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Health system requires a shakeup

In nearly two decades of practising medicine in New Brunswick, I have watched the health-care challenges in our province worsen.

What we are experiencing — from patient issues like obesity, diabetes, and mental health, to system issues like the shortage of physicians and nurses, overburdened emergency departments, and limited hospital resources — is not unique to New Brunswick. But these issues are exacerbated by the acuity and age of our population.

As physicians and other health-care professionals deliver care without the necessary resources to do so, strains are evident. These challenges affect both urban and rural, French and English alike. They add stress and impact the health and well-being of patients, physicians, and other health-care providers.

Change is necessary, not only from a patient care perspective, but from a health system perspective. Physicians, nurses, and other health-care professionals are on the frontlines facing these challenges every day, and we must play a greater role informing policy and decision making on how to address them.

As the incoming president of the New Brunswick Medical Society (NBMS), I am encouraged by the recent collaboration between the NBMS and government.

Health Minister Ted Flemming’s announcement last weekend that billing numbers for family physicians and specialists will be eliminated by Dec. 15, 2019, is a positive development and one the NBMS has long advocated for.

New Brunswick needs a new physician recruitment strategy with special attention paid to our rural, underserviced, and northern regions. Over the coming months, the NBMS will be working with the Department of Health and regional health authorities to build a new plan to enhance physician recruitment and retention across all areas of New Brunswick. 

Enhancing electronic medical records (EMRs) by giving physicians a choice in EMR providers is another important step forward.

The transformation can’t stop there. The health-care challenges we face require a wholesale system shakeup.

We should look to our peers in Nova Scotia, Prince Edward Island, and Ontario to examine how we can integrate virtual care in our province to enhance patient care and access. Virtual care has the potential to improve access to primary health care by connecting physicians and patients remotely. In New Brunswick, physicians and patients connecting via video conference, telephone, text, or email could be particularly beneficial in rural areas.

We also need to continue to advocate to the federal government for a new, demographic-based top up to the Canada Health Transfer (CHT). The Canadian Medical Association and the Atlantic provinces’ medical associations agree that the current financial arrangement between the federal and provincial governments does not reflect the costs associated with caring for an aging population.

With the proposed CHT top up, the federal government would deliver additional funding to cover a share of the health costs associated with the populations aging in each province/territory, consistent with the current federal share of total health costs (22 per cent). For New Brunswick, this would mean an additional $798 million over 10 years. This additional funding could greatly impact how we deliver health care in the province.

As president of the NBMS, I look forward to working with my physician colleagues, government, and allied health professionals on these and other important system issues in the next year.

But we can’t change the challenging demographics and health issues in our province if we don’t start by taking care of our own health and wellness.

In 2017, the New Brunswick Health Council released data showing that more than 61 per cent of New Brunswickers are battling at least one chronic health condition.

That same year, Statistics Canada released estimates showing that more than 70 per cent of adults in New Brunswick are either overweight or obese. Obesity is directly linked to chronic diseases like diabetes, asthma, heart disease, stroke, and cancer.

The NBMS will continue to promote preventative health care to New Brunswickers, including healthy eating and physical activity. 

We can do better. But it will take effort from all of us — health-care professionals, communities, all levels of government, and the citizens of New Brunswick.

 

Dr. Chris Goodyear, FRCSC, is a general surgeon in Fredericton and the new president of the New Brunswick Medical Society.