to settle here.

According to Dr. Lynn Harrigan, who is the chief of medical staff for Annapolis Valley Health, another orthopedic surgeon had already been selected to fill in the fifth slot in the orthopedic department when Veljkovic came on a locum.

“Dr. Murphy was already hired,” she told me, pointing out that Dr. Andy was recognized as a wonderful surgeon. She added, however, that aging hips and knees are the biggest issue for orthopedic surgeons.

On Feb. 4, in response to an e-mail from another patient of Veljkovic’s, Health Minister Dave Wilson indicated funding was not the issue that is causing her departure. He suggested that all the current orthopedic slots province-wide are filled.

So what’s going on that Nova Scotia is losing such a needed specialist? It’s complicated when you consider almost half our tax dollars - $3.9 billion - go toward health costs.

Harrigan said that the province has been following a Physician Resource Plan since last May. For the first time, the government has been trying to improve planning and management of the province's physician workforce.

The province's initial actions in this 10-year plan included making commitments to: 1) investment in four new collaborative primary care teams in communities of need and provide additional support to existing teams; 2) provide additional incentives for doctors practicing in communities of need; 3) working with Dalhousie University's medical school to increase the number of family doctors; and 4) strengthening efforts to recruit and retain physicians where they are needed most.

We have many competing needs when it comes to health care. In fact, I think you’d need the wisdom of King Solomon to make everyone happy. Earlier this month, a school fundraiser for a New Glasgow girl with diabetes snowballed into a drive to urge the province to cover the cost of insulin pumps. An online petition accumulated over 3,000 signatures and opposition politicians got busy deriding the government.

In January, there was a call for terminally-ill patients at home to have tube-feeding supplements paid for. These needs are very real, but as Harrigan pointed out, the province can’t keep throwing money at the loudest issues. Planning is required.

Her advice was for patience until the health system is under control. I also learned that Dr. Eric Howatt, a well-known local orthopedic surgeon, is vice-chair of the planning group, so the message should be loud and clear about feet and ankles.

When the budget came down last spring, then-Finance Minister Graham Steele said, “Nova Scotia needs a health-care system that is well planned and managed. We need a system that is sensitive to the needs and priorities of local communities, and that acknowledges the hard work of our health-care professionals.”

That is political rhetoric at it’s best; however, he did include a promise to “make investments this year to reduce the time Nova Scotians wait for receive orthopedic surgery.” If that’s part of good planning, then we have to make the Dexter government live up to that promise.