Unit 7 Future Directions

Helping to Manage Physician Shortages and ER Congestion 

According to a CBC News (2017) article, there are approximately 30,000 people in Kamloops, BC looking for a doctor or a nurse practitioner. Even simple things like prescription refills, may mean waiting in the Emergency department for several hours when the walk-in clinics are booked for the day. People line up hours before the clinics open hoping to secure a time to see a physician. In the past few years, Kamloops has seen several general practice physician's leave either through retirement or moving onto to another job. This has left thousands of people in the area looking for another doctor. A promise of the NDP government during the 2017 campaign was to reduce the numbers of British Columbians' not attached to a physician or receiving primary care. The lack of qualified medical professionals has reached critical levels in the province and something needs to be done.

"For the NDP, the solution involves making communities like Kamloops more attractive to doctors by offering incentives and focusing on team-based care involving nurse practitioners. The NDP also pledged to build urgent family care centres as a way to help improve access to health care in B.C., but few details have been released on where funding would come from" (CBC News, 2017). These centres would be built in the areas that had the most need, where the emergency room departments were overcrowded.

In March 2017, the first primary care centre, staffed with nurse practitioners, opened in Kamloops to provide patient centred care for all ages. The NDP's four-point plan had additional centres opening with the second site designated to the senior population (BC Ministry of Health 2017).

An announcement in May 2018 by BC Health Minister Adrian Dix and BC Premier John Horgan stated additional funding was being put into primary care, general practitioners and nurse practitioners to form the basis for team-based approach instead of the previous disease-based approach, allowing patients more involvement in their care (Vancouver Sun, 2018).

In June 2018, Kamloops opened the province's 'first of its kind' Urgent Primary Care and Learning Centre. The UPCLC will see patients that would wait in emergency for non-emergent services, but still require urgent care. Considered the go-between for the emergency department and the walk-in clinics, patients can now self-refer to the UPCLC and book an appointment time and not go through the triage department as initially done.

"Patients will be able to see a range of health care providers depending on their needs, as the UPCLC will be staffed by a multi-disciplinary team of health professionals and staff, ranging from family doctors and physiotherapists to nurses. The centre will also be integrated into a local network of health care providers, services, and programs, making it easier for people to receive follow-up care and access to other services they may need" (CBC News, 2017).

Within the same building of the urgent primary care clinic is the University of British Columbia Learning Centre where Interior Health has partnered with UBC. "This learning centre will improve services for patients currently without doctors in Kamloops by attaching them to a clinic where there is coordinated, comprehensive and quality care provided through team-based care" (CBC News, 2017). As well, it will provide opportunities for the new physicians to continue their practice in Kamloops.

Future trends for the Urgent Primary Care and Learning Centres are very exciting. As patients are now being seen in a clinic setting, and the UBC medical residents can provide regular follow up, the services of emergency departments may change. If these centres can effectively manage the urgent care patients, will there be a shift in how emergency departments are being run? There is local chatter regarding the triage levels 4 and 5 being removed altogether with the opening of the urgent primary care and learning centre. If this happens, more space can be available for the emergent triage levels 1-3.

In conclusion, this trend in healthcare to manage urgent primary care with a team-based approach is catching on. Taking control of primary health with a variety of professional resources in this setting is proving to be a success. The UPCLC to date has already seen thousands of patients since opening in June 2018 and reduced the burden on the ER department. With the plan to open additional centres in the province, similar positive outcomes are expected. Additional patients of all ages are being seen at the primary care centres in the city, relieving some of the pressure created through the lack of general practitioners. But more work has to be some, more professional services are required to meet the demands of the public.

