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Lack of access to a family doctor is an issue that plagues thousands of Nova Scotians. In the first five months of the Need a Family Practice website, almost 30,000 patients in Nova Scotia added their names to the provincial waitlist – and statistics show that many more people need a doctor but aren’t on the list.
Access to a family physician matters because primary care providers should be the first stop for patients who need help with an illness or injury, management of a chronic condition, or general health and wellness advice. Lack of access to primary care – either not having a family physician or having to wait for weeks before you can get an appointment – means everyone’s health suffers. Improving access should be a priority across the province.
There’s no one-size-fits-all solution – ensuring that every Nova Scotian has a family doctor requires lots of changes. Doctors in Nova Scotia recently developed a list of 11 recommendations to improve primary care and access to family doctors. The recommendations range from developing a provincial recruitment and retention strategy to changing the way physicians are paid so they can spend more time treating patients and collaborating with other providers. Here are some of the highlights.
According to the government’s Physician Resource Plan, Nova Scotia must hire approximately 1,000 doctors over the next 10 years. Half of those are family doctors. Physician recruitment and retention – that is, hiring physicians and ensuring they stay in the province – must be a priority in Nova Scotia.
Collaborative practice is a team-based approach to primary care. In a collaborative practice, a family physician works with other health-care providers – such as nurse practitioners, family practice nurses, nutritionists and physiotherapists – to care for their patients. Doctors Nova Scotia supports collaborative care for physicians who choose to practice in a team-based practice, but flexibility is key – It’s important that physicians who are already working in Nova Scotia can choose whether or not to practise in a collaborative setting. Other provinces have already made the leap to fix their primary care system – Nova Scotia needs to catch up.
How many times have you had to make an appointment weeks in advance for a question your physician could have answered over the phone? Expanding non-face-to-face services – appointments done over the phone or online – would save patients unnecessary trips to the doctor’s office and make more room in the doctor’s schedule for patients who need to been seen in person.
Nova Scotia’s fractured e-health system is an obstacle that needs to be overcome. Developing a system that works for all patients and all care providers across the province will improve how care is delivered by making it easier for physicians to share information with their colleagues – so they’ll be able to make diagnoses and develop treatment plans faster – and with their patients, who’ll no longer have to make an appointment to get the results of a routine blood test.
The way doctors currently get paid doesn’t support the kind of care that Nova Scotians need. It’s time to develop and invest in a blended payment model – one that will allow physicians to spend more time with their patients and support collaboration with other health-care providers. It’s a good way of ensuring that patients are getting the care they deserve.
If you need to help with your taxes, you consult an accountant; if your teeth hurt, you go to the dentist. To successfully reform the health-care system, the government needs to listen to doctors. When physicians are meaningfully involved in health system change, governments and health authorities benefit from their expertise and perspective. Meaningful physician engagement is key to successfully changing the health system.
Access isn’t just about having a family doctor, it’s also about being able to see your doctor when you need to. It’s time to help physicians move to a system that enables them to see patients with urgent concerns that day or the day after. It’s called same-day/next-day access, and it makes a difference. Until that happens, we need to keep walk-in clinics – they deliver important primary care to patients without a family doctor.
Doctors believe every Nova Scotian must have access to a primary care team that includes family doctors. If you believe that too, tell your local political candidates. Share your health-care concerns when they knock on your door, through social media or when you meet them at public debates – or send them a letter!
Remember: You have the power to make health care part of the election discussion.