Dr. Gord Simms is a family doctor in Antigonish, but that’s only part of his job. He’s also a hospitalist, looking after patients admitted to St. Martha’s Regional Hospital. He has a PhD in biochemistry, a particular interest in complex chronic disease, and a patient roster whose median age is somewhere around 72 to 75.
We sat down with Gord to talk about what family doctors actually do all day, why a 15-minute appointment is not really a 15-minute appointment, what happens when your doctor doesn’t call you about your blood work, and why the family doctor shortage is still such a problem in Antigonish.
So What Does a Family Doctor Actually Do?
The short answer is: almost everything.
Family medicine is designed to be the first point of contact with the healthcare system. Gord sees children, adults and patients over 100 years old. His practice includes preventative care, chronic disease management, acute illnesses, mental health, addictions and palliative care. He also has patients he has technically never met — people who are registered with his practice but haven’t yet needed to come in.
His own patient roster is unusually complex. When Gord began practicing in Antigonish three years ago, he took patients from the provincial registry, some from a retiring physician, and others from people he encountered while working as a hospitalist who had significant medical problems but no family doctor. The result is a practice with a median patient age in the mid-70s.
He likes it that way. Complexity, it turns out, is one of the things that drew him to family medicine.
From the Lab to the Clinic
Gord didn’t exactly take the conventional route to becoming a family physician.
He fell in love with chemistry as an undergraduate, then went on to complete a PhD working on Alzheimer’s disease research. He spent years in front of a laboratory bench, a computer or an NMR machine, developing molecules that might eventually contribute to treatments.
But something was missing: people.
Research can take decades to produce a tangible result. You can work on a molecule for years and, if everything goes perfectly, perhaps a drug eventually helps somebody twenty years down the road. Family medicine offers a rather different form of gratification. A patient can walk into your office with a problem and, five minutes later, tell you that you’ve helped.
Gord realized that what he really enjoyed was the human connection — building relationships with people and helping them directly. He applied to medical school, didn’t get in on his first attempt, applied again, and eventually made the transition from the laboratory to the clinic.
The 15-Minute Appointment
One of the questions almost everyone with a family doctor has probably wondered about: why does my doctor seem to be running late?
Gord’s answer is that the 15-minute appointment is more complicated than it sounds.
If you’re seeing 25 patients in a day, adding just five minutes to every appointment can add two or three hours to the working day. And a 15-minute appointment isn’t actually 15 minutes of conversation. There are questions to ask, medications to discuss, blood work and imaging to order, referrals to arrange and notes to write.
Gord tries to negotiate the appointment with patients: What’s your list today? What do they want to discuss, and what does he need to address? Sometimes everything can be dealt with. Sometimes something has to wait.
If something is genuinely urgent, however, the rules change. A patient who needs 45 minutes gets 45 minutes. The consequence is that someone else may have to wait.
For many family physicians, these time constraints—and knowing that there is a backlog of patients in the waiting room—are a constant source of stress.
The Inbox Avalanche
The part of family medicine that patients probably see least is the work that happens after they leave.
There is an overstuffed email inbox. It never stops.
Specialist letters arrive. Blood work arrives. Imaging arrives. Notes from other healthcare providers arrive. There are decisions to make about patient care, calls to return, forms to complete and results to communicate.
Gord describes it as a never-ending avalanche. Even though the clinic day might officially run from eight to four, he estimates that another two or three hours of work can follow.
And the inbox doesn’t take weekends off.
If a specialist calls on a Saturday about one of his patients, he answers. If an urgent blood test comes back while he’s working his hospitalist week, he deals with it. During a seven-day hospitalist shift, he might see 25 patients a day while simultaneously managing issues belonging to his family practice patients.
So Why Didn’t My Doctor Call?
There is another side to the communication question.
If you’ve had blood work or imaging done and haven’t heard from your family doctor, it doesn’t necessarily mean that nobody has looked at it. Gord’s practice tries to “close the loop” with patients when results are normal — staff may call to say that everything is fine and that an appointment is only necessary if the patient wants to discuss it further.
If something requires attention, patients will be contacted.
That said, Gord’s advice is straightforward: if you’re concerned, call your doctor. It never hurts to close the loop yourself.
Maple, 811 and the Four-to-Six-Week Wait
Gord’s current wait time for a routine appointment is around four to six weeks, which he says is fairly standard.
That creates an obvious question: what do you do when you need medical care before your appointment?
There are alternatives. People can call 811, use Maple or virtual healthcare, or go to an emergency department when appropriate. Gord doesn’t consider it a failure if one of his patients sees another doctor for an acute problem when they can’t get in to see him.
The limitation is continuity. A Maple physician may not have access to all the same records Gord has, and Gord may not know what was discussed during that appointment.
