HALIFAX -- As her ailing husband looked on Friday, Theresa Zukauska combatively sliced the air with her hand and made a blunt request of Nova Scotia Premier Stephen McNeil.
"Find me a doctor," she said.
Zukauska told a news conference Friday at her Halifax apartment that her 75-year-old husband has Parkinson's disease that muddles his thoughts and exhausts his body.
Three times in the past five years, Zukauska has had to call around and visit clinics to ensure that Walter -- a retired astronomer -- has the necessary primary care.
Then, last month, the retired school teacher received word that the couple's current family physician is departing her practice in Halifax in early November.
In a province with thousands on waiting lists for a physician, losing your family doctor is worrying news, especially for families caring for someone with chronic illness.
As of Sept. 1, 35,777 people -- about four per cent of the population -- have registered online or by phone with the Nova Scotia Health Authority's Need a Family Practice registry, indicating they do not have a primary care provider.
Zukauskas told the news conference her husband needs care from a physician who has ongoing knowledge of his illness and treatment.
When Walter's blood pressure plummets or his bowels are blocked, a call to the family doctor was the lifeline to permit a visiting nurse to carry out a procedure, or to provide instructions to administer medicine.
Yet, when Theresa called the province's 811 telecare service, she says she was told there's no definite time she can get a doctor again, and she was directed to use walk-in clinics in Halifax.
That infuriated her.
"My response is that he's in a wheelchair, I can't go there. They're dirty and understaffed and the doctors don't have a commitment to the people because they're not with them all the time. Who is going to follow through consistently in Walter's case?"
However, creating a plan to address Nova Scotia's doctor shortage is proving to be an uphill struggle for health administrators in a region with one of the country's oldest and sickest populations.
The health authority says in an email that about 1,700 people on the agency's registry have been accepted by family practices and over 4,400 individuals who have added their names to the registry have had their names forwarded to practices.
Meanwhile, Statistics Canada figures from last year suggest the total number of citizens without a doctor is over 100,000, if you include those who haven't signed up on the registry.
Kevin Chapman, a spokesman for Doctors Nova Scotia, estimates a current shortfall of 65 family doctors, and his organization is calling for the recruiting of about 500 more primary care physicians over the coming decade.
The numbers of the waiting list, particularly chronic patients like Walter Zukauskas, are concerning, said Chapman.
"That's a huge number ... You're talking about 25 family physicians needed just with that pool (waiting list) alone," he said.
Chapman said the problem is partly about an outdated compensation model, along with the need for a more flexible system.
For example, he suggests the province could set up more part-time jobs that don't require younger physicians to take over entire practices with crushing workloads.
He also said the existing fee-for-service model for family physicians poses problems in an aging province where patients like Zukauskas are increasingly ill.
Each year, doctors are seeing fewer patients daily as they cope with the needs of sicker patients that require more time, he said. Under the existing structure, that means less pay.
Tricia Cochrane, vice-president of primary care at the Nova Scotia Health Authority, said the waiting list is not currently set up to sort out which patients are in the gravest need of a family doctor.
She said for the time being people awaiting family doctors will have to use telemedicine services, or go to either emergency or a walk-in clinic.
"None of us are supportive that this is ideal, but our focus needs to be on getting enough providers and improving access through that route," said Cochrane in a telephone interview.
McNeil said this week the government planned a series of "strategic investments" in Tuesday's provincial budget, although he cautioned that there are no short-term fixes when it comes to doctor shortages.
In the legislature Friday, NDP Leader Gary Burrill asked the premier whether the plight of families like Zukauskas's who have demonstrated "significant medical need," constitutes a crisis in the province's health care system.
"There are families across the province who are looking for and require a health care team," replied McNeil.
"We know the anxiety that families feel when they do not have access to that primary care. That is why we are continuing to work with our partners very hard to ensure that we have in place the appropriate health care teams to be able to provide care to those families."
Theresa Zukauskas, meanwhile, said she's looking for a solution before Walter's physician departs.
"We are not the only people in this situation. We are the tip of the iceberg," she said.