To: Family physicians and nurse practitioners
Family physician resiliency: A thank you message from the Department of Family Practice

(This editorial was originally included in the September 2020 Issue of Doctors NS Magazine)

The first half of this year has been unprecedented for most, if not all of us. We’ve been faced with the worldwide spread of a potentially fatal disease about which we initially knew relatively little, for which there was no specific treatment, resulting in huge societal and economic disruption. The effects on people, society, the economy and our health-care system will linger on for years, even if the disease itself is conquered.

I want to personally thank you for your efforts as we all adapt, both in our professional and personal lives, to the rapid pace of change locally and globally as a result of the pandemic. This has proven how resilient and responsive we can be in our family practices and in the primary health care system.

We’ve seen the importance of flexibility and patience, along with a mindset of curiosity, as we learn new ways of delivering care together with our patients. Our patients have responded well to the shift from face-to-face to virtual care (and to the new look of face-to-face care), in no small part because of your approach to instilling confidence in new models of care and providing a safe environment for care.
We have not been without challenges during the pandemic. Acknowledging and learning from these experiences in the health system, and in our practices, will serve us well as we plan and prepare for continued COVID-19 activity in our province and country.

My biggest personal learning was that our historically relaxed approach to infection control in primary care was likely not protecting our patients, our staff and ourselves all that well. It certainly left us ill-prepared for a major infectious disease outbreak. Since our health system runs very close to the edge most of the time, a disruption of this magnitude has created significant delays in care, resulting in morbidity and mortality beyond the direct effects of COVID-19.

I appreciate that there was information overload with the many emails and memos on changes in service provision and new guidelines and policies to deliver safe, quality care. Communication that is timely, consistent and clear is instrumental to our work. The plethora of rapidly changing (and sometimes conflicting) information coming at you from multiple sources was stressful for most of us, as was the uncertainty about how we would be paid and if we would have access to personal protective equipment.
We hope that the health authority’s COVID-19 online information hub, the updates from the Department of Family Practice and VP Medicine’s office, along with the webinars and emails from Doctors Nova Scotia helped support you in your practice. Your engagement, questions and ongoing feedback have been appreciated as we collectively learn and take an iterative approach to providing you with useful advice and answers to the best of our ability.

On behalf of the Department of Family Practice, thank you again for providing accessible and quality care for your patients, for supporting your colleagues and for continuing to build a strong foundation for the health system in this province.
Free online wellness sessions for Nova Scotians – Fall 2020 schedule

Primary Health Care is offering a variety of online wellness programs this fall for adults of all ages on healthy eating, physical activity, mental wellness, parenting, and reducing one’s health risks. The wellness sessions are offered online in a friendly group setting using Zoom for Healthcare, and are facilitated by health care professionals, including dietitians, physiotherapists, social workers, and occupational therapists.

Anyone with a valid Nova Scotia health card can participate in these online sessions. To learn more and to register, patients can visit, or view the complete fall wellness schedule. Available sessions include:
  • Building better sleep
  • Understanding pain (3-week program)
  • For the health of it (7-week program)
  • Take charge of your stress
  • Self-compassion (4-week program)
  • Time management and well-being
  • Free time and you
  • Key assertiveness skills (2-week program)
  • Nutrition: fact or fiction
  • Making the most of your food dollar
  • Why am I still hungry?
  • Food and mood (2-week program)
  • Beyond weight (2-week program)
  • Sit less, move more
  • Finding an online exercise program
  • Pregnancy and exercise
  • Mindful movement
  • Self-compassion for parents
  • My child is anxious (2-week program)
  • An introduction to parenting your teenager
  • Screen time and your family
  • And many more!
Your Way to Wellness

Your Way to Wellness is a six-week program for people living with a chronic condition such as arthritis, chronic pain, or diabetes. Led by trained volunteers who have chronic conditions themselves, participants will learn current information about healthy living, share ways to manage, and take charge of their life – all in a relaxed, supportive, social environment online. To learn more and to register, visit

The Family Practice COVID-19 Screening Guide has been updated to reflect the revised COVID-19 screening criteria as outlined by the Office of the Chief Medical Officer of Health last Friday.

