New Brunswick is once again exploring collaborative care clinics as a solution to its primary care shortage. The province has earmarked $20 million to establish collaborative care practices in this year’s budget, a sum that could see around 30 clinics open or be shifted to fit that model. Collaborative care clinics, or the patient medical home model, involve a system of care that groups together physicians, nurses and other allied health practitioners with central administration support. The idea is to ensure that a visit is tailored to get a patient the appropriate level of care for their needs, freeing up doctors or nurse practitioners to take on more acute cases. Patients belong to one clinic, which can then provide appointments with the type of practitioner best suited for their visit.
The government has pegged collaborative care clinics as its main strategy to meet its primary care goals, which are ensuring that all New Brunswickers have access to a provider within five business days. It has also looked to fill in the gaps for the 84,000 people without either a family doctor or nurse practitioner with its NB Health Link clinics.
The province’s attempts to move to a collaborative care model even predate the pilot project that Keating was part of at the beginning of the last decade. In January 2003, a framework for Community Health Centres (CHC) was tabled with the legislature, which described something quite similar to what is once again being proposed. The latest health and medical news emailed to you every Sunday.
“CHCs are designed to improve access to Primary Health Care services and help focus efforts on population health promotion, chronic disease management, and the prevention of illness and injury through strengthening interdisciplinary teamwork and partnering with communities,” reads the framework, which arose out of a special legislative committee.
The provincial government has earmarked $20 million to establish collaborative care practices in this year’s budget, a sum that could see around 30 clinics open or be shifted to fit that model. Horizon is looking to open three new clinics in Fredericton, Sackville and Sussex and says it will look to convert a number of CHCs into something closer to their original conception in the 2003 framework.
Vitalité is also seeing some success as eight new teams have accepted more than 11,000 patients. Health Minister Bruce Fitch, who has already announced he isn’t running in this fall’s election, says he hopes that pushing the move to the care model may be one of his final achievements. As for why this attempt will be more successful, Fitch says the focus on administrative support will make the program extremely attractive for physicians.
“Putting the resources behind those collaborative practices, I think people will realize that that is the pathway forward,” he said.
Keating says the problem has never been with the desire of physicians and other practitioners to work in a collaborative setting, adding that the message hasn’t seemed to get through from professionals to policymakers for years. The NBMS and the New Brunswick Nurses Union asked the government to spend $70 million on collaborative care in this year’s budget and push forward with 50 new clinics this year. Keating hopes that this third attempt to move to the model is more successful than the last two.
“I think we need to go all-in on this and the benefits are many,” she said. “Think about the benefit, widespread across the province, how many people we can get off that patient connect list and into those family-based primary care teams.”
