The president of the New Brunswick Medical Society believes programs offered by the province for patients without family doctors may actually be contributing to the physician shortage.
Paula Keating points to services such as NB Health Link, which offers patients the ability to receive primary care virtually.
“Those models are paying the same, if not more, to the providers than physicians that are in family community practices,” Keating said.
“Through the NB Health Link, for example, those physicians don’t pay overhead where physicians in their community offices are faced with significant costs to run an office, all kinds of administrative work to do.”
The result, Keating says, is a system that is far more appealing for family doctors.
Meanwhile, the province’s emergency rooms have been overwhelmed with patients, and the New Brunswick Nurses’ Union (NBNU) says nurses are being forced to work outside their areas of expertise to make up for staffing shortages.
“What has happened in the last few weeks is nurses have been placed in a situation where they are sounding the alarm,” NBNU president Maria Richard said.
“They are telling the employer. They’re filling out work situation reports, and they’re telling the employer, ‘You’re forcing me to practise unsafely.'”
The union is calling on the province to fill vacancies urgently to prevent situations where a labour and delivery nurse might be expected to work in the ER, for example.
Dalhousie University health policy expert Robert Huish points to British Columbia’s primary care incentives as a possible solution.
“The government should be in a position to follow other examples across the country, notably that of British Columbia, where there’s been packages put together that can incentivize physicians to put more patients in their roster,” Huish said.
He says there are also incentive structures included so that if a person has chronic long-term conditions, or is at risk of developing one, there can be “financial mechanisms” put in place to keep people from having “costly, big-ticket items down the road.” Examples could include smoking cessation or programs that promote better lifestyle choices.
“That can definitely work in integrated health planning in this way. I’ve seen it work in other countries around the world to a great level of success,” he said.
The New Brunswick Medical Society sent a proposal to Health Minister Bruce Fitch in November 2023, which included suggestions such as increasing billing fees for doctors who take on more patients and agree to work evenings.
“We’d like to sit down and look at longer-term solutions, with government and all the primary care stakeholders. But in the meantime, because of the urgency of the situation, we’d like to get some of our ideas off the ground,” Keating said.
“These bridging proposals would recognize that the backbone of the primary health-care system is community family physicians, and they need to be compensated for their time, energy and work in a better way.”
The Department of Health told Global News it is reviewing the society’s proposal.
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