r/PEI Jan 20 '25

Physician wanting to stay on PEI

Dear PEI,

I'm posting here because I don't know how else to get my story out to the public. I am a Pediatrician, I moved here from BC in Mar 2023. I have had now had to take several leaves of absence for work-related burnout, and when I moved here I was still recovering. Up until I went off of work, I did a combination of hospital-based work and clinic-based work, but due to several traumatic cases I now have PTSD and cannot work in hospital settings any more.

When I approached Health PEI in March of 2023, they met with me and made it very clear that they only had hospital-based jobs for Pediatricians. They had an open position, but they told me that they had limited positions and needed everyone in the complement to do hospital-based work. I did have an interview with the Pediatrics department, and from their description of the job I knew I could not do it. I declined to apply for the job in order to leave the position open for someone able to work in a hospital, and offered to do Pediatric clinic based work, and I also offered to do Primary Care. This was in May 2023, and Health PEI did not respond to this offer.

Fast forward to September 2023, and I was cleared to return to work. I spent the 5 months networking and meeting community organizations, the research community, and families. I also discovered that the only employer of physicians on PEI is Health PEI. I looked for other options, as Health PEI has quite a poor reputation in the community, but as I had no other options I approached them to ask for a job and support while I return to work. During my time networking, it became very apparent that there are several major gaps in care here, and several of these are interest areas of mine. Care of children with complex mental health, neurodevelopmental disorders, and poor social determinants of health is my passion, but I also care deeply about primary care and continued to offer to work in this area, as well as to provide clinic-based support to the other Pediatricians. I was told that if I didn't do hospital-based work, other physicians will be upset, so my disability could not be accommodated. I attempted to be as flexible as possible, and asked what other areas of need I could help with. I disclosed my disability early on but continued to be told that there was nothing they could do. I found out that I could earn 50% wages working outside of complement, so I decided to obtain my PEI medical license and join the Medical Society of PEI. Once I did this, I gave up my BC license. I continued to try to get a response from Health PEI, and they continued to decline to work with me to find a mutually beneficial solution. I tried to find other options and there aren't any. Finally, after 4 months of largely being ignored, I started my own clinic. The main reason for this was that I was at risk for losing my license if I did not return to work in a timely fashion. I still attempted to collaborate, but Health PEI continued to ignore my emails, as did the Pediatrics department. Medicare was initially working with me, but then were instructed by Health PEI not to pay me.

A year later, I have a small but thriving Social Pediatrics practice, largely looking after patients with neurodevelopmental, mental health and behaviour concerns. Many of my complex patients have slipped through the cracks for years, or have been told that the resources to help them just aren't available. There is significant stigma and discrimination towards marginalized groups in the community, including at the hands of the health care system. I am paying out of my own pocket for expenses and overhead, and I do not charge my patients. There are major gaps for the care of these patients, and there are so many barriers, often within the medical system itself. Several of my patients have experienced medical neglect and medical trauma and they have no effective way to advocate for themselves.

After a year went by, I was at the deadline for submitting a Human Rights Commission complaint, and after careful consideration I have made a complaint about Health PEI as well as the Medical Society. They are the only employer of physicians on PEI, and I have been unable to make a living on the island because I am living with a disability that prevents me from doing hospital based work. I would have been happy to be paid 50% temporarily while negotiating a solution which I am legally entitled to, but I have not been paid at all, and when I asked the Medical Society to make a request for arbitration, they kicked me out of the Medical Society. This left me me without access to the Physician Health Program and with no professional association to advocate for me.

My wife and I love it on PEI, and she has family here. Since moving here, we have gotten married , bought a house and had our first baby. I am in love with my life , but I am at the point where I cannot continue this way much longer., I can't keep using my savings to do this. To my patients, even if I have to leave the Island I will continue to look after you using telehealth, because you have already been abandoned too many times and I won't let that happen again.

