FORT FRANCES—While they still have to approve a $1 million loan to buy the clinic, Fort Frances town council clearly supports the ideas of a community-owned clinic and Family Health Team operating model as the way of the future here.
With Fort Frances facing a severe doctor shortage, and the need to improve primary care access greater than ever, John McTaggart, chair of the Fort Frances Community Clinic Inc. board, presented a plan to council outlining those two health care solutions at a special meeting Monday night regarding the future of the Fort Frances Clinic.
And members of council had only positive feedback for McTaggart and the board.
“I want people to know, the taxpayers to know, this has been a very lengthy process. We started two years ago,” said Coun. Rick Wiedenhoeft.
“Some people would say we’ve taken too much time to do this, but we wanted to make sure we dotted every ‘I,’ crossed every ‘T,’ and that we’ve guaranteed the security for the taxpayers in this community, not only of the $1 million loan, but the security of the future of health care for the community,” he added.
He noted members of council attended the Ontario Good Roads Association conference in Toronto last week, where Health minister Greg Smitherman touted the Family Health Team concept as the way of the future.
“We are very fortunate we’ve proceeded down this line,” stressed Coun. Wiedenhoeft.
“If we hadn’t, if we’d buried our heads in the sand and not proceeded down this line, and not gone public with the clinic, then we’d be behind the eight-ball and never be able to attract and retain young physicians,” he remarked.
“The future of health care in Ontario is Family Health Teams, and we’re very fortunate that we’ve proceeded down this line,” he added.
“I’d like to extend my compliments to the board of directors of the Fort Frances Community Clinic for seeing a need in our community and stepping forward to spearhead a drive to fill that need,” said Coun. Andrew Hallikas.
Coun. Sharon Tibbs noted while the town initially looked at teaming up with another not-for-profit organization (the Group Health Association) to help set up a community clinic and run it, she was glad to see “a made-in-Fort Frances solution” come into focus.
“I think that money is well-spent, not on administration and consultation, but on the clinic and the people it services,” she added.
Coun. Tibbs stressed having a community-owned clinic is not going to solve the issue of doctor recruitment here.
“But it is one of the key points we need to address, bring some conclusion to and move on,” she explained. “If we don’t do this particular thing, the other is never going to come.
“Whether we’re successful or not is based on our efforts from this point on. It’s necessary to do it.”
Coun. John Albanese thanked the community clinic board for its hard work.
“I think Fort Frances deserves the best health care, and you people are going to look into that and make sure Fort Frances gets it,” he remarked.
Coun. Paul Ryan said he’s weighed the “pluses and minuses,” and has come to the conclusion that a community-owned clinic and Family Health Team model is the right thing for Fort Frances.
“I can see no other alternative. We don’t want to be outside the system the current government wants to be in,” he warned. “I’m in favour of what we’re doing here tonight [Monday].”
Coun. Ryan also thanked the local physicians for all they do, adding they’re overworked, stressed out, and have little time for themselves.
“I hope that working through this, we can make that a little bit better,” he said.
“I’m excited about this proposal,” echoed Coun. Tannis Drysdale. “It’s not perfect, but we don’t live in a perfect world. I think it’s very realistic.
“I think it’s worked well in other areas and I think it can work well for us,” she added. “I look forward to the rewards the community will reap from this investment.”
“I’ve been supportive of this since day one,” said Mayor Roy Avis. “I think it’s the best thing for the community and I’m glad to see we’ve got a dedicated group that’s come forward to lead us on this path.”
< *c>Two-part plan
The Fort Frances Community Clinic’s plan includes two parts—the purchase of the Fort Frances Clinic by the not-for-profit Fort Frances Community Clinic Inc. and the development of the Fort Frances Family Health Team.
The Fort Frances Community Clinic Inc. board, which consists of McTaggart, vice-chair Todd Hamilton, secretary Dr. Robert Algie, Dr. Barry Anderson, Liz Clark, Mark Kowalchuk, and Riverside CEO Wayne Woods, is asking the town for a loan of $1 million to be paid back over 15 years at zero percent interest.
