KENORA — Dr. Bradley Kyle says a woman’s recent visit to his practice underscored how much the local health-care model needed to change.
“I had a new mother in, coming to see me for a well-baby exam, (she) hadn't been able to have an examination of her baby done for six months,” the general practitioner said. “Routinely, for somebody who (has a primary care provider), that's going to be two months, four months, six months — it's very regular checkups, but without that attachment, there's no access.”
Kyle also holds a number of positions on the Rural Generalist Council, which is under the umbrella of the All Nations Health Partners Ontario Health Team, to administer a new health-care model in the Kenora area, which includes a number of nearby First Nations and extends south to Sioux Narrows-Nestor Falls.
He is one of several senior health-care officials who told Newswatch they’re already seeing positive changes. That comes after a new agreement was signed between a number of local partners in the health-care field, the province and the Ontario Medical Association, with it taking effect in April.
Among many changes to how health-care is delivered in the region and how physicians are compensated, it allows doctors and nurse practitioners to see patients who aren’t rostered to them.
“In Ontario, where we're talking about two-and-a-half to three million people who don't have primary care, right?” Kyle said. “And that becomes even more polarized when you're in a rural environment because there are no walk-in clinics.”
“We started to see the people that were invisible to us before with some very significant issues that they just couldn't have managed, and you start to see and hear the stories of gaps in care that really are unforgivable.”
Doctors and nurse practitioners practicing in the All Nations Health Partners coverage area now have some dedicated time slots every day to see patients who aren’t attached to a specific family practitioner, said Cheryl O'Flaherty, the president and CEO of the Lake of the Woods District Hospital.
She is also on the partnership’s recruitment committee.
“That primary care practitioner will have access to their patient records and will be able to address issues that may be of chronic disease management or that sort of thing — follow-up for cancer screenings and all of those things,” she said.
O'Flaherty added that will reduce the need for people to be seen in the emergency department for things that aren’t necessarily medical emergencies.
Another component of the new agreement is that physicians should greatly see a greatly reduced administrative burden, O'Flaherty said, as the agreement “allows for different elements of compensation in this model.”
That means other organizations, like the hospital and other service providers, will provide the administrative staff and will effectively operate clinics on behalf of the physicians. That means “with the new model that we have, the physicians aren't running a business,” Kyle said.
“Frankly, physicians are not business people, they're physicians.”
That re-balancing of duties should lead to more normal work days for primary care providers, reducing or eliminating the administrative work that O'Flaherty said was often being done at night and on weekends.
The agreement also aims to “eliminate the funding silos,” given that family medicine-trained physicians provide other services in rural communities, Kyle said, such as staffing emergency rooms, doing a lot of inpatient care, providing obstetrical and gynecological procedures, among many other things. It also incentivizes practitioners to work in the coverage area’s rural communities and First Nations.
Dr. Jillie Retson, who is the medical director for the Kenora Chiefs Advisory, was one of the physicians who helped develop the new model and said early feedback is showing “with respect to the remuneration, the model is extremely competitive.”
“We've heard that this is one of the best deals in the province with respect to rural generalism or family medicine practice, so we're very proud of the model that we've developed and negotiated.”
The model, which is funded for three years, should make it easier to attract and retain health-care professionals to the area, Retson said — something that has historically been difficult.
“We're hoping that that will work towards … sustainable recruitment and a real big push for an increase in recruitment of physicians to the area, but also retention of our current physicians, which is really important as well,” she said.
“We've already had a number of new physicians come and inquire about the model, and we've had some already agree to sign on,” Retson continued. “So, that's been a real win, both in emergency and across primary care.”
And the incentivization to work outside of Kenora proper is an important component, officials said; Retson said previous compensation models “were disincentivizing work out in First Nation communities.”
“We needed something to change, plus we knew that our First Nations communities were not being well served,” she said.
“The previous models were outdated.”
