What's the Opportunity?
Nanaimo has an opportunity to take a good look at our primary care system as a whole and decide on some ways we can make it better for everyone – for patients, for providers, and for our community. Our goal is to talk to our community, explore challenges, and come up with local solutions that address gaps and build on our strengths.
Community input will be used to create our own local grassroots Primary and Community Care plan for Nanaimo. This plan will inform Nanaimo's Primary Care Network (PCN) and what our strategic direction will be over the coming years.
A Primary Care Network aims to move to a more team-based, integrated and supportive community of primary care. It's one where patients get the care they need and where health professionals love to work.
Why is this important?
Over 20,000 patients in Nanaimo are without a Family Doctor. Finding a Family Doctor is challenging and involves many phone calls to many clinics, multiple times, often with little success. While we have had success in recruiting new Physicians to Nanaimo, this hasn't kept up with retirements and our growing population.
We know that having a primary care provider that you know and trust, and that knows you and your medical history, results in better care. We hope to find innovative ways to connect patients with Family Doctors and Nurse Practitioners, and ensure that everyone has a team of health professionals working to keep them healthy.
For Primary Care Providers
Family Doctors in Nanaimo are doing their best to provide care for their patients. With so many patients without a primary care provider, there's pressure to take on more patients while still trying to maintain comprehensive patient care, often with little support. This is unsustainable and not an attractive career choice for graduating physicians.
But what if we could ease some of the burden experienced by Family Doctors? What if they had a strong network of physicians, nurse practitioners and other health professionals they could turn to to get their patients the right care at the right time? How might that make Family Practice a more attractive option for new physicians? How would that support existing physicians to better manage their workload and provide the best care to patients?
Who's funding this work?
The Ministry of Health is providing funding to communities across BC to develop Primary Care Networks. Initial funding was used to engage with clinics and health service providers, better understand community needs and build key relationships between medical clinics, primary care providers, Island Health, the City, First Nations Communities, the university and other local service providers. Equipped with a better understanding of community needs and desires, Nanaimo has created its own local plan. Current funding is being used to design the services which will be implemented into the community over the next few years.
There is no one size fits all approach to designing a Primary Care Network or better supporting a medical practice (also called a Patient Medical Home). Every community, every patient, every practice, every provider is unique and what works for some, may not be ideal for others. As with any funding we have certain criteria we need to meet, boxes to check, timelines to meet, and while the sandbox we can play in has defined boundaries, we are actively encouraged to be creative and come up with solutions that meet our local needs. The amount of funding each community will receive will vary by population size, the number of residents without a primary care provider, and the service needs of specific populations.
Some communities in BC are further down the road than us, which gives us the added advantage of seeing what they are creating as part of their Primary Care Network. We've compiled some examples below, and please keep in mind that while these give us a better idea of what's possible, our goal is to create something that fits our context in Nanaimo.
- Mental Health and Substance Use (MHSU) Clinicians connected to local Medical Practices to support mild to moderate MHSU patients and connect to appropriate MHSU services.
- Other allied health supports such as social workers and nursing.
- Incubator style medical clinics to provide an attractive place for early career physicians to start a practice and receive mentorship.
- Mobile Specialty care teams and/or case managers assigned to support patients from existing medical practices, in particular to help manage complex seniors care.
- High Complexity Care Team: a Multi-disciplinary Primary Care Home for high needs patients. Team of Family Physicians, Nurse Practitioner and Social Worker.
Understand the Jargon
Yep, like most things in the healthcare world, we love Jargon! Yes, it's important to give things names, we get that, but what's more important is cutting through the jargon to fully understand what Patient Medical Home (PMH) and Primary Care Network (PCN) really are (Yes, we love acronyms too).
We want to paint a picture and get tangible so you can envision what this might actually look like for Nanaimo. Let's start with a picture – literally!
This image should give you a general sense of how PMH and PCN are different but highly interconnected. Patient Medical Homes really are the heart of our primary care community. Ideally, these medical clinics are the first place patients turn to when they have health concerns. Primary care providers have long-term relationships with their patients and are the best people to help connect patients with the care they need. And here's the thing, they can't do it all alone. The system needs to work better so that primary care providers can do what they do best and focus on the care needs of their patients, and themselves, and not get bogged down trying to navigate the system for their patients. This is what a Primary Care Network aims to do.
If an image speaks a 1000 words, imagine what a couple videos could do. Here are our favorites. These ones in particular are geared towards physicians, but we find them helpful for anyone. And what's better than a Family Doctor speaking directly to Family Doctors?