Post by Administrator on Apr 18, 2013 19:33:25 GMT -4
Health and Well-being
TRANSFORMING HEALTH CARE IN NEW BRUNSWICK
CHANGING HOW FAMILY DOCTORS WORK IS THE KEY
Why the Current System Must Change
We have come to over rely on the hospital system for health care, which is unsustainable.
We are less healthy than we have ever been.
We are not getting enough good advice about how to improve our health.
Despite having more family doctors than ever, some of us still don't have one.
Even if we have a family doctor, we often cannot get in to see them when we have a
health issue.
If we have a physical or mental health issue it is often not detected as soon as it could be.
Those with chronic illnesses end up in hospital for lack of community-based support.
Too often we are prescribed medications but our underlying health conditions go
unresolved.
Over-reliance on prescription medications contributes to dependencies and even ill-
health.
Mental health issues go undiagnosed or are poorly treated.
What needs to change?
The reality is that we expect a lot, perhaps too much from our family doctors. They need a life
too, so we cannot expect them to be there for us 24/7. The current fee that they receive for
seeing us in their office does not encourage them to spend the time necessary to fully understand
all situations, to educate patients, or to involve other health professions with different capabilities
in our care.
To better meet our needs, family doctors should become the lead players in collaborative
care teams with colleagues and other health professionals. In addition to our family doctors,
collaborative care teams would include nurse practitioners, registered nurses, pharmacists,
life coaches, mental health counsellors, rehabilitation professionals, respiratory educators and
dietitians.
Ideally, the collaborative care teams would be located under one roof in collaborative care
Community Health Centres. We should work toward this goal. However, with the advent of
electronic patient records, collaboration can take place without occupying a common space.
What will collaborative care mean?
People will have the advice and support they need to become healthy.
It will be less necessary to seek care in emergency rooms and after-hours clinics.
Health problems will be detected earlier and treatment will be initiated sooner.
Early detection reduces health care costs and results in better outcomes.
The number of prescriptions, diagnostic tests and hospital admissions should decline.
Those with mental health needs will be diagnosed earlier and treated more effectively.
Chronic physical and mental health problems will be better managed.
Doctors will have the professional satisfaction of knowing that their patients are receiving
the best care, are healthier and better able to manage their illnesses.
All health care professionals will be used to their full potential to enhance public health.
The health care system will become sustainable and New Brunswickers will be healthier.
Who needs to do what?
The transition to collaborative care in our communities is slowly beginning to happen. For
example, a group of six family doctors in Miramichi, working on two sites, are in the early stages
of transitioning to a collaborative care team with other professions. The Horizon Health Network
is assigning nurses and diabetic educators to work part-time alongside these doctors.
The provincial government has introduced a "Primary Health Care Framework" and will soon
provide a complete suite of electronic patient records. But we need action.
Recommendations
The Minister of Health must establish a timeline and implement a strategy to ensure that
most New Brunswickers have access to collaborative teams of health professionals within
five years, and all have such access within ten years.
The Green Party proposes that the Minister of Health require the regional health
authorities to call for proposals to establish community-based collaborative care teams so
that all New Brunswickers are served in this way within the decade.
The establishment of collaborative care teams and community health centres should
be supported by New Brunswick's capital budget, as they represent investments for the
future.
The two regional health authorities (Vitalité and Horizon) should encourage their existing
family practice staff to organize in family practice teams and reassign other health
professions' staff to these teams.
The public need to let their MLAs know they want their family doctors to have the
means be able to work with other health professions within collaborative care teams.
The New Brunswick Medical Society and the government need to develop a physicians'
pay plan that gives family doctors the incentive to participate in collaborative care
without a loss of income.
The New Brunswick Medical Society and the New Brunswick Nurses Association need
to resolve their impasse over the roles that nurses and nurse practitioners will play in
collaborative care.
Family physicians need to organize groups of colleagues to provide extended hours of
service to their patients in the community.
All political parties must join together in support of achieving universal access to
collaborative primary care for everyone in every region of New Brunswick.
