The doctor won’t see you now

When Danielle Fraser moved to Westville, Nova Scotia in 2021, she did not know this province has a severe the lack of family doctors. She had always planned on retiring in Pictou County. This is where her father’s family is from. She is a distant relative of Canadian civil rights icon Viola Desmond. When the opportunity to work from home as a law clerk presented itself, she packed up her home in Cambridge, Ontario, and relocated.

Westville is a small town of 3,500, a far cry from the 147,000 in Cambridge. The whole of Pictou County only has 44,000. When she arrived, at the same time she applied for her health card, Fraser added herself to the Need a Family Practice Registry. Four years later, she is still waiting.

Shortly after moving to Nova Scotia, Fraser had to get a prescription refilled. She was left with no choice but to go to the emergency room in New Glasgow, about 15 minutes away from Westville. The Aberdeen Hospital, opened in 1895, is the only emergency department in Pictou County. Fraser had to go there to refill a prescription she had had for more than two decades. She had to wait for ten hours.

Fraser believes that an issue like that should never make it to the emergency room. At the ER she “was taking up a chair, then taking up a room and then I was taking up time. The person who saw me was a nurse practitioner – I never actually got to see a doctor.”

Fraser lives with irremovable thyroid cancer, and will never be cancer-free. She beat uterine cancer back in 2024. The main concern with thyroid cancer is that it may spread to other areas. It does not pose an imminent threat when properly managed.

To keep an eye on it, Fraser needs regular scans and bloodwork. Her lack of a GP means she does not have what she calls “a middleman.” A general practitioner can refer patients to specialists for further care. People who do not have a GP are left to do their own investigating, have to dive into their illness or symptoms in order to pinpoint their needs.

Fraser’s uncertainty about her own care comes from an inability to be sure she is taking the proper measures. “Because what is your next step? Who do you call? Where do you go?” Not having a GP makes monitoring her thyroid difficult. She misses what she had: “steady care in Ontario.”

Prognosis negative

Fraser is far from alone. As of March 14, 2025, fully 95,875 Nova Scotians are without a family doctor. That is roughly 10% of the population. Doctor retirements contribute to the shortage – and more are coming. CBC reports that nearly one in four Nova Scotia doctors are over 60.

Nicole LeBlanc of Healthy Pictou County, a program aimed at recruiting doctors to the area, says the effort to recruit new doctors has lots of challenges. Some new doctors choose to specialize rather than pursue general practice. This leaves fewer doctors available to care for the general population. Also, Nova Scotia has to compete with the rest of Canada and the world to recruit doctors. Some simply don’t want to settle here.

Samuel Stewart, a professor of epidemiology and pharmacy at Dalhousie University, says this shortage makes it harder for current family doctors to give patients the care they need. He said that people who do have GPs feel the impact of the shortage because their GPs’ heavy patient load can make it harder for their patients to see their own doctor. And ailments can pile up, Stewart said, “if you can’t see your general practitioner for a while.” In extreme cases, “something that could have been fixed with medicine, now needs surgery.”

The Legionnaire

Fraser sits behind the marble countertop, tending bar at the Westville Legion for a Saturday jam session in the basement. She does this for free. Her white hair is tied back into a ponytail, cat-eye glasses resting on her nose. A Buffalo Bills lanyard hangs around her neck. When she lived in Cambridge she had season’s tickets to Bills’ games. The lanyard obscures a Pictou County hockey team logo on the front of her hoodie.

When Fraser gets up to grab a drink for someone, she does it with a smile. She makes her way to the cold room door, which is covered by a chalkboard advertising $25 bird feeders and lawn ornaments. She hands the drink to the patron and as they turn away her smile disappears, replaced by a wince.

Often she rubs her right leg, out of habit, without even knowing she is doing it. When another Legion-goer wants a drink and to discuss how “horrible pensions are these days,” Fraser’s positive attitude reappears alongside her smile. It is a friendly smile, the kind you cannot help smiling along with. But what the cheeriness does not show is that just over a year ago Fraser was diagnosed with osteoarthritis in both of her knees.

Trying to balance arthritis with a busy schedule is tiring. Fraser says she does not get discouraged too often. She splits her time between the Westville Legion, the town council chambers where she serves as a councillor, delivering Meals on Wheels and volunteering with community pantries across Pictou County. But the development of arthritis in her knees has left Fraser with another reason to need a doctor.

At home

She now spends most of her time at home, with her two pugs Pat and Archie by her side. Her two-level home is tucked into a sleepy side street full of potholes and kids playing road hockey. This is where she spends the bulk of her time. She now relies heavily on her 30-year-old son Brandon, who shares the house with her and the pugs. She often asks her son to get things from upstairs or to bring things in from the car. The house being two levels presents a challenge; it takes a toll to go up and down the stairs frequently. Fraser worries that she leans on her son too much, despite him telling her otherwise.

Sitting on a black recliner-couch in the living room, Fraser says the old sectional couch had to go because the dogs ruined it. This isn’t a bad thing; it had become hard to get out of. Attached to the living room is Fraser’s home office, full of football memorabilia, dog toys and a multi-monitor setup for work. She is thankful for the ability to work from home.

Through the window facing the road you can see the town hall. The large brick exterior is visible through trees across the street. This is where Fraser goes for monthly council meetings. Despite how close it is, she drives. She says this is “embarrassing,” but uneven ground and potholes make it difficult to walk. One of difficulty she faces is worsening balance. Some days it is nearly impossible to go up and down stairs without feeling she is going to fall. Even the few steps on the purple porch attached to her house can be an obstacle.

The concern about balance keeps Fraser home more than she would like. It would be easier to volunteer and handle council responsibilities if she did not have to battle knee pain. Still, she will head back to the Legion to tend bar again the next day. It’s karaoke.

Fraser now needs both knees replaced, and is on a waitlist to see an orthopaedic surgeon. “It runs in my family,” she says, “knee replacements.” She is concerned about what condition her knees will be in when she finally gets off the waitlist. She fears that before too long the pain in her legs will become debilitating. The uncertainty about when she will receive treatment for her knees is a big concern.

London calling

It’s a sunny and cold day in Westville. Fraser is packing up her burgundy Hyundai Palisade to drive to London, Ont., 18 hours away. She has driven to Ontario many times since moving to Westville, usually to visit family and friends. But this is for a different reason. She is driving to Ontario for a doctor’s appointment to have her thyroid checked. She has received this treatment in Nova Scotia, but says it is no longer available.

She set off on March 13. Fraser’s mother would look after the dogs while she was gone. The drive up was clear and sunny, a relief of good weather. She stopped for the night in a Cornwall, Ont. hotel, about 12 hours from Westville.

Fraser considers herself lucky to have this doctor 18 hours away. When she talks to people at the Legion, she realizes she is one of the lucky ones. They are unable to drive to Ontario, or anywhere else, while she still can.

The specialist in London said there are no new complications with the thyroid, happy news for someone dealing with so much uncertainty. Fraser said she is still anxious, but ultimately satisfied with her trip to Ontario. She would rather have been treated in Nova Scotia, though, “so I don’t have to do this trip again.”

Fraser is optimistic that her time on waitlists is nearing an end. For now, though she remains one of 95,000 Nova Scotians without the help and security that comes with a general practitioner. This feeling will remain until her number is called.

About the author

Jack Sponagle

Jack Sponagle will graduate this spring with a Bachelor of Journalism degree from the University of King’s College.