with long waiting times in emergency room Across the province, opposition parties are demanding the government urgently build additional primary care clinics to relieve pressure on the creaking health care system.
That style of clinic has a few different names, referred to as primary care clinics, multi-disciplinary clinics, or non-urgent care clinics. The idea is based on the community health center model, where multiple health practitioners, often with different areas of expertise, work together to provide patient care, rather than the traditional single primary care provider model.
Both the Liberal and Green parties want to see an expansion of clinic options in the province, allowing more people to access primary care outside the emergency room.
“For that type of clinic, it could be a nurse practitioner, various health professionals, pharmacists, who is able to take walk-ins, who is able to take appointments and who are able to get people out of the ER who are there are not related to,” said Liberal health critic Rob McKee.
There are already 14 such clinics across the province, the first of which was introduced by the Bernard Lord government nearly two decades ago. One of the clinics that is more successful is the Downtown Community Health Center in Fredericton. Health Minister Bruce Fitch says he has begun taking some less acute patients out of the emergency room at Dr. Edward Chalmers Hospital to help reduce wait times.
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But very few of the existing community health centers currently take walk-ins, something Green leader David Coon says must change immediately.
“Community health centers need to be given the resources, all 14, which are not currently providing walk-in services, need to be able to take patients,” Coon said.
He points out that the Queen’s North Community Health Center in Minto is one of the few that is already doing this, but says it needs to be expanded.
“We have given them space so, with the proper budget, they can provide walk-in services. This needs to be done quickly to reduce the pressure on the ER.
The province’s five-year health plan also identifies the need to move toward a team-based collaborative care model and has begun to take steps toward doing so. Fitch says similar projects are underway, including an upcoming family clinic in Lamec, where a team of doctors will work together to provide patient care.
“We encourage more family doctors to work in collaborative practices where they share patient records where they are available. It may not be the same doctor every time you go in, but a doctor whose have access to your records so you can better manage clients,” Fitch said.
The province’s primary care waiting list is being gradually eliminated by taking patients and giving them access to HealthLink NB, a network of different physicians that will take in-person and virtual appointments on an as-needed basis.
The program began earlier this year in the Moncton area and has been expanded to the Capital and Restigouche areas. Fitch says it could be across the province by spring.
In Dalhousie, the program includes a physical clinic where people will go for primary care. This can be expanded to other communities as well.
“Where we have Health Link, you can go in, you can see a doctor, a nurse, possibly a nurse practitioner, and your records will be there and kept. So it’s not a walk-in clinic where you Close follow-up, that’s not continuity,” Fitch said.
Koon sees this as proof that there is potential to expand the clinic model to more areas of the province. He says Horizon’s former CEO, Karen McGrath, told him she planned to open six more community health centers across the province, but that proposal was ultimately scrapped.
“Health officials were submitting proposals for six additional community health centers with multi-disciplinary teams in that year, with 2018 or 2019 on the horizon,” he said.
“[McGrath]explained to me that they had all kinds of real estate on the horizon … so that wasn’t the issue. The issue was the budget to prepare and equip the crews, and they didn’t get it. So it’s clear There is a lack of political will to move forward.”
Events prior to his time as health minister, Fitch says he was not aware of McGrath’s plan.
Fitch says the biggest obstacle to setting up additional community health centers is the same one that faces the rest of the health care system. With chronic shortages of staff and an inability to fill existing vacancies, Fitch says creating new clinic positions won’t do much good.
But Mackie says there’s no reason not to try. In fact, he says, positioning the clinic can be a recruiting tool in itself.
“My understanding is that there is a desire for professionals, young professionals who are looking for more work-life balance, are looking for collaborative practices,” he said.
“If I get an indication from the government that they’re moving in that direction, I think you’ll buy from those professionals.”
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