This Manitoba town bought out its clinic for $1 to keep it open as a social enterprise

A Manitoba town is making the unusual move of purchasing its local clinic, after the centre's future was thrown in question when one of the physicians who owned it fell seriously ill.

A pair of doctors sold the Santé Ouverte Niverville Open Health clinic to the town of Niverville for the whopping price of $1, Mayor Myron Dyck said Tuesday.

The deal came after the husband-wife team approached the town for help in January, Dyck said. The pair had been forced to step back from the clinic after the female doctor fell ill, and the clinic was facing a deficit.

Now, the town plans to spend between $75,000 and $90,000 over the next six to nine months to cover that deficit and realize the doctors' vision of running the clinic as a social enterprise, Dyck said.

'They came here with a dream'

After the deal takes effect on March 2, the town will own and operate the clinic, and all profits will be rolled back into maintaining and expanding the centre itself.

"They came here with a dream of what they saw for health care services," Dyck said of the husband-wife doctor team.

"By going with this model, his dream is able to be continued, and we're going to continue to work with them and partner with them on seeing health care services done."

The model is unique in Manitoba, Dyck said, although the town is taking cues from another clinic that uses some of the same ideas. All current physicians will continue at the centre, including the former owners.

"Health care services are something that is key and important to all of us as Canadians, and in our community as well," Dyck said.

"To think that you might have to go elsewhere for … your health needs, is just something that was a concern. "

Vision for a 'mini Mayo' clinic

Rural Manitoba communities have long faced challenges in recruiting and retaining doctors. Out of the 2,982 licensed medical practitioners in Manitoba in 2019, 2,262 of them — more than 75 per cent — worked in Winnipeg, according to the College of Physicians and Surgeons of Manitoba's annual report for that year.

Niverville is roughly 40 kilometres south of Winnipeg and has a population of roughly 4,600, according to the 2016 Census — although Dyck said that number is more like 6,500 if you include rural residents in the surrounding area.

The couple opened the Niverville clinic in 2005 and have operated it as a private, for-profit business ever since.

When they approached the town council in January, Dyck said the clinic was facing a "perfect storm" of staffing challenges. The clinic was facing a deficit after the owner's illness, and another physician was also away on maternity leave.

"They made it very clear to us that, you know, the financial viability for them was such that … we were talking months, not years," Dyck said.

The former owners envisioned a social enterprise model he called a "mini Mayo," Dyck said, based on the non-profit Mayo Clinic in Minnesota. The two doctors couldn't be reached for comment by publication time.

Consultant endorses vision

That vision was also endorsed by an independent consultant's report commissioned by the town and completed by Kathy McPhail, the former CEO of the Southern Regional Health Authority.

McPhail recommended the town pursue the Mayo model, with pointers from the "quasi-social enterprise" C.W. Wiebe Medical Centre in Winkler, Man. That clinic is owned by a board including local government and community members, but the board isn't involved in operations and physicians don't sit on the board.

Michael Barkman, Manitoba Public Policy Coordinator for the Canadian Community Economic Development Network, said in an email it's difficult to say for sure whether the Niverville clinic is the first true social enterprise clinic in Manitoba.

Examples of non-profit health care centres — not necessarily social enterprises — include Winnipeg's Mount Carmel Clinic, Klinic Community Health and Nine Circles Community Health Centre, he said.

'Niverville-ize'

Dyck said the report also sought out community opinion on whether provincial or municipal government should step in to help the clinic.

"It was overwhelming that yes, this is something that is needed," he said.

To support the social enterprise clinic, the town created a new corporation, Niverville Health Care Services Incorporated, which will run the clinic through a board. The board will include representatives from local government, a member from the Chamber of Commerce, a community member and a physician from the clinic itself.

The corporation is in the process of hiring a business manager who will answer directly to the board and the town's CAO, Dyck said. The manager will oversee operations with an eye toward patient care and financial accountability.

In an effort to recruit doctors, the town will lower the overhead fee paid by each physician to keep the centre running. Instead of 30 per cent of their pay, doctors will pay 20 per cent, Dyck said.

He said the town has been known to "Niverville-ize" projects that are important to community.

"We have people in our community that believe in community. They're willing to become involved, both with their time and with their money," he said.

"And when you have a community or community members that do that kind of thing, well, now you're able to do a lot more than just simply waiting for a handout from the provincial government — which … we're appreciative for."

In her report, McPhail wrote the community's "creative, forward-thinking spirit" is well-suited for a social enterprise model.

"The 'love story' about two physicians who invested in a welcoming town and established a medical clinic is very well known across the province," she wrote. "The story continues with that rural town in return reciprocating and investing in the physicians."