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Smarter health care means more physicians where patients need them

As part of the New Brunswick Medical Society’s ongoing campaign to enhance patient care in the 2018 provincial election, physicians have a prescription for smarter health care and a healthier province. 

Young or old, sick or well, strong or infirm — for the vast majority of New Brunswickers, a family physician is typically their first point of contact with the health care system. And as our patient needs grow more complex, these ‘quarterbacks’ of care delivery are needed more than ever. New Brunswick has its share of health difficulties, and an aging population to boot. According to the New Brunswick Health Council’s report from last year, 14-18 per cent of Fredericton’s population is over 65, a figure which is rising every year. Thirty-five per cent of residents are overweight, an additional 25 per cent are obese, and just over half report eating the proper serving size of fruits and vegetables every day. These trends are troubling, and primary care physicians are on the front lines caring for some of our most complex patients every day.

It’s clear that family physicians have never been more important than they are now. And New Brunswick simply doesn’t have enough of them to go around.

New Brunswick currently has 39 family physician vacancies that are unfilled. Over 44,000 New Brunswickers have no family physician. Even those lucky enough to have a family physician have no guarantee of getting in to see them in a timely fashion: only one in three can get a same-day appointment, and our patient ratio of 1800 patients per family physician is almost twice as high as neighbouring Quebec.

It’s no wonder, then, that 82 per cent of New Brunswickers identify having more family physicians as a “critically important” health care funding priority. I agree. We have to hire 50 new family physicians, in addition to filling the current vacancies. But I also know that the current approach is not setting New Brunswick’s heath care system up for success.

New Brunswick’s billing number system controls how many physicians are allowed to practice in the province — and where they must practice. Although regional health care needs and provincial demographics clearly change from year to year, billing numbers have not. New Brunswick is the only province that still officially restricts where physicians can practice. New Brunswick is stuck in the past, and it’s hurting our ability to recruit physicians — and to keep the ones that we educate here.

Fifty students graduate from our two medical schools - Dalhousie Medicine New Brunswick and Centre de formation médicale du Nouveau-Brunswick - every year, along with 37 new physicians who complete their residencies in our province. Many of them struggle to find positions in New Brunswick because of the restrictive billing number system. I feel this is a crucial missed opportunity to keep talented, hard-working people in this province.

There’s no doubt this is a complicated issue, but there are a few things that the government can do right now to set us on a better path. We have to hire 50 new family physicians, in addition to filling the 39 current vacancies. We have to better focus our recruiting efforts on physicians that are learning, graduating and living in this province. And we have to modernize the billing number system to create a financial incentive for physicians who practice in underserved rural and northern communities throughout the province. Think of it as “more carrot, less stick.”

As we approach the provincial election, New Brunswick’s physicians want enhanced patient care to be a priority and we have a prescription to address those challenges. I want to extend the opportunity to collaborate with political parties interested in hearing from my colleagues on the front lines to gain an understanding of what we need today and in the future. Physicians are ready to work with you.

Dr. Dharm Singh, MD, FACS, is the President of the New Brunswick Medical Society.