The revised screening criteria testing is now as follows:

In the past 48 hours have you had, or are you currently experiencing:

Fever OR Cough (new or worsening)


Two or more of the following symptoms (new or worsening):
  • Sore throat
  • Runny nose
  • Headache
  • Shortness of breath

Documents on the NS Health COVID Hub have been updated with the revised COVID-19 screening criteria.
Seasonal flu vaccination clinics and COVID-19 considerations

Public Health has provided preliminary information to help physicians plan to immunize patients for seasonal flu:
  • Everyone six-months of age and older is eligible for influenza vaccine.
  • The vaccine should be available the week after Thanksgiving (Oct. 12) barring any vaccine supply delivery issues from manufacturers. Consider holding larger vaccination clinics toward November to ensure the majority of Nova Scotia’s supply is available.
  • The initial supply of vaccines will be equitably distributed to all providers. The supply of vaccine will be available over several months.
  • Patients should wait 15 minutes after receiving the flu vaccine in case of syncope (fainting). This must be taken into consideration due to space needed to accommodate physical distancing and potential plans for drive-up clinics, where drivers and passengers will need parking space to wait.
  • CDC Guide: Considerations for Planning Curbside/Drive-Through Vaccination Clinics
  • Consider having family bubbles attend flu shot clinics together so that shots can be administered and they can wait together.
Guidance for influenza vaccine delivery in the presence of COVID-19
The Public Health Agency of Canada in consultation with the Canadian Immunization Committee and the National Advisory Committee on Immunization has developed guidance for the delivery of seasonal influenza vaccine this fall. As usual, priority should be given to providing influenza vaccine to persons at high risk of influenza complications and those capable of transmitting infection to them.
A number of approaches are being recommended for delivering immunizations, including:
  • designating specific times for immunization clinics to ensure that only well persons are in the area at the time (for example, at the start or end of the day)
  • cooperation between several medical practices to operate a joint influenza vaccine clinic in a dedicated space with dedicated staff
  • administering vaccines outdoors (for example, in a provider's parking lot or a drive-through clinic,weather permitting)
  • developing an outreach strategy to administer influenza vaccine to vulnerable persons, housebound persons, and seniors who are sheltering in place
  • providing immunization during home care visits
  • administering influenza vaccine at congregate living centres such as retirement homes, group homes, homeless shelters, student residences, and correctional facilities

Covid-19 Guidance Document for Students with Specialized Healthcare Needs

the Nova Scotia Department of Education and Early Childhood Education has developed a guidance document for students with specialized healthcare needs.

Given the importance of school attendance on children’s physical, social, and emotional well-being and while cases of COVID-19 in the Maritimes remain low, attendance is encouraged for all children. It is recognized that there are some children with medical complexities who cannot be in school at this time, just as they would not be attendance pre-COVID.

This document provides guidance to school staff as they plan for children with specialized health-care needs in their return to school, and the information may be a helpful reference for primary care providers you during your discussions with families about their health care concerns.

Included in the guide is information on students who:
  • require an aerosol generating medical procedure (AGMP) at school,
  • require close contact from school staff for personal care or procedures,
  • are immunocompromised, and/or
  • have common chronic medical conditions (e.g. Asthma, Diabetes)

This guidance document also includes information related to the type of support that may be required depending on the level of community transmission.

As you meet with families, it will be important to consider the current COVID-19 epidemiology, the overall back to school plan, the child’s school environment and the additional measures and advice within this guidance document.

