Demonstration hospitalist program to gauge impact on productivity
Representatives of health-care organizations in Kapuskasing have come together to address the chronic problem of access to primary care in the community.
Kapuskasing and area has a population of approximately 12,000, but approximately half of the population is unrostered, according to Centre de Santé Communautaire (CSC) executive director Marc-André Gravelle, co-chair of a leadership committee established to address the problem.
Primary care is provided by the Centre de Santé Communautaire de Kapuskasing et Région with three nurse practitioners serving a total of 1,500 patients, a Family Health Organization (FHO) with six family physicians, a GP/anesthetist and a regular locum.
“We all have the same struggle, so we sat down together – the hospital, the FHO and ourselves for a full-day meeting in December,” said Gravelle. “The goal was to improve access to primary care in Kapuskasing and area, to maximize the resources we have and to fill the gaps as much as we can.”
The lack of primary care for newborns was one of the first issues addressed by the committee.
“A lot of newborns weren’t rostered anywhere,” said Gravelle. “That was a big problem, so the FHO and the CSC are meeting together to find a way to automatically refer unattached newborns to a primary care provider.”
The lack of a hospitalist program at Kapuskasing’s Sensenbrenner Hospital was another problem because the five family physicians in town split their time between office consults and hospital rounds.
“The physicians are very busy,” said Gravelle. “It was stressful for them and not very effective, so we created a hospitalist demonstration program using unused funding for a physician at the CSC. It helps the hospital pay for a locum hospitalist and frees up the family physicians in the area to spend more time in their clinic. We’re hoping it will also help with physician recruitment because new physicians don’t want to work in 50 places at the same time.”
The CSC received permission to use its funding for the demonstration project and data on access to primary care and recruitment success will be collected by the community to support a future request for sustained hospitalist funding.
Recruiting physicians to Kapuskasing is challenging “because we’re competing against all of the other communities in our area, and many of them have hospitalist programs funded by the Ministry of Health,” said Gravelle.
Nicole Hachez, the physician recruiter for Kapuskasing and area, estimates that the community requires 10 family physicians to fully address the primary care needs.
The Northern Ontario School of Medicine (NOSM) has been helpful, accounting for the recent recruitment of Dr. Danielle Martin, a NOSM grad from Kapuskasing.
Another recruit, Dr. Nicholas Sylvestre, a graduate of the University of Ottawa, who is doing his residency in family medicine at NOSM, has agreed to set up practice in Kapuskasing, and fourth-year NOSM student Crystal Boulianne has indicated an interest in returning home in two years following the completion of her residency program.
Another family physician is scheduled to begin practising on a half-time basis at the CSC in March.
Kapuskasing, said Hachez, “is a nice, family-oriented place to live. We’re a small community, but we have many services that are available in larger cities. We have a variety of sporting activities for youth, music festivals and a nice four-season climate. There are no traffic jams and you’re always 10 minutes away from anything.”
Physicians in Kapuskasing aren’t limited to a nine-to-five office practice, said Hachez. As is the case in other rural communities, they can work in their clinic, the emergency department and do OR assist.
Family physicians are backed up by two general surgeons and one general internist at the 53-bed Sensenbrenner Hospital and have the support of physiotherapy, occupational therapy and respiratory therapy services, as well as ENT, dermatology and other specialty clinics.