ST. JOHN'S, N.L. - Newfoundland and Labrador is scrambling to find a replacement for the province's only infectious disease specialist, who will be leaving next month.
Two months after Dr. Mazen Bader tendered his resignation, the province's largest health board continues to look for a physician who can take over his duties.
Doctors and health-care advocates are concerned Bader's departure could leave patients with HIV, hepatitis and other infectious diseases without adequate treatment for some time and say it reflects a larger problem across Canada.
"We have to keep in mind that there are shortages in the medical specialties across this country," said Dr. Julia Trahey, a general internist at the Health Sciences Centre in St. John's.
"We're going to face challenges because everybody's looking."
At full complement, Newfoundland and Labrador is supposed to have three infectious disease specialists. It now becomes the second province to be without one. Prince Edward Island is in a similar position.
Trahey said Bader's expertise is extremely important in her treatment of patients with ailments including hospital-acquired infections and tropical diseases.
"You have the very, very ill in hospital who are dependent on his advice and his skill," she said.
"If they get beyond a certain antibiotic regime, we don't actually have the expertise to contact about what else we should do."
Dr. Gerald Evans, president of the Association of Medical Microbiology and Infectious Disease Canada, said Newfoundland may find it a struggle to recruit for Bader's job because there are only eight to 12 new infectious disease specialists annually.
"Overall, it's really kind of analogous to the situation that's happening in other specialties," Evans said.
"The only thing for ID is that there are less of us to start off with and we don't produce as many infectious disease specialists, principally because it's not as popular."
Eastern Health says it is actively recruiting for Bader's replacement and has received some expressions of interest in the position.
But it is also devising a contingency plan for Bader's patients in case it can't hire a replacement before he leaves in mid-March.
"As far as we know, they will not have to leave the province, but will receive an alternate form of service as part of that contingency plan," Eastern Health spokeswoman Deborah Collins said in an email.
"Eastern Health will inform its patients of what that contingency plan entails once Dr. Bader leaves."
It's not clear why Bader is resigning. He did not return messages seeking comment.
His resignation is particularly worrisome because he ran the province's only HIV/AIDS clinic, overseeing about 120 patients, said Christopher Pickard, executive director for the AIDS Committee of Newfoundland and Labrador.
"All of a sudden to know that there is nobody there that has that specialized knowledge is quite frightening," Pickard said.
Microbiologist Dr. Jim Hutchinson said he is willing to take on some of Bader's workload.
But the rest of Bader's duties will likely be assigned to other physicians with an already heavy workload, he warns.
"You can't have the last person who was an extraordinarily busy clinician leave without there being a problem," he said.
Infectious diseases are the fifth leading cause of premature death in the country, according to Genome Canada.