When Avens CEO Daryl Dolynny found out that NWT physicians could not provide care for his 57 residents during 2023's wildfire evacuation, it came as a bit of a surprise, he said.
"I was dumbfounded that this was a thing until we were caught in the middle of it," he recalled.
Avens is a long-term care home for seniors, some of whom have dementia. During evacuation, they flew in a military C-130 Hercules to Alberta, fleeing wildfires burning across the NWT. Once he realized NWT physicians could not provide care, Dolynny said he and his team quickly got in touch with Alberta Health Services and their contacts.
"Within probably a day, day-and-a-half, we had everyone registered," he said.
According to the NWT Health and Social Services Authority (NTHSSA), physicians who left the territory during the evacuation could not provide physical care to transferred NWT residents because they were not licensed to practice in another jurisdiction, as per existing Canadian licensing guidelines. In the event of an emergency, it begs the question, why have them to begin with?
"In Canada, physicians are required to be licensed in each province and territory they wish to practice in," said Krystal Pidborochynski, a communications director with NTHSSA. "Currently, there is no national licensure available for physicians in Canada, therefore, physicians need to choose which provinces and territories they will practice."
Licences in the NWT are issued for staff physicians and locum physicians, who are temporarily contracted physicians. They are also renewed each year for the physicians to keep practising in the territory. Any practising physician, be it permanent or locum, requires an NWT medical licence, said Pidborochynski.
A valid licence is usually not the only requirement to practice in another facility however, Pidborochynski noted. She said that facilities can grant privileges to allow licensed physicians to practice in hospitals or other settings.
Pidborochynski added that NTHSSA supports measures to reduce any barriers to recruitment of physicians, adding it is likely a national licensure would make some physicians more likely to explore work opportunities in the NWT.
Courtney Howard, an emergency physician in Yellowknife and the president of the NWT Medical Association, said having national licensure could help recruit more locums.
"We have frequent short-term care needs that we have trouble filling," said Howard.
Although the barriers to get licensure in the NWT might not be as extensive as some of the larger provinces in the country, it still takes time and effort, she said. The fewer the barriers, the greater the chances of health professionals being willing to work in the NWT, she reasoned.
In the long-term, attracting more locums could also mean attracting more full-time physicians, who live and work in the NWT, Howard said. She noted that the GNWT puts plenty of effort into making sure locums feel appreciated and welcomed to work in the territory, whether it's through group workouts, taking dips in the lake or other team-bonding activities.
"What we've found in the past is that effort pays dividends," said Howard, who described the NWT as offering a "very interesting practice environment, but also the interesting and exciting lifestyle the North offers, both in terms of the community and the outdoors."
Having national licensure would allow healthcare providers to go where people need care, she added.
"I think national licensure is not only part of providing better care now, but is going to become increasingly important as we contend with the fact that climate change is going to worsen until at the least the end of my practice lifetime and we're going to have more internally displaced people," she said.
As of Sept. 30, 2024, there were 50 physicians registered in the NWT, not including locums. The territory is funded for 80.7 full-time equivalent doctors.
Concept being explored
SA国际影视传媒 asked specifically for a comment from Health Minister Lesa Semmler on her thoughts about being part of national licensure. Instead, the Department of Health sent a statement. Currently, the NWT's health and social services professional legislation does not allow for national licensure, the department stated. However, it added that the GNWT is exploring how national licensure or labour mobility legislation could work in the territory.
For now, the department said it's proposing amendments to health and social services' profession-specific statutes, alongside proposed amendments to the Health and Social Services Professions Act, to cut existing barriers preventing licensed applicants practising in another jurisdiction from becoming licensed to practice in the NWT.
As for Dolynny, he said current healthcare providers in the NWT are at a disadvantage when they leave the territory.
"Nationalization in general is, in my humble opinion, something that we need to work on," he said. "If you're licensed and in good standing in one province in Canada, why put so many barriers to have you practice in another province in Canada, or territory?" he asked rhetorically.
Another possible solution, Dolynny mentioned, could be having some kind of legislation in place specifically in case of emergencies.
"Let's have legislation, regulation that says, 'In the event of emergency, you're grandfathered to practice," he said, explaining that for national or extreme emergencies, as long as someone is licensed in any location in the country, they should be able to practice anywhere in Canada.
"That's a no brainer," said Dolynny. "That doesn't exist."
