Allison Dysart put the "closed" sign on his Sackville, N.B., office yesterday and the 37-year-old family physician began pondering his future in the province of his birth.
He was one of more than 1,000 doctors who staged the first provincewide walkout in the history of New Brunswick yesterday.
Across the province doctors ignored the pleas of Premier Bernard Lord that their actions were "unnecessary and unwarranted." They shut down their offices indefinitely to protest against a contract offer by the provincial government that they say will only exacerbate their comparatively low wages and long hours.
The move came after a marathon negotiating session with a provincially appointed mediator failed to end in agreement on how to solve the doctor shortage in a province where as many as 36,000 people don't have a family physician.
"I wish we had a different message today but we don't," John McCann, president of the New Brunswick Medical Society, told a news conference yesterday. "The walkout will go ahead as planned."
Mr. Lord said that the province has improved its offer to the doctors and is working to bring a quick end to the work stoppage.
If necessary, Mr. Lord said, the province would take the case to an arbitrator for a decision on how much doctors should be paid. "We're not going to let this go on very long," he told reporters.
Dr. Dysart, like most physicians, was still seeing patients in hospital and providing emergency services. Emergency rooms across the province reported larger-than-usual crowds, but most hospitals said that patients were not being subjected to extraordinarily long waits.
For Dr. Dysart and his wife and two small children, the outcome of the closed-door negotiations scheduled to resume today are crucial.
He's one of a large group of young, mobile doctors who are fed up with fees they say are some of the lowest in the country. They blame low fees for an continuing shortage of physicians that forces those employed to work as many as 60 hours a week.
They are considered the future of medicine in a province where more than 40 per cent of the physicians are over 50 years old and many want to retire. The young physicians have been pushing the Medical Society to take a more aggressive stand and demand that their fees be increased by at least 30 per cent to bring doctors' incomes up to the same level as neighbouring Nova Scotia.
The society is demanding an increase in compensation of about $50,000 a year over three years. The province is offering an immediate increase of $17,000 a year and a total of $23,000 over four years.
Doctors in New Brunswick make an average of $150,000 a year after ordinary expenses.
"Most of us feel that if this [round of negotiations]doesn't go anywhere we can forget about any improvement for a long, long time," Dr. Dysart said in an interview at the Sackville Memorial Hospital. "For us this is very personal. This is the choice: Do we stay or do we go?"
If he went to nearby Amherst, N.S., he would make as much as 40 per cent more a year. Other places such as northern British Columbia also look attractive to the doctor, especially the relief from the constant headache of not being able to care for people who call his office now looking for a doctor.
In the small town of 6,000, he has a waiting list of 100 and is caring for 2,000 patients. As many as 10 people a day call asking to be added to his list. He wants to stay in the small town where he and his wife have deep roots, but not at any cost.
"My family has been in New Brunswick for 200 years and I look on this as my turf, but on the other hand I'm not prepared to be a martyr for the New Brunswick health-care system," he said.
Ross Thomas, the hospital's chief of staff, said many doctors who located in small towns to escape the stresses of large urban practices now feel that they are working too hard to enjoy their new settings. As well, lower fees and the doctor shortage are scaring off medical-school graduates.
"How do you get people to come here if somewhere else is offering them more money?" Dr. Thomas asked. "The money is not the only thing. But the financial aspect is important. When you have a situation where it is hard to recruit people and you have a physician shortage, that unfortunately becomes the critical thing."
So far, Mr. Lord has maintained that the province can't afford the increase the physicians demand and is successfully recruiting doctors through the use of relocation grants of as much as $40,000.
But on the first day of the walkout it appeared that the doctors had public sympathy on their side -- even patients who battled snowdrifts to wait for medical care at emergency rooms.
Eugene LeBlanc of Memramcook suffered stomach pains early yesterday and phoned his local clinic, only to be told the doctor wasn't working.
He drove about 20 minutes to the Sackville hospital and waited calmly to see the doctor on duty.
Mr. LeBlanc pointed to the fact that the Tories are spending money on hiring a consultant to find a new logo for the province.
"I think Bernard Lord should take the money he's spending to change the logo of New Brunswick and use it to pay the doctors," he said.