Premier Tim Houston and Health Minister Michelle Thompson visited the Dalhousie Family Medicine Clinic in Halifax on Wednesday to announce new initiatives designed to help recruit more family doctors and to help more people access health care.
There are currently close to 110,000 Nova Scotians registered on the Need a Family Practice Registry, a number that has grown by 40,000 in the past 14 months since the Conservatives were elected on a promise to fix health care.
The result is that across the province it’s not unusual to see lineups of 30 people or more waiting for walk-in clinics to open so they can be seen by a health care professional. Or people paying a monthly fee of $25 to a new private medical clinic called Algomed just to ensure they can get an appointment to see a nurse if they happen to get sick or need a prescription refill.
“Improving health care is the most pressing issue for Nova Scotians,” Houston said on Wednesday. “And I assure you it is one of the most pressing issues for me and my government.”
Houston and Thompson said recent changes made at the Dalhousie Family Medicine Clinics located in the West End Mall and in Spryfield have resulted in 780 patients coming off the Need a Family Practice Registry. By the end of June 2023, Thompson expects approximately 3,500 people will no longer be without a health care provider.
Changes being trialed by the Dalhousie clinic where student doctors are trained include hiring a licensed practical nurse, a physiotherapist, and a social worker to form a collaborative team that can provide ongoing care to people with chronic health issues such as diabetes and COPD. Teamwork means more patients can be seen without necessarily involving a medical doctor or a nurse practitioner. If consults are required, the visits will be shorter.
The licensed practical nurse or “rapid onboarding team” is another idea targeted to reduce some of the paperwork associated with taking patient histories and dealing with patient referrals that consume a lot of time. According to Dr. Joanna Zed, the medical director of Dalhousie’s Family Medicine program, that one change has increased the capacity of the Dal clinics to see about 30% more patients.
Over the next four years, these changes being tested at the Dalhousie Family Medicine Clinics will be offered across the province to other community clinics and family medicine practices.
“We are hopeful Nova Scotians will experience faster access to care once these new projects are scaled up and out across the province,” said Gail Tomblin Murphy, vice-president of research, innovation, and discovery at Nova Scotia Health.
Changes to the composition of family practices along with reducing the paper burden should help nurse practitioners and doctors see more patients.
A third change is aimed at encouraging more medical students to consider family medicine as a career and to retain even more graduates of Dalhousie University’s Family Medicine program.
About 44 family medicine doctors graduated from Dalhousie last year. According to Jane Gaffney, media relations for Dalhousie Medical School, over the past five years, about three-quarters of the family medicine graduates have chosen to stay in Nova Scotia.
Starting this summer, when the next cohort is due to graduate, newly minted family doctors will be offered free office space and an experienced mentor if they sign on to work at Dalhousie Family Medicine clinics before establishing their own practice. And they may take their Dal clinic patients with them.
“This offers new doctors an optimal training environment,” said Zed.
This same offer may be available sooner than next summer to doctors who are new or moving to Nova Scotia, according to Grayson Fulmer, senior director medical affairs with Nova Scotia Health.
The premier announced the province has budgeted $6.3 million over four years to test these new models and “scale them up” at community clinics across the province.
Liberal leader Zach Churchill said he hopes that it will work.
“We want to see less people who need a family doctor,” Churchill said in an interview with the Examiner. “So, time will tell whether this is an effective model or not. We have to evaluate it based on how many new family doctors are being brought into the system and how many patients are being attached.”
“Another real important question is whether we are going to be able to keep up with the pace of retirements. We know, for example, there are more than 100 family doctors practicing who are over the age of 65.”
NDP MLA Gary Burrill said Wednesday’s announcement were “good baby steps” at a time when “bold steps” are required to improve access to health care.
“At this time, when we have 110,000 people on the list waiting for a family practice, I think it is true this is not a moment for baby steps. It’s a moment for the kind of bold and comprehensive steps that were promised by the Conservatives and the government 14 months ago and I think we are not seeing those today.”
Burrill said it’s a question of magnitude. “We are talking about acquiring better access to health care for 3,500 people in a situation where we have 110,000.”
Meanwhile, the emergency rooms remain overcrowded when people have no other option.
The legislature goes back in session on Thursday. The premier declined to respond to a question from reporters about why he asked Conservative MLA Keith Bain to consider resigning as Speaker of the House. Houston said he didn’t want to “taint” the good news around health care by responding to “rumours” and a “manufactured story.”
Bain has not offered his resignation.