This would be to make the currently private clinic into a community-owned one, run by the not-for-profit organization. The $1 million would cover the shares of the Fort Frances Clinic holdings and assorted start-up costs. McTaggart noted doctor-owned clinics “don’t work anymore,” and are a hindrance in attracting new doctors to move to town. A new graduate leaving medical school with an average debt of $100,000 is unwilling to start off their career by having to buy into a clinic, he said.
“Would you consider a town where you’d have to consider more debt to have to buy into a clinic?” he asked. “Or would you consider a location where you could set up a practice with no fixed monthly cost with little initial investment?
“With a community-owned clinic, we will move ourselves closer to a level playing field with other communities, our competition,” McTaggart added.
“We will be in a stronger position to offer interested doctors a facility to practice in with their colleagues with no overhead, and without a large capital investment.
“Our competition—Atikokan, Emo, Rainy River, Dryden, Kenora—have all moved to a community-owned model for clinics for primary care physicians,” said McTaggart.
“These are the very communities we compete with in recruiting doctors for Fort Frances,” he stressed.
“Today’s doctors do not want to, and will not, invest in the clinic. Potential recruitments have stated that until the business model changes here, they’re not interested in coming to Fort Frances.
“It is our view that we need to move quickly to a model that will attract new physicians to the community clinic,” McTaggart concluded.
He also stressed the clinic will not be owned by the town.
“It will belong to a not-for-profit corporation that is managed and represented by a cross-section of community members who are consumers and stakeholders of the delivered services,” he remarked.
“I can’t overemphasize that enough.”
< *c>Family Health Team
The second solution is the Family Health Team—an operating model to increase access to physicians and nurse practitioners for routine primary care—that will be sponsored and managed by the Fort Frances Community Clinic.
“To become successful in attracting new physicians and retaining our current doctors, our community will have to expand our base of allied health professionals as a way in which to offer a more supportive work environment for our physicians and a more effective way of delivering health care to all the citizens of our community,” said McTaggart.
Last year, he noted, the community clinic board was given funding to develop a Family Health Team business and operating plan, which now is in its final stages and will be submitted to the Ministry of Health for final approval within 10 days (as of Monday).
This Family Health Team model here will include the following programs and services:
•anticoagulation;
•cardiac rehabilitation;
•congestive heart failure;
•smoking cessation;
•diabetes;
•senior activation;
•adolescent health;
•cervical screening;
•breast health;
•respiratory therapy; and
•injection clinics
These programs and services will be provided directly or in collaboration with health care stakeholders as purchased services or through partnerships.
McTaggart said performance measures are being developed to assess the impact of the Family Health Team’s delivery of primary health care services and programs, and these will be reviewed regularly.
As required by the province, patients will be rostered within the Family Health Team, which means they are members of a group that have access to a certain physician or group of physicians.
If they are not members, they will not be denied access.
Physicians are paid, in part, according to the number of people they have on their roster. It is no longer piecework or getting paid according to how many people they can see in one day.
The advantage to the Family Health Team model is that physicians can spend more time with patients, and the Fort Frances Community Clinic can add other providers to their team that will help them deliver needed health care services such as nurse practitioners, explained McTaggart.
He noted the clinic already has received funding from the Ministry of Health and has hired a new nurse practitioner, who will begin work there next month.
< *c>Governance
McTaggart explained the purpose Fort Frances Community Clinic Inc. board is to oversee, administer, and implement the delivery of health care services and programs in Fort Frances—but make no mistake, it is a community-based group.
The not-for-profit organization eventually will offer membership applications to the general public.
Board members will be chosen from the general membership, with three-year terms of office. No director will hold office longer than nine years.
The board of directors will include two physicians (active or retired), one allied health care professional (active/retired), one hospital representative, one aboriginal representative, and three community representatives.
Local resident Bill Krukoski spoke very briefly at Monday night’s meeting, leaving council with a list of 23 questions regarding the clinic (such as did the town undertake an environmental assessment of the clinic building and if a default on the $1 million loan occurs, will the taxpayers own the clinic).
He asked council to respond to the questions in writing.
Two other people scheduled to speak—Allan T. Bedard and Nick Wihnan—were unable to attend the meeting.
After thanking the clinic board for all its hard work, council accepted McTaggart’s report and passed a motion of continued support for the community-owned clinic and Family Health Team initiatives.
Council still must vote on the $1 million financial agreement at a future meeting.
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