Supply of Masks for Family Practice

As a reminder, the Department of Health and Wellness is currently supplying community-based physicians with procedure masks until early September. Considering ordering what you may need for the fall season:

Contact with any questions.
Family Physician Opportunities
Physician Consultant - Request for Proposals

The Health Workforce Branch of the Department of Health and Wellness has issued a request for proposals for the services of a Physician Consultant to provide support, advice and representation on a range of issues related to insured medical services policy, negotiations with providers, audits and appeals, out‐of‐province and out‐of‐country referrals, determination of medical necessity of services, among other topics. The Physician Consultant will also provide support and advice across the Department and directly to the Deputy Minister and Minister, as required.

More information can be found here.
Dalhousie University Faculty of Medicine - Seeking family physicians to participate in student learner opportunities

Please contact Denise Lavoie, Physician Resource Officer, Department of Family Medicine, ( if you are interested in participating in the following opportunity:
Family Medicine Med 1 Experience

During their first year of medical school, students have a mandatory Family Medicine Experience of 6 half-days with a Family Physician. Students primarily observe you, although we hope that as they learn communication and physical exam skills in their Skilled Clinician unit, they may be able to practice skills such as taking vitals or starting the history.  Students would be assigned on either Monday or Tuesday afternoons and there are 4 blocks available.

Prior to the start of this unit, students will have had PPE training and NS Health continues to support the provision of PPE to you for any medical students working in your clinical setting. It is hoped that students will be able to join you for in-person patient visits for the rotation, however we understand that many of you may still be providing primarily virtual care. This, too, is a very important learning opportunity for our medical students.

There are several strategies to include them in virtual care. You could conduct a phone call with a patient on speaker phone with both of you sitting in the same room together. Phone calls can be merged together so that the students could join a phone call remotely. If conducting video visits the student can be invited to attend the video appointment.

Teaching resources have been, and continue to be, developed to assist us all in this new teaching environment. We will select those most relevant to you to assist you in developing more comfort with this type of learner-teacher interaction and are happy to discuss with you individually about which methods might work best in your situation.

Upcoming Webinars & Learning Opportunities
BRIC NS Student Seminar Series: Chronic Disease Prevention and Treatment in Pregnant Women Examples of Dietetic Research at the IWK - September 16

The webinar on Wednesday, September 16, between 12:30 - 1:45, will cover two topics:

  • The effect of a home-based glycaemic index education intervention on dietary glycaemic index and glycaemic control in Nova Scotian women living with gestational diabetes mellitus: Intervention evaluation from the patients’ perspective. Presented by Julianne Leblanc.
  • Examining the implementation of the institute of medicine weight gain guidelines in women living with obesity. Presented by Amy Mireault.

Register for the webinar.

See the BRIC NS Student Seminar Poster for further details.
Let's Talk Informatics - Nova Scotia's Virtual Care Revolution – September 24

During the COVID-19 pandemic, the Virtual Care team facilitated the onboarding of over 3,000 clinicians across the province to Zoom for Healthcare, as well as undertaking many other virtual care related activities in order to support health care delivery throughout the pandemic.

Katie Heckman and Stacey Lake from Nova Scotia Health’s Information Management & Technology (IM/IT) Virtual Care are the guest speaker's for the next Let’s Talk Informatics webinar – Nova Scotia’s Virtual Care Revolution on Thursday, September 24.

This presentation will provide an overview of the challenges and opportunities associated with the unique circumstances that prompted a revolution in virtual care in Nova Scotia.

Let's Talk Informatics is certified by the College of Family Physicians of Canada and the Nova Scotia Chapter for one Mainpro+ credit by providing content aimed at improving computer skills as applied to learning and access to information. It is also approved by Digital Health Canada as a Continuing Education Provider enabling participants to claim 1CE hour for each presentation attended.
5 Minute Cognitive Behaviour Theraphy Online Course September 30 -October 28

This 5 week online course is designed for the busy clinician to learn brief Cognitive Behaviour Therapy (CBT) tools to improve coping and health outcomes for patient self-management and for personal benefit. This course brings minimal intervention to life, deepens understanding of behaviour activation and enhances competence in using tools for a wide range of patients, diseases & disorders.

