Getting in to see your doctor or nurse is getting harder, N.B. survey finds

About 85 per cent of New Brunswickers have access to a family doctor or nurse practitioner, but only one in three people can get an appointment within five days, according to the New Brunswick Health Council's latest survey on primary care.

People in the Campbellton region, Zone 5, experienced the worst timely access in 2022, with only 17 per cent being able to see their primary care provider within that time frame, the results released Wednesday show.

It's a sharp decrease from 2020, when nearly 90 per cent of New Brunswickers reported having access to a primary care provider and nearly 51 per cent said they could get an appointment with their family doctor within five days, said executive director Stéphane Robichaud.

'What we're seeing is, as we're multiplying the options to access a doctor," such as after-hours clinics and eVisitNB virtual care, "it's affecting people who already have a primary care provider and that primary care provider's availability to practise in their own practice," said Robichaud.

Nearly two out of three (62.6 per cent) people with a primary care provider reported using at least one other health-care service in the previous year due to the unavailability of their provider.

The top three services included:

• Pharmacists — 36.6 per cent.
• Emergency department — 26.6 per cent.
• After-hours/walk-in clinic — 23.3 per cent.

New Brunswickers have also experienced greater difficulties in navigating the health-care system over the past couple of years and are becoming less confident in managing their chronic health condition, according to the more than 5,000 people aged 18 and older surveyed between October 2022 and January 2023.

Nearly 22 per cent reported having trouble finding their way around the health-care system in 2022, up from 7.6 per cent in 2020. The Fredericton region, Zone 3, saw the biggest jump, to more than 26 per cent, from roughly eight.

Only about 33 per cent said they are very confident in managing their chronic health condition, down from nearly 41 per cent.

Robichaud says more oversight of how doctors and nurse practitioners practise medicine is needed.

As it stands, solutions have been driven by various groups, such as the Department of Health, the New Brunswick Medical Society, the regional health authorities and Ambulance New Brunswick Extra-Mural, he said.

"We need to clarify authority for primary care. Who is responsible at the end of the day to understand the needs of the population, the current state of health-service quality, and is responsible for the plans and approaches that are being put forward."

Province plans 'transformation' with team-based delivery

The Department of Health is reviewing the survey results and welcomes having more information and data, said spokesperson Sean Hatchard.

He noted the survey was conducted during the COVID-19 pandemic when not all primary care services were fully accessible, but acknowledged many New Brunswickers struggle to access their family doctor or nurse practitioner in a timely fashion.

"One reason for that is that New Brunswick has one of the country's highest rates of family doctors who work in solo-practice models," Hatchard said in an emailed statement.

In addition, nearly 40 per cent of New Brunswickers have at least one chronic disease, such as heart disease, dementia or diabetes.

The department is taking steps to "transform" the primary health-care system to a team-based model, with nurse practitioners, registered nurses and other health professionals working together, he said.

This interdisciplinary approach will help to lift some of the pressures on overworked physicians and can increase the time spent with patients with complex and/or chronic conditions, he said. It's also expected to help with recruitment efforts.

About $39 million has been set aside in the 2023-24 provincial budget to support improved access to primary health care, including more than $10 million for the transformation of primary health-care delivery, said Hatchard.

Medical Society points to complex patients, pandemic burnout

New Brunswick Medical Society president Dr. Michèle Michaud said she's not surprised the survey found access to primary care has become "more challenging" over the past few years.

She attributes it to a variety of factors, including the province's population being "one of the fastest aging, most chronically ill in the country."

That means patient health issues are "more complex and time-consuming to treat, which results in longer office visits that leave physicians unable to see as many patients," Michaud said in an emailed statement.

During the pandemic, family physicians were also often asked to "do more in order to help cover gaps" in the health system, leaving them with less time for their own practice, she said.

"The resulting burnout led some health-care providers to scale back their practice or leave the profession entirely."

Another factor is the increasing amounts of paperwork and other administrative activities physicians face, which take away from the time they're able to devote to seeing patients, said Michaud.

The medical society is encouraged by the provincial government's investments aimed at addressing many of the barriers to primary-care access, she said.

Expanding collaborative care models will be key, according to Michaud, along with continued focus on recruitment, particularly to regions where access is most limited, retention, and training.