Retired family physicians present ideas on how to better access health care in N.B.

Four retired family physicians are expressing their concerns about what’s happening within New Brunswick’s health-care system and have put their thoughts on paper.

They say the province is responsible "to provide care to everybody in our society," but they’re hearing from former patients and colleagues that primary care can be hard to access.

And while that’s not a new problem, they have some new ideas.

“Health care, as we know it, will not be back. It’s in the past and we need to look at new ways of doing things,” said Dr. Stephen Hart in an interview with CTV Atlantic. “And probably the key element to our recommendation is the whole idea of the collaborative care practice.”

That care practice would be a team -- a family physician, family practice nurse and a nurse practitioner -- with the aim of increasing the number of patients the team can treat, and allow a patient quicker access to care.

It’s a model that is being tested in several parts of Canada.

But Dr. Bob Tingley says there’s one step that needs to be taken in New Brunswick before collaborative care teams are realized.

“These family practice nurses are worth their weight in gold ... The first thing that has to happen is to address the nursing shortage, because there’s not a big enough pool of registered nurses in our province right now; to find 300 or more family practice nurses who would be interested in family care … Most of the nurses we have right now have to work in hospitals or extramural program,” he said. “So the government must address the nursing shortage with collaboration with the nursing profession.”

The New Brunswick Nurses Union has said there are 1,000 registered nursing positions and 300 licensed practical nursing positions available right now in the province.

The four retired doctors also feel an audit on the number of practising family physicians is necessary.

“Many of them are not doing primary office care. They’re doing a lot of other good services,” said Dr. Ian MacDonald. “Many of them are doing hospital care, many of them are doing hospitalist care, many of them are in special clinics such as oncology clinics, some of them are doing OR assisting, but they’re still labelled as primary physicians.”

The number of people on the province’s family doctor wait list is about 40,000.

But while the majority of the province has a family doctor, the group of four says not everyone is getting access in a timely manner.

They warn that virtual care shouldn’t replace the personal, face-to-face experience.

“Virtual care is best if it’s between a doctor and a patient who already do know each other and have had personal, face-to-face contact in the past,” said MacDonald. “It’s difficult to do virtual care properly if the doctor and the patient have never been in touch with each other before.”

The group say the issues that need immediate action include:

• auditing the number of family physicians
• addressing the nursing shortage
• developing Urgent Care Centres associated with all eight regional hospitals
• delivering a provincial bilingual standardized electronic medical record system
• providing funding assistance for family practice nurses

Dorothy Shephard, New Brunswick's health minister, says she agrees access to primary care is one of the biggest challenges facing New Brunswickers and says she’d like to speak with the group further about their perspectives.

Shephard also said her departments’ Primary Care Network is on track to becoming a reality.

She released the details of the network in the fall, saying patients who are on the current waitlist for a family physician will be able to schedule an in-person or virtual appointment with a family doctor or nurse practitioner through an online registry.

“We certainly want it by the end of Q4, which is the end of March, to be offloading patients from Patient Connect onto our primary care network,” she said.

The groups says the "prime consideration" should be the patients’ needs.

“Medical systems, administrative matters, and politics should not overshadow the guiding principle of doing the best thing for the patient,” they said.