TRANSFORMING HEALTH CARE IN NEW BRUNSWICK
CHANGING HOW FAMILY DOCTORS WORK IS THE KEY
Why the Current System Must Change
We have come to over rely on the hospital system for health care, which is unsustainable.
We are less healthy than we have ever been.
We are not getting enough good advice about how to improve our health.
Despite having more family doctors than ever, some of us still don't have one.
Even if we have a family doctor, we often cannot get in to see them when we have a
health issue.
If we have a physical or mental health issue it is often not detected as soon as it could be.
Those with chronic illnesses end up in hospital for lack of community-based support.
Too often we are prescribed medications but our underlying health conditions go
unresolved.
Over-reliance on prescription medications contributes to dependencies and even ill-
health.
Mental health issues go undiagnosed or are poorly treated.
What needs to change?
The reality is that we expect a lot, perhaps too much from our family doctors. They need a life
too, so we cannot expect them to be there for us 24/7. The current fee that they receive for
seeing us in their office does not encourage them to spend the time necessary to fully understand
all situations, to educate patients, or to involve other health professions with different capabilities
in our care.
To better meet our needs, family doctors should become the lead players in collaborative
care teams with colleagues and other health professionals. In addition to our family doctors,
collaborative care teams would include nurse practitioners, registered nurses, pharmacists,
life coaches, mental health counsellors, rehabilitation professionals, respiratory educators and
dietitians.
Ideally, the collaborative care teams would be located under one roof in collaborative care
Community Health Centres. We should work toward this goal. However, with the advent of
electronic patient records, collaboration can take place without occupying a common space.
What will collaborative care mean?
People will have the advice and support they need to become healthy.
It will be less necessary to seek care in emergency rooms and after-hours clinics.
Health problems will be detected earlier and treatment will be initiated sooner.
Early detection reduces health care costs and results in better outcomes.
The number of prescriptions, diagnostic tests and hospital admissions should decline.
Those with mental health needs will be diagnosed earlier and treated more effectively.
Chronic physical and mental health problems will be better managed.
Doctors will have the professional satisfaction of knowing that their patients are receiving
the best care, are healthier and better able to manage their illnesses.
All health care professionals will be used to their full potential to enhance public health.
The health care system will become sustainable and New Brunswickers will be healthier.
Who needs to do what?
The transition to collaborative care in our communities is slowly beginning to happen. For
example, a group of six family doctors in Miramichi, working on two sites, are in the early stages
of transitioning to a collaborative care team with other professions. The Horizon Health Network
is assigning nurses and diabetic educators to work part-time alongside these doctors.
The provincial government has introduced a "Primary Health Care Framework" and will soon
provide a complete suite of electronic patient records. But we need action.
Recommendations
The Minister of Health must establish a timeline and implement a strategy to ensure that
most New Brunswickers have access to collaborative teams of health professionals within
five years, and all have such access within ten years.
The Green Party proposes that the Minister of Health require the regional health
authorities to call for proposals to establish community-based collaborative care teams so
that all New Brunswickers are served in this way within the decade.
The establishment of collaborative care teams and community health centres should
be supported by New Brunswick's capital budget, as they represent investments for the
future.
The two regional health authorities (Vitalité and Horizon) should encourage their existing
family practice staff to organize in family practice teams and reassign other health
professions' staff to these teams.
The public need to let their MLAs know they want their family doctors to have the
means be able to work with other health professions within collaborative care teams.
The New Brunswick Medical Society and the government need to develop a physicians'
pay plan that gives family doctors the incentive to participate in collaborative care
without a loss of income.
The New Brunswick Medical Society and the New Brunswick Nurses Association need
to resolve their impasse over the roles that nurses and nurse practitioners will play in
collaborative care.
Family physicians need to organize groups of colleagues to provide extended hours of
service to their patients in the community.
All political parties must join together in support of achieving universal access to
collaborative primary care for everyone in every region of New Brunswick.
