American podiatrists are leaving Nova Scotia due to bureaucratic frustration

An American surgical podiatrist says he has decided to leave Nova Scotia because he is unable to fully treat his patients, leaving them on long waiting lists.

Dr. Ronald Barron said he is fed up with dealing with the Nova Scotia College of Physicians and Surgeons and the provincial health department, which won’t allow him to perform some minimally invasive surgeries at his clinic.

“I haven’t worked anywhere, especially in the United States, where you have to wait three years to get a bunion or hammertoe repaired,” Barron said.

“If I had been allowed I could have fixed (these) issues very easily and very effectively. But as it is with the government and the college, I was prevented from doing so. It was very difficult.”

Baron moved to Dartmouth to work in a clinic in early 2024, hoping to stay long-term. His mother was from Guysborough County, and he said she spent many summers in the province.

“It seemed like a very, very good opportunity,” he said.

His arrival coincided with significant changes for podiatrists in the province. The change meant that for the first time, they could prescribe medications and order X-rays instead of asking primary care providers to do it on their behalf.

In a statement to CBC News, Dr. Gus Grant, head of the province’s College of Physicians, said the move “brings accountability, structure and proper recognition of the contribution podiatry can make to NS health care.”

But Barron said that in his case, the changes didn’t go far enough.

Unlike Canadian podiatrists, his American training included minimally invasive surgeries such as treating bunions or hammer toes in his clinic rather than sending patients to hospital operating rooms.

“I told the college in detail about my background, they were aware of it. Initially they seemed very happy to have someone with my skill set coming to the province.”

He said he approached the provincial government and the college several times for expansion of its services, but received no response.

Barron said he felt like he was “imposing my responsibility on myself” as he looked at patients he knew he could treat.

He pointed to a case where a 40-year-old diabetic patient was hit in the leg with a hammer and developed a wound on his leg.

“It had been over a year since he was able to walk regularly, he had gained more weight. His diabetes, his blood sugar was not particularly well managed. It was really having an impact on him, even his mental health was greatly affected. This is not a unique situation.”

according to Wait times posted by the Government of Nova ScotiaHalf of the patients who need a bunionectomy wait about a year for a consultation, and then another two and a half months for the actual surgery. Some patients are waiting more than three years for a consultation, and then almost another six months for surgery.

Barron said he was surprised that, given those wait times, there was no urgency from the college or the province to utilize his full skill set.

“I was very surprised and disappointed. Unfortunately I did not expect any changes.”

Grant says the solution isn’t as simple as allowing Barron to keep working.

In his statement, he described the complex work that took place behind the scenes to allow podiatrists to expand their scope over the past year.

The negotiations included IWK, Nova Scotia Health, pharmacies, government, drug information systems and regulators.

“There are system-wide changes to be implemented, not just changes to accommodate an outside practitioner,” he said.

The Department of Health and Welfare also sent a statement in response to CBC News inquiries. It reads that he is disappointed that the Baron has decided to leave the province.

It reads, “The Department is working closely with the College of Physicians and Surgeons of Nova Scotia and the Nova Scotia Podiatry Association to explore expanding the scope of podiatry practice and integration with the public health care system in the province.”

“Any expansion of scope or integration must also take into account the resources required for coordination and integration across the entire health system.”

Barron said he appreciates that it is the college’s responsibility to ensure that physicians are properly trained.

“But I think it’s also not their role to be a barrier to prevent skilled physicians from providing those services. I think it’s important that they allow qualified medical practitioners to practice.”

He said the lack of communication prompted him to return to the US, where he is now looking for job opportunities in New York.

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