Family doctors ‘drowning’ as Fredericton struggles to recruit staff

In the second quarter of this year, Horizon Health Network hired 44 new physicians in the province’s cities, but only one of them went to Fredericton.

Data from the regional health authority shows that the region around the capital lost three general practitioners in the same period.

Will Stymiest, a physician who is also president of the New Brunswick Medical Society’s section of family medicine, is not surprised by the net loss.

He said recruiting and retaining staff has been an issue in the Fredericton region since he began his family medicine training 10 years ago.

“Over the last five years, we’ve had half a dozen or more, maybe even close to a dozen, young, new, practicing physicians who have started a family practice in the community and left,” he said of the physicians he’s seen pass through.

“And there are a myriad of reasons for that, but a lot of it comes back to feelings of lack of support. Feelings that their time is valued more elsewhere, in other parts of the health care system and sometimes in other provinces.”

According to Stymiest, the remaining GPs in the region are struggling to keep their heads above water.

“We, as a group, are drowning due to lack of support,” he said.

“That is why people do not choose a GP practice, that is why people do not stay in their GP practice.”

NB Health Link cannot keep up with demand

Measures put in place by the New Brunswick Ministry of Health, such as NB Health Link, which connects patients without a doctor or nurse practitioner to primary care at local clinics, are also not meeting demand.

According to the department, as of June 30, 61,173 New Brunswick residents had accessed appointments through that portal. Only 7,700 of those are residents of the Fredericton area.

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Mayor Kate Rogers says there is a need for primary care for “severely underserved” residents.

The province also has 35,600 patients on a waiting list to access NB Health Link, of which 60 per cent live in the Fredericton region.

Stymiest says the government programs are well-intentioned, but that the health care system will ultimately fail if more doctors aren’t hired.

The Department of Health referred questions about NB Health Link to Extramural New Brunswick, where spokeswoman Christianna Williston said the program is designed “to make the most of existing resources within the system.”

According to Dr. Ravneet Comstock, who oversees primary care at Horizon, the measures are intended to improve access in the short term while the health network improves services in the long term.

Horizon acknowledged the continued high need in the capital region in a press release last week.

It announced a partnership with Extramural New Brunswick that promises to “increase access to education [to care] for non-affiliated patients in the Fredericton region, where the waiting list is currently the longest.

“Horizon will identify opportunities where physicians, nurse practitioners, registered nurses and other allied health care providers can support the NB Health Link network,” the press release said.

Neither Horizon nor Extramural New Brunswick responded to questions about whether the agreement would provide additional staff or other resources to the Fredericton region.

Fredericton steps up recruitment efforts

Stymiest declined to comment on the announcement due to the lack of details, but did say New Brunswick should take into account updated service agreements reached in neighboring provinces over the past year.

Nova Scotia and Prince Edward Island have introduced new financing models specifically for primary care physicians, with additional compensation and simplified administrative processes for billing.

But Stymiest says it’s not just about compensation.

The agreements also provide funding for GPs to hire ‘paramedical care providers’, an important step, he said, as general practice increasingly deals with chronic, complex diseases.

“I need help to get people the care they need, where they need it and from whom they need it. I can’t do it alone,” he said.

“If I try to do it myself, I won’t have the time to take on more patients. And if I’m just starting my career, I might not make it.”

While health care is a provincial responsibility, Fredericton Mayor Kate Rogers said this year that the municipal government saw the growing problem and was reaching out to help.

“The fact that people did not have access to primary health care was a major barrier to delivering the quality of life we ​​want to provide our residents,” she said in an interview.

“We got involved in the conversations they were having about how to recruit staff to the region, and we said, ‘Nobody can sell our city better than us.’”

While Horizon is hosting visits to the hospital, city officials are now also asking prospective doctors to complete a “getting to know you checklist,” which is then used to tailor a longer visit to each doctor’s interests.

Rogers said the city is also working with local economic development agency Ignite to create a bylaw guide for doctors looking to open their own practices in Fredericton.

Stymiest said listening to doctors working in the city is a simple step that can pay big dividends.

“If we’re really interested in changing the landscape of primary care in this city … we need to listen to what new staff are telling us and make decisions that align with that way of thinking,” he said.

“Otherwise we will remain unsuccessful.”