Partnerships key to recruiting, retaining doctors

Partnerships are key to solving the doctor recruitment and retention problem.
That was just one piece of advice Jim Neufeld, clinic administrator of the Wiebe Medical Centre in Winkler, Man., shared when he addressed town council at Monday’s regular meeting.
Neufeld, who also met with the local physician recruitment and retention committee for more than two hours earlier Monday, related how Winkler boosted its number of doctors from five family physicians and one general surgeon in 1998 to 19 of the former and one of the latter in 2005.
With an orthopedic surgeon on the way next month and another family doctor by the end of July.
Neufeld said back in 1998, the city of 9,500 was struggling when it came to health care, with all of its doctors overworked and facing increasing overhead costs at the clinic—and consequently thinking of leaving the area.
So a group of people got together to address the problem.
“Our approach was to find all the stakeholders that had to be there. The surrounding municipalities, the physicians, the business community, the city itself,” Neufeld said, adding when the clinic administration had tried to work with the provincial government on its own to solve the doctor shortage, “We weren’t particularly successful.”
This group was dubbed the Winkler and District Health Board.
Neufeld noted the group came to realize it couldn’t rely on the province to intervene and solve their problems and instead took action.
“We chose to look at the health-care problem as somewhat of an economic opportunity. The city was growing. We thought, ‘Why can’t more health-care services be located in Winkler?’’ he said, adding many people were having to go to Winnipeg for many types of treatment.
Neufeld also said board had to look at health care “as a piece of infrastructure that’s needed as much as school, streets, and any of those other things.”
The solution was a state-of-the-art medical facility, owned not by the physicians but by the WDHB.
In a change from the way things were run at the old clinic there, doctors would rent space from the WDHB, which would provide equipment and all the other necessary items to run a clinic.
This would translate into no upfront costs for new physicians as well as reduced overhead for those who stayed—serving to both recruit and retain doctors.
Neufeld said the WDHB also can subsidize the rent if necessary, so that if an individual physician leaves the clinic, the remaining doctors don’t have their share of the costs increased.
He also noted their model allows physicians to choose their style of practice and volume of patients. For instance, all doctors wouldn’t have to do ER while some could practice part-time.
“This is particularly important when trying to recruit female physicians who want to raise a family,” Neufeld said.
The facility also was given its blessing by the city since it was located downtown to fit into the city’s plans for core revitalization.
The facility was open by 2001 and has been a great success. In fact, it currently is undergoing a 3,000 sq. ft. addition.
Neufeld also said since the clinic has opened, the WDHB has been more successful attracting more health services to the city.
“Were there any measures you took in the short-term?” Fort Frances CAO Mark McCaig asked Neufeld at Monday night’s meeting.
He replied that in 1998, the group lobbied for help from the province—and got four physicians to come to Winkler through the promise of guaranteed contracts.
“We had not had any success in lobbying the province on our own. But once we got the group together, we did have some success,” Neufeld said, noting those four physicians have stayed in Winkler ever since.
Coun. Struchan Gilson asked Neufeld how the WDHB got its start-up funds for the new clinic.
Neufeld said the $1.5-million project was given $300,000 by the local physicians’ group which had liquidated its assets from the old clinic, $300,000 by the public (businesses and individuals), and $600,000 by the board, which actually got the money from the City of Winkler and the surrounding municipalities.
An additional $250,000 was supposed to be contributed by the province, but that fell through. But based on the success of the project, the City of Winkler has agreed to pay off the balance.
Operations and Facilities manager Doug Brown asked Neufeld if quality of life was a factor in luring physicians.
“At one point, we were willing to take anyone with a MD beside their name,” Neufeld responded. “That’s no longer the case. We work very hard to sell the benefits of our community, and to match that up with the physicians we’re recruiting.
“Since we’ve been able to be more selective of who we recruit, we’re more successful in keeping them,” he added.
Neufeld said he was hopeful Fort Frances could come up with a solution to its doctor shortage.
“I think you have plenty of things to offer, and see plenty of opportunities for whatever you choose to do,” he remarked. “This is the model we chose, and it worked for us.
“I’m sure you’ll get the resolutions to your problems in a short time.”
“We have to sit down and identify the stakeholders in this process. Not just in Fort Frances, but the whole district,” said McCaig when asked what message he got from Neufeld.
McCaig, who also sits on the local physician recruitment and retention committee, stressed no one should think that what Winkler did (i.e., setting up a new clinic) was a direction Fort Frances should follow, but more an example of what can be done through a successful partnership.
He added it was “good to get a perspective from a different community,” noting that Neufeld gave everyone “food for thought.”
McCaig added Dr. Diane Haak should be given credit for suggesting Neufeld come here to speak. “It was an excellent recommendation by her,” he noted.
“I think the information was invaluable,” echoed Coun. Todd Hamilton of Neufeld’s presentation.
“Maybe the only thing to say is municipalities such as Fort Frances are going to have to step up to the plate and become major participants in physician recruitment and retention,” he added.