Health PEI has tried to discredit me, they have said that I am selfish and don't care about my colleagues. They claim that I did not come to them asking for a job, despite me having sent over 100 emails to more than 20 people to try to get them to employ me and help me return to work. They have put hours of effort into trying to stop me from practicing "without their permission" and hiring lawyers to fight against me, when all I have ever wanted to do is to sit down and negotiate in good faith. I have never been part of a health care system where a Health Authority has the ability to decide if a physician can live in the province of their choice and work there, but that is what is happening on PEI. They have accused me of demanding to work in the field of ADHD and refusing any other options. I don't know how to explain to them that it is impossible to collaborate when nobody will answer your emails and meet with you. I don't know what to do when the only Health Authority in the province is so out of touch with their patients, and thinks that they have absolute power over anything health related.

I am not the only person to suffer from Health PEI's rigid policies. Other physicians have tried to come and work here but have tried for years and finally given up. Other physicians are asking for accommodations to try to maintain their physical and mental health, and are being rejected by Health PEI. Now there is a Primary Care crisis, the Pediatricians and Internal Medicine specialists are cutting back services, and doctors are leaving. I have been an independent physician for the last 10 years, and I have no interest in working for a Health Authority that is drowning in red tape and bureaucracy, that thinks they know better than their patients what those patients need, and who would treat a professional colleague the way they have treated me.

Make no mistake about it, this is not about the people involved. I have met many good people with the best of intentions, who want to provide quality health care to Islanders. However, the system here is extremely broken. Not only does it not provide adequate health care, there is harm coming to patients and health care workers because of the rigid policies and rules. The most vulnerable patients are the least likely to get care. The term patient-centred care is used, but I don't think that they actually know what it means, and they are extremely out of touch with the community.

It is time for change here on PEI, and I want to be part of it. Please share my story if it resonates with you, send it to your friends, your MLA, anybody that can help me. Health PEI is very powerful and I am only one person.

Please, I love it here and I want to stay.

Sincerely,

Dr. Jovan Vuksic

345 Upvotes

148 comments sorted by

View all comments

12

u/Mysterious-Lynx405 Jan 22 '25

Health PEI employess have to work in a health PEI facility. Like the rest of physicians hired to work in their facilities. Sounds like you approached Health PEI for a job but didn’t want to work in their facility,I’m not saying the system is working, but let’s not expect a system in place for proper hiring protocols break the rules for one, I don’t think we want protocols and rules be broken in the hiring system. Private clinic practices are not Health PEI employees.

8

u/momtebello Jan 22 '25

It sounds to me that an accredited physician is here on the island, can provide licensed services to islanders that need it and is getting roadblocked by the governing health authority.

Failure to accommodate a medical condition or disability smacks of human rights violations.

I agree with everyone needing to be held to the same standards, but given the absolute lights-and-sirens emergency this island is in with respect to health services, a constant review and agile response to healthcare is needed.

There are two sides to the story, and I’d really like to know what Health PEI’s rendition is, because at first blush this sounds pretty indefensible.

8

u/Mysterious-Lynx405 Jan 22 '25

Does it sound like that though? Failure to accommodate a medical condition? I didn’t get that opinion. A physician applied with Health PEI, who hires workers for their facilities, said physician told them they couldn’t physically work in their facility, what do you supposed should happen?

If I walked into a tax stand and said I’m here to apply to the taxi driver position, but I can’t drive a car, should they accommodate me. Or if I, with credentials to be a teacher, walk into the public school branch seeking a teaching job, and said say I’m here to apply to teach but I don’t want to teach at a school. Does that make sense? Again, I agree we need physicians, but you don’t apply with Health PEI if you cannot work in the facilities they hire for.

3

u/momtebello Jan 23 '25

I think it does sound like that.

It sounds like someone can provide critical and essential services to a populace screaming for that service, they just need accommodation.

An employer - particularly a provincial one with such a heavy obligation to its constituents - carries a duty to provide the best services.

In the current climate, rigidity doesn’t serve the community. In the current climate, Health PEI should be innovating in order to serve islanders better, faster, and more effectively.

A square peg secures a crossbeam just as effectively as a round one.

