‘Real solutions’ for doctor shortage touted

FORT FRANCES—Town council and the public were witness to a plan “to chart a new and successful course for health care in Fort Frances” on Monday night during a special meeting regarding the future of the Fort Frances Clinic.
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, said they have been working hard over the past year and Monday night put forth two “real solutions” for council’s approval.
The first is the purchase of the Fort Frances Clinic by the not-for-profit Fort Frances Community Clinic Inc. while the second is the development of the Fort Frances Family Health Team.
The Fort Frances Community Clinic Inc. board, which also consists of 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 clinic, 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.
“Would you consider a town where you’d have to consider more debt to have to buy into a clinic?” McTaggart 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.
“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,” added McTaggart.
“Our competition—Atikokan, Emo, Rainy River, Dryden, Kenora—have all moved to a community-owned model for clinics for primary care physicians. 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 recruits 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 community clinic,” McTaggart continued.
He 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 Inc.
“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 (of Monday).
This Family Health Team model here will include the following programs and services:
•cardiac rehabilitation;
•congestive heart failure;
•smoking cessation;
•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 noted 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 no longer is 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 Inc. 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 program 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.
< *c>Feedback
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 the undertake an environmental assessment of the clinic building and if a default on the $1 million loan occurs, will the taxpayers own the clinic), and asked for council to respond to them 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.
However, council still must vote on the financial agreement for the $1 million loan at a future meeting.