References

BC Government Ministry of Health. (2017). Interior Health Primary Care Services set to open. Retrieved from Interior Health Authority website: https://www.interiorhealth.ca/AboutUs/MediaCentre/NewsReleases/Documents/Interior%20Health%20Primary%20Care%20Services%20set%20to%20open.pdf

BC Ministry of Health. (2018). More patients receiving primary care support in Kamloops. Retrieved from Interior Health website: https://www.interiorhealth.ca/AboutUs/MediaCentre/NewsReleases/Documents/More%20patients%20receiving%20primary%20care%20support%20in%20Kamloops.pdf

Canadian Institute for Health Information (CIHI). (2016, April). Primary Health Care in Canada: A Chartbook of Selected Indicator Results, 2016. Retrieved from https://secure.cihi.ca/free_products/Primary%20Health%20Care%20in%20Canada%20-%20Selected%20Pan-Canadian%20Indicators_2016_EN.pdf

CBC News. (2017, April 25). Ground zero in the doctor shortage is Kamloops where as many as 30,000 are without a GP. Retrieved from https://www.cbc.ca/news/canada/british-columbia/provincial-doctor-shortage-crisis-gets-political-in-kamloops-1.4069677

Culbert,L. (2017, April 24). Fact Check: B.C. NDP says it will 'fill the gap' for 700,000 residents without doctors.Vancouver Sun[Vancouver]. Retrieved from https://vancouversun.com/news/politics/fact-check-b-c-ndp-says-it-will-fill-the-gap-for-700000-residents-without-doctors

Edwards, K. (2018, September 4). Kamloops urgent primary care centre expands services to help more patients. Retrieved from https://infotel.ca/newsitem/kamloops-urgent-primary-care-centre-expands-services-to-help-more-patients/it55426

Fayerman,P. (2017, November 22). https://vancouversun.com/news/local-news/number-of-b-c-doctors-growing-but-work-life-balance-means-fewer-patient-visits-worsening-access.Vancouver Sun[Vancouver]. Retrieved from https://vancouversun.com/news/local-news/number-of-b-c-doctors-growing-but-work-life-balance-means-fewer-patient-visits-worsening-access

Fry, G. (Writer). (2018, September 4). Kamloops' urgent primary care centre expands [Television series episode]. Kamloops, BC,Canada: Kamloops' urgent primary care centre expands. Retrieved from https://www.cfjctoday.com/article/635371/kamloops-urgent-primary-care-centre-expands

Interior Health Authority. Roden, Barbara. (2018). New urgent primary care facility in Kamloops will serve entire region Clinic at Royal Inland Hospital will relieve pressure on emergency department. The Ashcroft/Cache Creek Journal. Retrieved from https://www.ashcroftcachecreekjournal.com/news/new-urgent-primary-care-facility-in-kamloops-will-serve-entire-region/

Kamloops BC Now Stuff That Matters., & Duncan., J. (2018, September 4). Family Practice Learning Centre opens in Kamloops to provide more primary care support. Retrieved from https://www.kamloopsbcnow.com/watercooler/health/news/Health/Family_Practice_Learning_Centre_opens_in_Kamloops_to_provide_more_primary_care_support/

Lawrence, A. (2018, October 29). New primary care centre in Langford just the first step to address doctor shortage says B.C.'s Health Minister. Chek News [Langford]. Retrieved from https://www.cheknews.ca/new-primary-care-centre-in-langford-just-the-first-step-to-address-doctor-shortage-says-b-c-s-health-minister-503469/

Province of British Columbia. Office of the Premier. (2018, October 26). New urgent primary care centre will deliver better health care to the West Shore. Retrieved from https://news.gov.bc.ca/releases/2018PREM0079-002080

Seucharan, C. (2018, May 24). B.C. launches new health strategy with 200 doctors, 10 new facilities. Vancouver Sun [Vancouver]. Retrieved from https://www.thestar.com/vancouver/2018/05/24/bc-launches-new-health-strategy-with-200-doctors-10-new-facilities.html

Statistics Canada. (2015, June 17). Access to a regular medical doctor, 2014. Retrieved from https://www150.statcan.gc.ca/n1/pub/82-625-x/2015001/article/14177-eng.htm