The closure notice taped to the emergency department doors at Eastern Shore Memorial Hospital wasn’t a surprise to Darlene MacKeen anymore. She’d grown used to the routine: check social media, call the hospital’s information line, or read the notices posted around her coastal community of Sheet Harbour, Nova Scotia.
“My husband needs regular care for his heart condition,” MacKeen told me as we sat in her kitchen overlooking the harbor. “Last month, I drove him 115 kilometers to Halifax when our ER closed unexpectedly. We left at 4 a.m. just to make sure we’d get seen that day.”
What was once considered extraordinary—hospital emergency departments closing temporarily due to staff shortages—has become a troubling norm across Nova Scotia in 2025. According to data released by Nova Scotia Health last month, emergency departments across the province were closed for a combined 31,724 hours in the past year—representing a 22% increase from 2024 and nearly double the closure hours recorded in 2022.
The crisis is most acute in rural communities where a single physician shortage can trigger cascading closures. In Sheet Harbour, the emergency department was unavailable to residents for 142 days last year—nearly 40% of the time.
“We’re seeing a healthcare system in serious distress,” explains Dr. Leisha Hawker, president of Doctors Nova Scotia. “Many physicians are retiring or reducing hours because of burnout, and recruitment hasn’t kept pace, especially in communities outside Halifax.”
The province’s Physician Resource Plan, updated in March 2025, estimates Nova Scotia currently needs an additional 278 physicians to meet baseline care standards—96 specialists and 182 family doctors. The shortfall has created what health policy experts call a “care desert” in many rural communities.
For residents like Jim Porter, a retired fisherman in Pugwash, the consequences are potentially life-threatening. “I had chest pains last winter and our local ER was closed. My neighbor drove me 80 kilometers to Amherst, and I found out later I was having a minor heart attack. Those extra 45 minutes could have been the difference between life and death.”
When I visited the North Cumberland Memorial Hospital in Pugwash this spring, the parking lot was nearly empty despite it being a weekday morning. The emergency department, which once operated 24/7, now averages closures three days each week.
At the heart of the crisis is what healthcare policy experts call the “perfect storm”—an aging physician workforce, increased care demands from an elderly population, and difficulty attracting new doctors to rural practice.
“Many new graduates carry substantial debt and are looking for positions with sustainable workloads and professional support,” explains Dr. Hawker. “When they see rural physicians working unsustainable hours with limited backup, it becomes a difficult sell.”
The province has implemented several initiatives aimed at addressing the shortage. In February, Nova Scotia Health launched an expanded Virtual Emergency Care program allowing residents in communities experiencing closures to access emergency physicians through secure video visits. The program has conducted more than 12,000 virtual assessments since January, but critics note it can’t replace in-person emergency care for serious conditions.
Health Minister Michelle Thompson defended the government’s approach when I spoke with her by phone. “We’ve increased physician compensation, especially for rural emergency work, expanded our recruitment team internationally, and launched new residency positions at Dalhousie Medical School focused on rural practice.”
The province also points to its Community Hospital Inpatient Physician Service (CHIPS) program that brings locum physicians to rural hospitals and has filled approximately 6,000 shifts in the past year. Despite these efforts, the closure data suggests the gap continues to widen.
For communities experiencing regular closures, the impacts extend beyond healthcare. Mayor Tom Taggart of the Municipality of Colchester told me emergency department closures are affecting economic development.
“We’ve had two businesses reconsider relocating here specifically because of healthcare access concerns,” Taggart said. “Young families are particularly worried about moving to areas with unpredictable emergency services.”
Some communities have taken matters into their own hands. In Middleton, local businesses, municipal leaders and residents formed the “Middleton Healthcare Action Coalition” after their regional health center experienced 94 days of emergency closures in 2024.
The group raised $175,000 to create a physician housing fund, providing free accommodation for locum doctors and new recruits. They’ve also established a “community connector” program that introduces potential physician recruits to local schools, recreation opportunities, and neighborhoods.
“We know doctors aren’t just looking for a job—they’re looking for a community,” explains coalition chair Sandra Miller. “We’re trying to show them what Middleton offers beyond the hospital walls.”
Their efforts appear to be working. Middleton has recruited two new emergency physicians in the past six months, reducing their closure rates by approximately 35% compared to last year.
Similar community-led initiatives are emerging across the province, from welcome packages for visiting physicians in Digby to recruitment videos featuring local amenities in Antigonish.
Back in Sheet Harbour, Darlene MacKeen has started organizing transportation networks for elderly residents who need to reach distant emergency rooms during local closures.
“We can’t just wait for the province to fix this,” she says, checking her phone for today’s closure notices. “These are our communities, our hospitals, our neighbors. We need to be part of the solution.”
As Nova Scotia’s healthcare challenges continue, that spirit of community resilience may prove as important as any government policy. What remains clear is that the status quo—thousands of hours of emergency department closures affecting Nova Scotia’s most vulnerable communities—is increasingly untenable for residents who simply want reliable access to essential healthcare.