This course is accredited for up to 18 hours MainPro+ Credits.

Course Instructors:
  • Keri-Leigh Cassidy, MD, FRCPC – A Geriatric Psychiatrist and founder of the Fountain of Health non-profit association with expertise in CBT and positivism in healthcare.
  • Michael Vallis, PhD., R. Psych – A Health Psychologist and behavioural change expert.
Foundation Course in Occupational Medicine

Submitted by Dalhousie University
The foundation course in occupational medicine provides you with knowledge and skills for areas in occupational medicine that are particularly encountered in family medicine and community based practice.
This blended learning course has been developed by the University of Alberta and covers materials and legislation relevant to the Maritime Provinces. The Canadian Board of Occupational Medicine (CBOM) will now offer the Associate Membership (ACBOM) examination to physicians who have satisfactorily completed Parts A and B of the Foundation Course in Occupational Medicine.
The key features of the course are:
  • Small class sizes 
  • 10 months: September 2020 to June 2021
  • Eight module course structured for blending learning 
  • Certified for 111 Mainpor+ credits in 2019-20
  • Self study, monthly videoconference/teleconferences run out of Dalhousie University and two one day workshops. 
  • Led by Dal Med family and occupational medicine faculty. 
  • Including information on how to recognize and manage work related disease and injury. 
For more information, please visit the course website or contact the course coordinator at
Gender Affirming Hormone Prescription Training Free Online Training

Are you a primary care provider in Nova Scotia who wants to learn more about prescribing gender-affirming hormones for trans and gender diverse patients?

The Community-Based Research Centre and prideHealth are pleased to provide a free online training program, which includes Mainpro certification for physicians and residents.

This training is completed independently, using recorded presentations and interactive quizzes. The time to complete the course is approximately 3 hours. While all healthcare providers are welcomed to take this course, the focus is for doctors, residents, and nurse physicians who have the capacity to prescribe.

The course is currently scheduled to be available online until August 2021 (when the Mainpro certification ends).

Participants should register online and will be then directed to the course on
Working with Transgender Patients - Free Online Training

30 minute course: this course is intended to offer basic information for staff working directly or indirectly with gender diverse clients within health care, mental health, and social work services. 

60 minute course: this course is for those interested in a more in-depth cultural competency training, which further explores gender diversity.
Surveys for Family Practice
Bringing care closer to home: Virtual care during COVID-19 and beyond

You are invited to participate in a brief survey for providers about your perspectives on the implementation of virtual care during COVID-19 to help inform ongoing considerations and improvements.

Participating is voluntary and takes approximately about 30 minutes to complete the survey. The survey has the option to be completed in stages; there is a save option in case you are unable to finish the survey in one sitting.

The rapid review study has received NS Health Research Ethics Board approval and the survey will be available until September 25, 2020. Learn more.

Physician Resilience COVID-19 Survey

Dr. Jackie Kinley (NSH mental health and addictions) and Dr. John Chiasson (DNS peer support program) and their colleagues ran daily open Zoom sessions, skills training sessions, delivered live and recorded webinars, and other custom initiatives to prepare Nova Scotia physicians for the pandemic.

They need your feedback to guide their preparation for the next wave. Your input is vital to this process and you are invited to complete this brief survey to help them serve you better.

Note: There is a request for consent at the beginning of the survey (that is to protect your safety and privacy). Please take a few minutes to complete this questionnaire.
Accreditation Canada Self Assessment Questionnaire for Physicians and Staff

Nova Scotia Health participates in an accreditation program to provide external validation and recognition that we are meeting national standards of excellence, based on best practice and evidence.

This self-assessment questionnaire for primary care is an opportunity to evaluate the extent to which we feel we meet these best practices in preparation for the organization’s next survey visit by Accreditation Canada, which is scheduled for fall of 2021.

The questionnaire is open until October 16, 2020.

Organizational Code: NOVHA
Password for Primary Care: F6EB9DE4