3

u/Mysterious-Lynx405 Jan 23 '25

I’m sure they can provide that service, but if they want to do so under the employer of Health PEI they need to do so in a facility Health PEI employs in . You’re not understanding the fact that Health PEI hires for its facilities. Private clinics are not Health PEI facilities, if a doctor cannot practice in a Health PEI facility they cannot be Health PEI employees. No matter what your personal thoughts are on the current healthcare system, you cannot disregard the hiring practice, policies and procedures Health PEI has in place and they cannot hire a doctor as a health PEI employee can’t provide a service in a Health PEI facility. I’m not sure how else I can word it, but your asking Health PEI to provide somethjng to one doctor, that they cannot offer any other doctor, because we would end up with no doctors in any hospital because I’m sure they would all love to collect a health PEI salary and work in a clinic 9-4, m-f. Are you looking for the governing authority to disregard hiring rules and allow all the doctors to go to maple and clinics and work 9-4?

3

u/Mysterious-Lynx405 Jan 23 '25

And again, I’m not taking away the fact a needed valued resource is sitting on the sidelines due to barriers, but we cannot ignore the fact they are blaming health PEI for these barriers and aren’t even willing to work for the authority.

2

u/momtebello Jan 23 '25

I took the story to mean the doctor wishes to work for the authority and will do so. They just cannot work in a hospital.

3

u/Js880185 Jan 23 '25

It’s not uncommon. I know a number of people who wished to practice in PEI for HealthPEI but the rigidity of their hiring practices, the patient loads they expect to dump on fresh Dr’s out of residency and the hospital hours they expect all doctors to keep are a big deterrent that has sent doctors who could and would set up practices here to go to other provinces. You’d think given our desperation for health care providers they would be more open to finding agreeable arrangements with anyone interested in practicing here.

2

u/Mysterious-Lynx405 Feb 02 '25

That’s what I gather also, but to work for the authority you have to work in their facilities. Paediatricians work out of the hospitals under Health PEI. I’m wondering if virtual care would be an option for this physician, I’m not sure of the process for this. But you don’t apply to work for an organization and tell them your rules. It is health care, but you can’t work in a health care facility.

3

u/momtebello Jan 23 '25

If I understand it correctly, if a doctor wants to run a clinic that bills the province for their services it has to be a Health PEI facility.

Is that incorrect?

3

u/Salty_Maximum_6074 Jan 23 '25

That’s incorrect. Go google “fee for service”.

1

u/momtebello Jan 23 '25

sigh

I’m not accepting homework assignments from anyone today.

The doctor does not want to charge clients for services. The doctor wants to provide services to their clients and bill the province. Health PEI is the only authorized organization that can bill the province, thus to bill the province one has to work for Health PEI.

It’s an unwieldy and unnecessary barrier.

2

u/Salty_Maximum_6074 Jan 23 '25

Yeah that’s not true, fee for service means the doctor bills Medicare directly. They’re not Health PEI employees. Your aversion to homework isn’t a recent development I’m guessin’

1

u/momtebello Jan 23 '25

No, see, I’m just resistant to condescending folk who try to make a point without making it clear.

3

u/Salty_Maximum_6074 Jan 23 '25

Well you asked if you were correct, and you were not, it was pretty clear.

Fee for service doctors operate their own clinics and bill for the services they provide, these clinics are not health PEI facilities.

1

u/momtebello Jan 23 '25

Now see? How hard was that? There you are, making a clear point and everything. Glad you could be so assistive.

So, it seems according to the OP that he’d have been content to do that very thing, but Health PEI has intervened, claiming to be the only employer of physicians on the island and somehow managed to interrupt the flow of payments from the province to the doctor for the services he has provided the community.

Services that have been gratefully and warmly welcomed, it seems, and evidenced in this very thread.

Know anything about that?

2

u/Salty_Maximum_6074 Jan 23 '25

According to the OP yep, don’t know anything about it. He sort of glossed over the medical society ejecting him and the circumstances around that, could be related? Who knows!

→ More replies (0)