By Angela Hill

Health plan redesign could help communities with doctor shortages

Apr 25, 2011 | 6:22 AM

Shellbrook is set to lose three physicians in July and Spiritwood has managed to recruit only one of the four they need to have acute care services returned to their hospital.

These communities aren’t in isolation when it comes to having trouble keeping consistent access to primary health-care services.

But these services are foundational to the health system, said Donna Magnusson, executive director of Primary Health Services Branch of the Ministry of Health.

“They’re generally your first point of contact with the system, either through a visit to a family physician, a nurse practitioner, contact with your pharmacist. They’re the entry way into the health system so they are very important to people,” she said.

The Ministry of Health is currently undergoing a primary health care redesign, prompted by the Patient First Review report of 2009 that wanted access to accurate, reliable care for all people.

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A big part of what could be rolled out as a new provincial primary care program is a team-based approach, encouraging sharing the workload, so it doesn’t all fall on the shoulders of often over-worked doctors.

“Certainly anything that can share the workload or encourage physicians to practice with other health providers in the communities makes their work, life balance a lot better,” Magnusson said.

During a press conference about the July departure of the Shellbrook doctors, Senior Medical Officer Dr. Edmund Royeppen spoke about finding “call suitability through various models.”

This speaks to decreasing the amount of on-call time a doctor has to have in these rural communities by making sure there is a greater focus on prevention and using other health-care professionals to the full scope of their practice.

The team-based approach already exists in some areas of the province, said Fay Schuster, director of the Ministry of Health’s Primary Health Services Branch.

There are about 73 of these teams in the province and there was a recent trip to Alaska to view a high-performing model there.

“I think what we are challenged with is how do we scale that across the province so that everybody has the same kind of access to a high preforming team, where those services they deliver are reliable and predictable,” Schuster said.

This team approached could also be used in inner city areas, she said.

The process began in Sept. 2010 with three key working groups —community engagement, chronic disease management and prevention through a team based approach and physician engagement, said Magnusson.

They are aiming for a meeting of these groups in mid-May and to have a draft framework in place by the end of June.

“It’s fairly ambitions timelines,” she said.

After that they will take the framework to consult with as many people as possible.

“If (you’re) looking at a change, you need to make sure people understand and support it,” Magnusson said.

One community, at least, has expressed concern that the teams will be too focused on the use of other health-care providers, such as nurse practitioners, without enough focus on doctors.

ahill@panow.com