Independent Nova Scotia MLA Elizabeth Smith-McCrossin is raising concerns about impending pay cuts for emergency room doctors in rural hospitals, claiming the move will drive physicians away from communities like Pugwash.
Smith-McCrossin first raised the issue in the provincial legislature last week and followed up with a social media post this week.
Rural emergency rooms across Nova Scotia are under threat.
— Elizabeth Smith-McCrossin (@NovaScotiaESM) April 1, 2025
Today, April 1st, a deeply concerning change has taken effect in our province’s healthcare system.
As of today, eight rural hospitals across Nova Scotia are experiencing emergency room closures or reduced services —…
“I had people contacting me behind the scenes to let me know that April the 1st, doctors in certain hospitals in rural Nova Scotia are going to be paid less,” she said.
“And what that means is many of the physicians are choosing not to work in our rural hospitals here in Nova Scotia because of the pay decrease. And here in my area, Pugwash is affected by this.”
Smith-McCrossin added, “any doctors that work in that emergency department are going to be paid as though it’s an urgent treatment center, which are patients that are more level fours and fives…. people that need a prescription refill or maybe an ear infection, not your sicker patients, and so the doctors are saying no, that they are not going to work and have to take care of very sick patients and be paid less now.”
She urged the minister of health to intervene.
“I know that many people working behind the scenes have not given up hope, so I am imploring the minister of health to step in and reverse this decision that is effectively really harming the hospitals in Nova Scotia,” she said.
The MLA highlighted the impact of potential ER closures, particularly during peak summer months when rural populations swell.
“Pugwash has a brand-new hospital,” she noted. “So the people in the community are saying, why did we build a brand new hospital to then lower the physician wage, to drive our physicians away from our brand new hospital? It doesn’t make any sense.”
She added hospitals in Queens County, Shelburne, Lunenburg, Richmond, Guysborough, and Musquodoboit Harbour are also affected.
‘Her claims are inaccurate’
The Nova Scotia health department rejected Smith-McCrossin’s claims in a statement to CTV, calling them “fearmongering” and “inaccurate.”
The department stated the government “negotiated an agreement with physicians that reflects that value and pays our hardworking doctors more.”
They highlighted “significant investments” in a new payment model for family physicians, resulting in “a 40% increase for some physicians.”
This model, they argued, will incentivize long-term rural recruitment, allowing rural physicians to be some of the highest paid family medicine doctors in Nova Scotia.
The department insisted the rate for emergency department work has only increased under the new agreement.
Doctors Nova Scotia, in an email to CTV, explained the new payment model.
“The new payment model is called the longitudinal family medicine (LFM) rural small site payment model for physicians who provide comprehensive care – primary care, UTC (urgent treatment centres), inpatient hospital care, long-term care. Or if the physician is providing care in the UTC, they will be paid either a sessional rate or the ED rate if negotiated separately,” stated the association.
Doctors Nova Scotia clarified, when a physician doesn’t want to provide comprehensive care, but chooses to provide only limited services, they will see a reduction in pay.
“Most physicians in rural Nova Scotia provide comprehensive care and will see their compensation increase under this new model. The LFM rural small site model incentivizes physicians to live in the community and provide a full array of services,” they explained.
When asked about doctors being paid less for doing more, Doctors Nova Scotia said this is not the case.
“Physicians who commit to rural communities will find their compensation package has increased when they provide collectively primary care, UTC, inpatient and long-term care,” said the association.
While the Nova Scotia Health Authority declined direct comment on Smith-McCrossin’s statements, they reaffirmed their commitment to recruiting and retaining health-care providers in Cumberland County and acknowledged concerns about potential service disruptions at the Pugwash Health Centre.
In a news release on Thursday, Smith-McCrossin called on the Department of Health to “stop downplaying” the impact of compensation changes on rural emergency care.
“These changes are real, they are happening and they will hurt rural communities,” she said.
‘We finally have a new hospital’
Sheryl Chambers, a Pugwash business owner, says it is disheartening for those in the area.
“We finally have a new hospital, we finally have the right facility to encourage people to come here to live, to work, to have doctors on staff, you know, cutting wages for the emergency room, what’s going to happen is we’re not going to have any doctors because the doctors we’re bringing in are coming from a distance,” she said.
Chambers highlighted the potential impact on her business and the community, particularly during the busy summer months, and recounted past experiences accessing health care.
“I went over two years here without even a physician at a very bad time. I had a leg infection for three years and I had to go to this hospital to get IV antibiotics and go through outpatients, and thank goodness we had somebody there because if I had to go to Truro or Amherst I would have had to close my business.”
Smith-McCrossin concluded by stating, “If we’re trying to recruit and retain physicians here in Nova Scotia, then we don’t lower their wage. If we do anything, we increase the wage, try to incentivize them and try to encourage them to stay and don’t lower it.”
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