Nova Scotia has lost 114 doctors over a six-year period, and those losses are happening at an accelerating pace — a trend that one recruitment expert describes as troubling.

"The fact that it's increasing in more recent years would suddenly put it on my radar," said Dr. Anil Verma, director of the Centre for Industrial Relations and Human Resources at the Rotman School of Management in Toronto.

"I'd want to investigate what's going on and what we can do about it," he said.

CBC News has analyzed six years of Nova Scotia doctor migration figures to and from all Canadian provinces, territories and foreign countries.

Nova Scotia has experienced a net loss of doctors to every region except the other Atlantic provinces. Net losses and gains represent the change in doctor numbers after both the arriving and departing doctors are taken into account. (CBC News)

The numbers, provided to the CBC by the Canadian Institute of Health Information (CIHI), show a net loss of 114 physicians since 2011, with 273 doctors moving into Nova Scotia over the six-year period and 387 leaving.

From 2011 to 2016, the losses increased steadily, with nearly 40 per cent of them happening in 2016, the last year for which migration figures are available.

The numbers show Nova Scotia is attracting doctors from the rest of Atlantic Canada, with a net gain of 25 from New Brunswick, P.E.I. and Newfoundland and Labrador.

But those gains are overshadowed by out-migration, especially to Ontario and British Columbia, which accounted for the net loss of 98 physicians.

'It's a little bit like a war'

Verma said convincing doctors to stay in Nova Scotia will take a multi-pronged approach.

"It's a little bit like a war, where you have to use all the weapons," he said. "It's not any single weapon that does it for you. You've got to fight it on all the fronts."

Because the province pays doctors as contractors, luring them with pensions, medical benefits and generous vacations isn't on the table.

Anil Verma is the director of the Centre for Industrial Relations and Human Resources at the Rotman School of Management in Toronto. (CBC)

But Verma said funding medical research and research facilities can draw new talent.

"Investing in R and D [research and development], creating these centres of excellence, tapping into pools of doctors who want to come to Canada, increasing salary — I would do all of those," he said.

Pay increase would help

Verma said Nova Scotia's position as the lowest-paying province for family doctors is responsible for some of its problems, especially the physician out-migration to Ontario, where an average family doctor earns more than $100,000 more a year than in Nova Scotia.

He believes increasing family doctor pay in Nova Scotia could start to reverse the outflow.

"I would be comfortable in saying that if you could offer 25 per cent increase in salary to Nova Scotia doctors, you would cut this turnover in half," he said.

A CBC News analysis of data from 2011-2016 has found Nova Scotia doctors are leaving for other provinces at an accelerated pace. 1:24

Based on CIHI statistics on the average salaries for Nova Scotia family doctors, that 25 per cent increase for the province's 1,118 family doctors would cost roughly $61 million per year.

But stemming the loss of doctors entirely would cost even more.

"If you did not want any doctors to leave Nova Scotia, then you will have to be the top paymaster in the country," he said.

Selling prospective recruits on Nova Scotia

Despite these daunting figures, Verma thinks there's hope for the province's recruitment struggles.

"You know, sitting from where I am, what jumps up at me is that Nova Scotia is a very unique place to live. And I think that's what you have to sell," he said.

"It's not just the practice of medicine, or the salary. You've got to look at what Nova Scotia offers for the spouse, for the children, for the long-term future."

According to Doctors Nova Scotia, there are currently 2,376 practising doctors in the province, not including medical students, residents and retirees.

The province's Physician Resource Plan calls for the recruitment of 1,000 new full-time doctors by 2026, evenly split between general practitioners and medical specialists.