In my last letter I outlined our prescription for putting physicians where patients need them by filling the current 39 family physician vacancies and adding an additional 50. When New Brunswickers become ill or injured, many can’t access their family physician, because they either don’t have one, or cannot get a rapid appointment. Unfortunately, the solution for many is to head to their local Emergency Room (ER).
ERs should be for urgent care patients only. Chest pain or trauma from an accident? The ER is the best place to be. Lower back pain or a cold? Maybe not. Patients with non-urgent care requirements should not be visiting ERs, and yet they are, in growing numbers. In fact, about 40 per cent of New Brunswickers indicated they would visit the ER for a non-urgent issue if their family physician was not available. Twelve per cent of New Brunswickers acknowledge they are regularly using ERs as primary places of care.
At the root of the issue is access to primary care. Walk-in clinics can fill an important gap in coverage between ERs and family physicians, but inconsistent approaches to appointment bookings and follow-up care are reducing their potential effectiveness in communities across New Brunswick. We need to look at how to make walk-in clinics work better for patients. Encouraging these clinics to offer increased, hours of service would help combat long wait times and difficulty getting appointments. Switching to a modern scheduling system rather than relying on a first-come-first-served model could take some of the uncertainty out of going to a walk-in and improve patient service. Widespread use of electronic medical records would improve information flow from physicians at the walk-in clinic to patients’ family physicians – something that often doesn’t happen. All of these changes would transfer some of our province’s primary health care burden from ERs to walk-in clinics that are specifically intended for non-urgent patients.
Walk-in clinics may not be a solution for some New Brunswickers and find themselves in overcrowded ERs. The New Brunswick Medical Society (NBMS) has identified the triage process within ERs as a key barrier to timely care. The NBMS is advocating for the establishment of “Quick Care” clinics within ERs. These clinics, staffed with other health-care professionals, could handle the less urgent cases. When ERs are overcrowded, it creates stress for patients and puts excessive burden on physicians, nurses and other staff. By investing resources into this process and better integrating other health-care professionals, we can speed up wait times for all patients.
It’s time to make the changes our health care system needs. We must ensure that New Brunswickers receive the best care possible, in the right place.
Dr. Dharm Singh, MD, FACS, is the President of the New Brunswick Medical Society.