President's Letter: Is the Minister of Health Opposed to existing family practices participating in team-based primary care?

President’s Letter: Is the Minister of Health Opposed to existing family practices participating in team-based primary care?

Dear Colleagues:

Last week the Minister of Health announced several new “Collaborative Team Clinics” (CTCs) – interdisciplinary primary care clinics to help absorb unattached patients without a family doctor in St. John’s, Grand Falls-Windsor, and Corner Brook. The NLMA’s immediate reaction was support for collaborative care teams, but a worry that, given the shortage of family physicians, any physicians hired into the CTCs will just create problems in other areas of the health system.

As we reflected on the Minister’s announcement a deeper concern surfaced. Why is the Minister not using the power and capacity of the hundreds of family practices by adding additional providers to these settings, as an additional way to address the unattached patient problem?

We realize that not every family practice would be ready to add a nurse practitioner or family practice nurse, and many would have space limitations. However, at limited cost to the public purse, we believe many practices would respond to the challenge. The NLMA tabled a proposal during negotiations on this topic. We would welcome an opportunity to lift it out of negotiations and implement it quickly.

But last week we became quite concerned that the Minister may be opposed to expanding team-based care in community family practices. You can find a lengthier explanation of our concern by reading the attached paper (here).

Essentially, the Minister poured cold water on every aspect of integrating family practices into team-based care. It appears CTCs will be one tier of care, and family practices for 325,000 patients will be a second tier of care.

This situation makes no sense. We are not sure if the Minister understands the impact of his words, so we are calling on him to clarify his position. We are also working with the Health Accord to build a model of Community Care teams in which existing family practices can bring the benefits of team-based care directly to their patients.

As always, I appreciate your feedback and encourage you to share it with me at [email protected].

Susan MacDonald