Amid a doctor shortage, a veteran physician in Yarmouth, N.S. is still working despite three attempts to retire.

“I can’t stand the guilt!” Dr. Shelagh Leahey, who has been practicing medicine in the oceanfront town for 42 years, told CTV Atlantic.

As doctors disappear from Yarmouth, Dr. Leahey has been caring for an increasing number of so-called orphan patients -- people who do not have a family physician of their own.

“I see whoever needs help,” Dr. Leahey explained. “I don’t make any rules because, what’s the point?”

One such patient is Bonnie Hendsbee.

“I’m supposed to have checkups on my kidney and blood work,” she said from Dr. Leahey’s office. “In order to do that, I have to go into emergency, sit there four to six hours just to get a referral.”

Thankfully, Hendsbee has found Dr. Leahey, who works out of unassuming building down a Yarmouth side street that looks more like a home than a health clinic. Dr. Leahey says the clinic has become an orphanage of sorts for patients like Hendsbee.

“I have seen acute breast cancers in young women, I have seen very severe diabetics who are totally uncontrolled,” Dr. Leahey said. “I have seen people with limbs that were in peril of being lost from infection… I could go on and on and on. It scares me that these people who don’t want to go to emergency because they know it’s not a crisis that moment are wandering around with nobody to take care of them.”

In the last year alone, she says the Yarmouth area has lost five family doctors -- a staggering number for a community of just over 7,000 people.

Another affected patient is Dermot O’Sullivan, who recently found himself without a family doctor for the fifth time in 15 years.

“I’ve spent 10 hours one time waiting for a renewal of a prescription and eight hours for another time waiting for a prescription when we were out of doctors,” he said. “So, that’s the kind of thing we’re faced with when we don’t have a physician here.”

This time, though, O’Sullivan is taking heart with the knowledge that while his family doctor might be leaving his practice, he will be taking up a full-time position at the local ER.

“That will mean he will be servicing all those people like myself who do not have medical service available, which in this area is quite high,” O’Sullivan said.

Family doctors in the area say they are losing colleagues because of intense workloads. According to local general practitioner Dr. Joe Gillis, O’Sullivan’s physician may have found a way to strike a better work-life balance.

“I do family practice, I do obstetrics, deliver babies, I do prenatal care, I do some ER shifts, four to six hour shifts… in support of the other main ER doc, and I do hospitalists service,” Dr. Gillis said, explaining the workload of a Yarmouth GP.

Despite the intensity of his job, Dr. Gillis says he knows that he’s a family doctor at heart. Still, the husband and father of three admits that finding a work-life balance can be difficult.

“(You want to) maintain a quality of care for your patients… ensuring that you don’t go home at night thinking, ‘Ah, I forgot to do that,’ or, ‘I wished I did that,’” he said. “Versus making sure you make your kids’ dance recitals or just spending time with them on the weekend, or take the Christmas lights off the trees outside, which my wife reminded me this morning I still haven’t done.”

Dealing with the duelling obligations of work and home can be difficult, to say the least. And when a doctor leaves the community, everyone else is left to pick up the slack.

“I am not the answer,” Dr. Leahey, who has given up on the idea of retiring anytime soon, said of the town’s doctor shortage. “Walk-in clinics, orphan patient clinics are not the answer -- but they’re better than nothing, and that’s all I can do. I can do better than nothing.”

Local recruiting

Both Drs. Leahey and Gillis say the Nova Scotia Health Authority needs to allow local communities more power when it comes to recruiting doctors.

“We need more bodies. And we need to be recruiting them ourselves,” said Dr. Leahey.

She says she wrote a letter before the last provincial election on the issue.

“We need to do our local recruiting. You cannot have a recruiter for the zone who will say, ‘I’ll take care of everybody’s needs,’ it’s not possible for one person to do that,” she said. “When we can explain to the person who’s interested in Yarmouth what we have to offer and the variety of things they can do – it’s a pretty compelling offer.”

Dr. Gillis says he was successfully recruited locally.

“Me and two others were recruited from outside of Yarmouth. We were nabbed in med school,” he said.

“In fact the person who recruited me heard that I was dating somebody from Yarmouth and within two or three months of dating her she was seeing if I would come to Yarmouth to work. And it worked. Here I am.”

He says it used to be that way – and believes the province would see more results if it allowed communities some responsibility when it comes to recruiting.

“You need that local recruitment and with the establishment of the Nova Scotia Health Authority that was taken away locally.”