Collaborative clinics are being touted as a solution to N.L.'s doctor shortage. Here's the plan

As Newfoundland and Labrador struggles with a shortage of family doctors, the provincial government is touting collaborative-care clinics as one of the solutions. But how do the clinics work?

Melissa Coish, Eastern Health's director of primary health care, says clinics will be able to connect more than 20,000 patients to a physician or nurse practitioner once they're fully staffed, and let them see the health professional best equipped to help them.

"While you traditionally would have come through the door at a family practice and the physician would have to meet all of your needs essentially, here you'll be able to access things like physiotherapy, occupational therapy, a pharmacist and social worker. just to name a few," Coish told CBC News on Thursday.

"Those professionals then will be able to collaborate around your care."

Nearly 100,000 residents in the province did not have a family doctor at the end of 2021.

Although the health-care approach would be collaborative, Coish said, each person will still be attached to a physician or nurse practitioner as their main point of contact. The aim of the clinics is to allow professionals to work within their scope of practice while having a patient's needs addressed as soon as possible, she said.

"That sort of therapeutic relationship is really important in primary care. Knowing your patients, but also patients and families feeling comfortable with their providers.… You may see all the other providers, but the information will flow back through that most responsible provider."

There are cases where a person may see a different doctor, such as if they need emergency care at the clinic, but Coish said every effort will be made to keep a patient with their primary physician or nurse practitioner.

Earlier this week, the Newfoundland and Labrador Medical Association and the Newfoundland and Labrador College of Family Physicians warned the clinics are recruiting overextended doctors from their family practices onto teams.

In a press release, the groups said doctors who take full-time jobs in the collaborative clinics can't bring their patients with them, creating a new sector of the population without a family doctor.

Coish says physicians have been recruited from across Newfoundland and Labrador, Canada and the United States but there is currently nothing within the system ensuring a patient transferring to a collaborative clinic will be able to connect with their current family doctor.

"If a physician has left their practice, then those patients have been instructed to register with [Patient Connect N.L.]," she said, referring to the province's online registration portal that connects patients without a family doctor to a collaborative clinic.

The portal will take the person's details along with their address, Coish said, which will allow them to be attached to a clinic in their region. She said there haven't been any requests from patients to see a specific family doctor but Eastern Health would be open to having those discussions as they arise.

Eastern Health is also looking to create a "hubs and spokes" approach to the clinics to help address the shortage of family physicians, she said — creating community hubs in larger areas along with rural sites that can provide the same level of care.

"That way we can retain the providers in team-based care in perhaps a bit of a larger hub, but that our smaller rural communities will have access to the same level of service," she said.

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