ValleyBiz Story |

The provincial Wait Time Reduction Task Force held a Public Meeting in Swan River on April 5, 2017. Approximately 30 people participated in the workshop-style meeting to identify concerns and solutions for emergency care wait times.

Proposed solutions at the public meeting included expanding the use of telehealth, providing better patient transport options and expanding the scope of practice health care providers such as pharmacists, nurse practitioners, dietitians, addictions counsellors etc. to help overcome physician shortages.

The strongest concerns surrounded the use of the emergency department as a walk-in clinic, wait times for clinic appointments and having a physician on call at the hospital.

We explored these concerns further with Dr. Rafiq Andani, a physician with the Swan Valley Primary Care Centre (SVPCC).

Emergency Department Visits
By design, emergency departments are for health emergencies. If the patient’s situation is not urgent, they should be seen by a primary care provider outside of the ER setting. Individuals looking for advice on how to proceed can also call Healthlinks at 1-888-315-9257 to discuss their health concerns with a nurse 24/7.

“If the patient feels it’s urgent, that should be enough to warrant seeking out care or calling an ambulance until more objective information can be obtained.” said Dr. Andani.

A common misunderstanding is that if you do not have a family physician your only option is to be seen in the ER. This is not the case.

If you do not have a family physician, you can still be seen by a primary care provider at the SVPCC.

Clinic Wait Times
Patients who need to see a physician have four options. They can book an appointment, they can have their name added to the cancellation list, they can wait at the clinic in case a “no-show” appointment becomes available or, if the situation is urgent, they can go to the ER.

Currently the average wait time for an appointment at the SVPCC is one to two weeks, depending on physician availability. This represents a 67% reduction in wait times over the past year. “Our goal is same day appointments and we have advanced access for that purpose, so we know we haven’t achieved our goal yet.” said Dr. Andani. “When a patient can’t get in, its not because the doc isn’t willing to see them.” he explained, “The handful of docs that are in this clinic are doing 6 to 7 other things simultaneously so that makes it a little bit difficult to accommodate the high volume that the community expects.”

In addition to seeing patients in the clinic, physicians also see patients in the hospital and personal care home, provide Emergency Room on-call services, support chemotherapy, hemodialysis, addictions medicine, community outreach, and have participated in expanding services for maternity services and physician recruitment. “We are advocating for resources for the community and we are partnering with the region and Manitoba health to get the types of things that the community feels it needs in Swan River.” said Dr. Andani.

Concerns were also raised during the meeting that salaried physicians see less patients, however none of the physicians at the SVPCC receive a salary and all are paid on a fee for service basis.

In House ER Physician
It was suggested that more patients could be seen if physicians continued to see patients in the clinic while on call and attended the ER when necessary. This process has been used in the past, but often contributed to longer wait times for both those attending the ER and those with appointments scheduled with the physician.

Many did not see a benefit to having the on call physician staying in the ER while on call. Dr. Andani explained that when a person comes into the ER with a life threatening emergency, the time between triage, assessment and treatment is delayed significantly when the physician isn’t there. “In context of trauma or heart attacks, these are very time sensitive issues and it would be inappropriate for the volume and severity of issues that come through this emergency department to have that delay result in poor outcomes for patients.” he said. Emergency rooms across the province have been closing due to lack of in house care.

ValleyBiz | Final Observation

Our community is fortunate to have an energetic group of new physicians who are committed to providing the services expected by the community, to keeping our emergency room open and to attracting more physicians and primary care providers. Several of these physicians are also pursuing additional training to enhance the services they can provide such as full maternity services and additional surgical procedures.

With physician shortages across Canada, physicians have their pick of where to live and work. Our physicians have chosen to work here. A little support and appreciation will go a long way to ensuring that they choose to stay.