Manitoba family doctors say they’re hopeful about some of the province’s plans to improve the health-care sector, but caution that it’ll take more than money for doctors and clinics to extend their hours.
Manitoba Premier Heather Stefanson announced a plan on Thursday to spend $200 million on programs to “retain, train and recruit” heath-care professionals, but details of how the money is being spent are yet to be decided.
Doctors and health-care experts say, however, those details will determine whether the money makes a difference.
One of the province’s goals under the plan — which is geared to easing the burden on emergency rooms and getting care to Manitobans quicker — is to give incentives to doctors’ offices and community health clinics to extend their hours.
Joanna Lynch, president of the Manitoba College of Family Physicians, says a small number of her members will probably be very happy about the announcement, because they’re now earning the same basic rate when they work evenings and weekends.
But Lynch warns that the “vast majority of family physicians are already working well above their capacity.”
“I have been in this business for 30 years. I don’t know any lazy doctors in family medicine,” said Lynch.
“They’re putting in 10-11 hour days and in some cases, visiting patients in hospital or the personal care home on their way home from work, and honestly, two to three hours worth of paperwork on top of that, every evening,” she said.
Lynch said she’s concerned the recommendation to open longer “won’t achieve the desired result because you just can’t get more hours into the day.”
Financial incentives do matter
Travis Barron, a doctor from Newfoundland who trained in Ontario, said his career is proof that financial incentives make a difference.
He says “it wouldn’t have been possible” for him to take up a job in Brandon as a young doctor if the government of Manitoba hadn’t provided a moving incentive.
Barron said many young doctors like himself also have six-figure student loan debts.
Several provinces have announced incentives this year to woo and retain health-care workers. That makes it more important for Manitoba to address the issues that aren’t about money, Barron said.
He said any plan to extend hours will only work if it includes all health professionals needed to run an office.
“You’re going to need more than a family doctor in that clinic, right. You’re going to need maybe a nurse, certainly a clerical staff,” said Barron.
He’s waiting to hear how the province will help cut the load of administrative work doctors carry, which he says currently eats up to 40 per cent of his day.
“As a relatively recently graduated physician, I’ll tell you the single biggest or the most daunting thing to me is the business side of running a clinic.… That wasn’t part of my medical training,” said Barron.
Real rural support
Barron believes “there needs to be an acknowledgement of the rural crisis within the broader crisis,” and more specifically rural solutions beyond what’s been proposed.
“It’s intimidating to physicians to think about moving to a rural region for practice if they don’t have specialist support,” he said.
“Money is important, but you know, you want to feel like you’re supported. ”
The province said it will use some of the funds to set up a centralized service for rural doctors called the Virtual Emergency Care and Transfer Resource Service (VECTRS).
The service will “support rural and northern physicians and other health-care providers to obtain specialist consultative advice, locate the most appropriate bed available in another hospital when needed, and co-ordinate inter-facility medical transportation to the most appropriate facility when required,” stated a release from the province Thursday.
Barron called the idea “absolutely revolutionary,” but wants the province to go further.
He suggested the province consider travelling consultants and specialist teams, which could include specialists travelling across Manitoba similar to a new travelling surgical team in Newfoundland and Labrador.
“As much as I love talking with virtual specialists and consultants and that sort of thing, to get advice for my patients, the in-person interaction really is indispensable and there is no equivalent to that,” Barron said.
Complex problem needs more voices
Sociologist Ivy Bourgeault of the University of Ottawa says the financial incentives by themselves will “help in the short term; they tend not to help in the long term.”
Bourgeault, who leads the Canadian Health Workforce Network, said the health-care sector is facing a “wicked problem.”
“They’re complex, adaptive, they change over time and so you need to have a multitude or a multi-layered approach to address,” Bourgeault said.
She said it’s important that the province invites as many health-care professions as possible to the table — and not just doctors and nurses.
The Manitoba Association of Health Care Professionals said it was not consulted prior to the announcement. That body represents 7,000 allied health professionals from 190 disciplines, including respiratory therapists and diagnostic technologist.
“I think that those types of conversations should be as open and transparent and evidence-informed as possible,” said Bourgeault.
“These are public funds.”