Doctor wait list jumps by 23,000 since November, N.B. health plan update reveals
Task force leader suspects the growing wait list is related to influx of new residents
About 63,000 New Brunswickers are now waiting for a doctor — 23,000 more than when the province announced its new health plan in November.
But Suzanne Johnston, co-president of the health plan implementation task force, told reporters at a briefing on Wednesday that there are other options in place while New Brunswick works toward broadening patient access to care.
"How do we spread the message that there's more than one way to access care and more than one way to support one another in this," Johnston said of the task force's objective.
When the province announced its health plan, about 40,000 people were on the Patient Connect New Brunswick list.
Health Minister Dorothy Shephard introduced the plan a month after missing a previously announced target. In April 2021, she said her goal was to give every New Brunswick a primary caregiver within six months.
The need for targets and speed of implementation were part of the health plan, which promised that by the second quarter of 2022-23, the wait list would be eliminated and replaced by the New Brunswick Primary Care Network.
With the network, anyone without a family doctor or nurse practitioner would be able to access one in a timely manner while waiting for a longer-term placement.
Asked how close the province is to meeting this target, Johnston cited the wait list numbers — 11,000 people have been added to the list since February — and suggested that while everyone on the wait list may not wind up with their own doctor, they will have better access to care.
Since February when the wait list was at 55,000, some 3,000 people have been referred to physicians, which means there has been a net gain of 8,000 people on the list.
Johnston said some of the increase is likely related to the people who have moved to the province recently.
Right now, the task force's work is focused on short-term stabilization and medium and long-term thinking, she said. In the short term, for instance, greater access to care is being provided through eVisitNB appointments and referrals through 811.
Gérald Richard, co-president of the health plan implementation task force, said work is being done to establish key performance indicators so the group will know if the plan needs to be adjusted.
"Just to talk about a plan, that's not enough. … We have to have targets.
Community connection
Task force members indicated they'd spent much of their time since November meeting with community and health-care leaders and learning about problems, potential solutions, and changes in some places that are already producing results.
"We especially listen to the communities to see how we can educate concerning the five pillars of the health plan," Richard said.
The pillars are: access to primary care, access to surgery, support for seniors, and access to addictions and mental health care.
The human resources side
Johnston said one tough decision that comes with the implementation of the health plan is deciding what jobs health care professionals can keep control of and what jobs they can pass on to the community.
"When we're in community and working in community-based environments, it's about who are the other people in communities that can do things," she said.
She used nursing homes without walls as an example. It is a seniors' care strategy helping seniors live in their own homes instead of nursing homes.
The people working with that program are not nurses or doctors, according to Johnston.
"They're community folks," she said. "They're ordinary people that are looking out for their neighbours."
Retention and recruitment
Johnston said a health human resources team has been working on implementing changes in the recruitment and retention of doctors, nurse practitioners and health care support workers.
She didn't offer specifics, but said efforts would be made to improve workplace culture to help retain workers.
A strategy for increasing recruitment includes partnering with other ministries that have experience in recruitment, she said.
A dashboard will be launched this week where the public can follow along with the health plan's implementation. It will include a deeper look at recruitment and retention, Johnston said.
'Is it in crisis?'
Johnston said looking at emergency care can be helpful in deciding if the health care system is in crisis.
"When we have people that could be seen in another environment, … we would want those people to seek care there," she said. "Right now, the default button goes to emergency care because we don't have that other system in place."
Once professionals are used to their maximum, and integrated community care is being implemented, Johnston said there will be more flow in the health care system.
She said when Medicare was invented, it wasn't meant for people with multiple complex medical health issues.
"It's a different world," said Johnston. "We have to think differently about the system. How do we bring innovation, how do we bring new thinking to our work?"