Currently my medical practice includes my private practice office plus working in the hospital. This includes many aspects of adult psychiatry and child psychiatry. It is definitely not sustainable, as the workload is beyond my capacity to manage in the medium term. There are a number of factors playing a role, but I would say being 67 years old is the most important one. My plan is to make these changes over the next year so that some adaptations can be made. These changes will begin January 1, 2024. After I close my private practice, I will continue to work at Yarmouth Hospital through the Department of Psychiatry.
This is the timeline I will be following:
September 1, 2024 –December 20, 2024:
I want to make sure that I see all the consults I have received before I close my practice. My administrative assistant and I are guessing that after September 1, 2023, I will no longer accept consults for child and adolescent psychiatry at my office, so that all of the outstanding consults can be seen. I am hoping by this point, the administrators of the mental health clinic and the western zone, in cooperation with the IWK, will have come up with a plan to fill this gap.
December 20, 2024:
My office will be closed. My administrative assistant and I will provide copies of medical records under the guidelines set out by Doctors Nova Scotia.
In summary, for a variety of reasons, my current practice mix is unsustainable. I will continue to provide psychiatric care at Yarmouth Hospital, but not in my private practice office. By doing this slowly over a year, I am hopeful that my patients and our health care system can adapt.
Sincerely,
James Chandler, MD FRCPC
Certified Specialist - Child & Adolescent Psychiatry
Dr. James Chandler Private Practice office
is closing December 20, 2024 (not 2023)
January 1, 2024 – August 31, 2024:
I will no longer be able to see consults from sources who are unable to prescribe medications. I will work with social workers, mental health clinicians, and other mental health providers to help them find primary care providers whom I can consult with, rather than taking on more patients as my own.
All our correspondence with patients and providers will explain the information in this document. The new yourhealthNS app should prove invaluable in this regard. Over the course of 2024, I will have seen all the patients in my practice to make sure they have access to their records and work on transferring their care to primary care providers. I will also work with the local pharmacies and pharmacy clinics to help them provide continuity of care. All prescriptions I provide from this point on will expire no later than January 15, 2025.
I would expect I will do more indirect care with primary providers and pharmacists to help them with management. Some of our primary care providers have not had a lot of child psychiatry lectures in their training, and I will be glad to provide that if needed.