That is one of the reasons the province is moving toward a “one person, one record” system. The goal is that a physician in one part of Nova Scotia will eventually be able to access the relevant blood work, imaging and medical information generated somewhere else in the province without having to navigate several different systems.
At the moment, Gord says, things are considerably more piecemeal.
Collaborative Medicine
There is also a new model emerging in the province and Antigonish: collaborative practice (officially called Health Homes).
Instead of every patient belonging exclusively to one physician, a truly collaborative clinic has doctors, nurses, nurse practitioners and other healthcare providers working together around a shared pool of patients.
Gord’s current practice at the Mediplex is what he calls quasi-collaborative. Doctors maintain their own patient rosters, but leave openings in their schedules to see one another’s patients when something acute comes up.
There are obvious advantages to a fully collaborative model, particularly when a physician wants to go on vacation. Someone else can monitor the inbox, blood work and imaging.
The Best Part of Being a Family Doctor
For all the discussion of workload and burnout, there is a reason Gord chose family medicine.
It’s the longitudinal relationship.
You see someone not once, but over years. You learn their history, their values, what treatments they’ve tried and what has worked or failed. You watch people move through different stages of their lives.
And Gord likes advocating for those people.
The healthcare system is strained, he says, and access can be difficult even for people who have a family doctor. Helping patients navigate that system and get the care they need is one of the things he finds most satisfying.
He also enjoys the complexity — patients who have accumulated illnesses over the course of their lives.
Burnout
The downside is that the same continuity that makes family medicine rewarding can also make it difficult to leave.
Gord describes the pressure of constantly having something that needs attention. There is the clinic. There is the hospital. There is the inbox. There are specialist calls. There are urgent results. And because you know and have a long-term relationship with your patients, it can be difficult to simply hand them off to someone else.
During one hospitalist week, Gord estimates he can work around 90 hours over seven days.
His approach to staying sane is fairly practical: take a week off every three months, exercise, and recognize that he has some control over how busy he chooses to be. He has a three-year-old and a five-year-old at home, and a wife who he describes as “hyper-capable” and who keeps the household running while he works.
He is, he admits, always tired.
Five Things
When Justin asks Gord what people can do to avoid needing to see a family doctor in the first place, the answer comes down to one word: Lifestyle.
Gord breaks it into five components: exercise, sleep, hydration, diet and social interaction.
None of these things will prevent every illness, he says. People get sick. But it is easy to let one or two of these pieces disappear from your life, and when several do, the effects on health, energy and general wellbeing can be significant.
It’s perhaps the simplest piece of advice in an hour-long conversation about a very complicated healthcare system.
Why Antigonish?
Gord grew up in Dartmouth. His wife, Holly, is from Antigonish. They moved to Antigonish with their children and Gord’s father to be closer to family.
The town’s size is part of the attraction. There is plenty for children to do, a university bringing energy and culture to the community, access to nature and enough of the amenities of a larger centre without actually being one.
Professionally, Gord says the medical community is another reason to stay. There are specialized clinics that support family doctors, local internal medicine specialists, and a surprisingly young cohort of physicians.
Since he arrived three years ago, approximately ten family doctors around his age have been recruited to the area.
The Things That Would Attract More Physicians
Gord is also involved in physician recruitment, so he spends some time thinking about what makes Antigonish attractive to doctors — and what makes it difficult.
His answer isn’t really about doctors.
It’s daycare and housing.
He and Holly were on a daycare waiting list before they even arrived in Antigonish, and then waited another year after moving here before getting a spot. If you’re trying to recruit professionals with young children, access to childcare isn’t a luxury; it’s a prerequisite for being able to work.
Housing is another problem.
These aren’t exclusively physician recruitment issues. They’re problems for anyone trying to move to Antigonish and for people who already live here.
Where Things Stand
There are still roughly 2,000 people in the Antigonish area without a family doctor, Gord says.
But there is some genuinely good news.
The percentage of Nova Scotians without a family doctor has fallen from 10.4% in January 2025 to 5.5% in May 2026. Gord and others involved in recruitment are starting to see the results of their work.
The problem isn’t solved. Rural and remote communities continue to face greater access challenges, and those challenges put pressure on both family practices and emergency departments.
But the numbers are moving in the right direction.
And Gord is optimistic that the work being done locally is beginning to make a difference.
After all, he came to Antigonish because he wanted a place where he could build a life with his family. He found a medical community he enjoys working in, a town with plenty for his children to do, and a profession that gives him the human connection he was missing when he was working in a laboratory.
The system is strained. There are still too many people waiting for care. And Gord’s inbox will presumably continue to avalanche.
But he’s happy to be here.
Get full access to Let's Talk Antigonish at letstalkantigonish.substack.com/subscribe
