Nonprofit model would tackle GP shortage and radically transform healthcare in Whistler
Whistler’s Primary Care Working Group last week outlined its ambitious vision for a community-driven primary care center that would dramatically transform the delivery of health care in Whistler.
Formed in 2019 in response to the shortage of family physicians in Whistler, the group has spent the past two years examining the local primary care landscape and analyzing a variety of different models at play. At a full committee meeting on Tuesday, September 21, the task force gave elected officials the most comprehensive view to date of its community-run, non-profit primary care center concept aimed at improving accessibility to physicians and delivering care more holistic. model that would include general practitioners, nurse practitioners and a range of other health professionals under one roof.
“Canadians across British Columbia are seeing shortages of family physicians, but we know that if we don’t do anything about it, something will happen that may be suboptimal for the community. Things like virtual health care are going to fill the void, and we know that doesn’t replace the continuity of having a family doctor, ”said task force chair Carol Leacy. “We have the opportunity to truly find a solution that will keep Whistler’s best interests in mind.”
With two family practice practices as well as two naturopathic clinics that have closed in recent years, the task force estimates that about 40 percent of Whistler residents do not currently have a family doctor. Today, the complex has between seven and eight full-time equivalent general practitioners, and with the British Columbia Ministry of Health recommending one doctor per 800 to 1,000 patients, Whistler is expected to add six to eight more doctors to meet the demands. community needs.
Whistler especially finds it difficult to recruit family physicians, especially with the high costs of living and commercial rent here which only adds to the high overhead costs family practice practices already face.
“Family physicians run small businesses: they find a location, they pay their rent, they hire staff, they manage them, they train them, they do all their billing if they manage their electronic medical records,” said Leacy. “So family physicians have always had these small businesses in Canada… but that has really changed over the last 10 years, say, where it has become a lot more complex. ”
The task force looked at eight different primary care models across British Columbia, and while none are a perfect fit for Whistler, they took elements of each when reviewing a new center. Align as closely as possible to what the group has in mind Coastal medical, a nonprofit primary care network based in Sidney and Brentwood on Vancouver Island where doctors work as a team, in collaboration with nurses, pharmacists, social workers and dietitians. Sidney’s original clinic started with just four doctors and now has 14, while the Brentwood location started without doctors and now has seven.
At the heart of clinic recruiting is the fact that the administrative workload that many physicians take on in family practice is handled by a dedicated CEO, who is responsible for everything from hiring and training staff, to establishing procedures and protocols; and managing billing and medical services. records. Under this model, doctors would pay part of their bills to the nonprofit company that runs the clinic, which Leacy said they were more than willing to do at Shoreline to ease the administrative burden.
“If we can remove all of the day-to-day administration and all of those barriers that make people choose to work in the clinic and not in full-service family medicine, we believe we can get more people to embrace this medicine that we know it’s just as satisfying, ”she said.
Ideally, the primary care center would be co-located either within the existing Whistler Health Care Center (WHCC), a refurbished center, or as a stand-alone facility nearby, using laboratory and clinical services. existing imagery and easily accessible from the village. Vancouver Coastal Health has tentatively agreed to help find space (the working group hopes to have two offices) within the WHCC to begin the process of adding providers.
Working group member Dr. Karin Kausky of the Whistler Medical Clinic said co-location is “of critical importance” to both providers and patients.
“Much of the literature shows that the ideal is co-location,” she explained. “I think one of the reasons the Whistler Medical Clinic has had such a longevity…. ”
Co-location also facilitates team-based care, a model intended to fill potential gaps.
“In addition to general practitioners and nurse practitioners, we would also have services like mental health support, addiction counseling; it could be social workers who are all working and really empowering people to do the job that best suits their skills, ”Leacy said. “So you might come forward thinking you need to see a doctor, but it turns out you might be better off talking to an addiction counselor. This seamless transition can happen there.
The implications of such a center would be immense, Leacy said, offering any resident who so desires quick access to a family doctor. “But it could really mean more than that,” she added. “You have a whole team that can proactively monitor your health and not only look for poor health outcomes, but stay on top of regular screenings or blood tests. It could mean that employers know their employees are going to have health care. It could also mean that the community could decide for itself what health services should be provided instead of being told by an entity what it would be. ”
The working group has a long way to go to make the center a reality. Planned in three phases, the first step is to achieve charitable status so that collaborative health management company Whistler 360 can start raising money in earnest. Phase 2 would include the recruitment of doctors and nurse practitioners and the establishment of a professional management system. The third phase would require obtaining additional space before the launch of the full-service primary care center.
While there are plenty of issues to be addressed before this happens, it was clear at last week’s meeting that Whistler’s mayor and council were backing the concept, with the presentation ending with applause from elected officials. .
“I think this is the first time that we have applauded a presentation,” said Mayor Jack Crompton.