Manitoulin Central FHT has also unrostered patients but they still have access to other FHT services
NORTHEAST MANITOULIN—Seven hundred patients rostered with the Northeastern Manitoulin Family Health Team (NMFHT) could soon be cut loose from health team services if a replacement physician is not found by May to replace Dr. Ken Barss, who has announced his retirement.
Dr. Anne McDonald, lead physician with the Little Current Medical Associates (LCMA), shared this startling news with the council for the Town of Northeastern Manitoulin and the Islands during its February 21 meeting.
Dr. McDonald explained that the LCMA is currently recruiting for six physicians and one nurse practitioner. Should a physician be found, Dr. McDonald said it is unrealistic to expect a doctor to take on the same patient load as the current physicians.
“The expectations of the workload is not conducive to retention,” Dr. McDonald explained, noting that the Manitoulin Central Family Health Team has lost a couple of recruits due to this fact. “There’s a good chance that Dr. Barss’ patients will lose access to the FHT and its services.”
An ad in the February 21 and 28 editions of this newspaper gives notice of the end date of Dr. Barss’ medical practice as May 1, 2024. It explains the options for further care, including attending the emergency room for urgent care, attending a virtual nurse practitioner at the North East Virtual Care Clinic, calling 811 and, for Indigenous patients, by contacting Noojmowin Teg.
“If you need to transfer your health records to another provider, please visit the NMFHT to sign a release for them,” Dr. Barss explains in the notice. “I wish to thank my patients for allowing me to take part in their healthcare for the past 25 years.”
Dr. McDonald told The Expositor that Dr. Barss has 700 patients rostered to his practice, 100 of which are with located outside the catchment area due to moving away but remaining rostered. Under the terms of FHTs in Ontario, all patients located outside of a FHT’s catchment area will be unrostered once a physician retires. This still leaves 600 patients who may soon find themselves without a physician come May 1.
“Every patient (of Dr. Barss) will be a sent a letter stating their options: a nurse practitioner virtual clinic, prescriptions refills for a year, transferring health records, a letter of follow-up that can be presented to either a walk-in clinic or a new practitioner or, in cases requiring urgent care, a visit to the emergency department.
Dr. McDonald told The Expositor that there are already about 150 patients on the waitlist for the Little Current Clinic who have no family doctor. How these people, plus those 600, will be dealt with in terms of first come, first served, should a new physician be found is still an unknown.
“We are working hard at trying to figure out a way to give unrostered, but in-catchment (area) patients at least some services at the FHT in the future,” Dr. McDonald continued. “We’ve never done that before and don’t know for sure if we will be able to. There are lots of roadblocks and sacrifices. It certainly won’t be the same type of service offered previously if we are able to do it.”
There are also unrostered patients at Manitoulin Central FHT, who were left without a physician when Drs. Sebastian and Mitchell left the practice. Dr. Maurianne Reade told The Expositor that they are also actively recruiting for replacements doctors, but those patients are still able to access care from the FHT, such as nurse practitioners.
A heavy workload
On top of running clinics at the FHT, physicians are also expected to take shifts in the Manitoulin Health Centre emergency room and inpatient unit. Dr. Cooper is the medical director of the Wikwemikong Nursing Home and he and Dr Mackeracher take turns each week going there for the day. Both physicians are part of the NMFHT.
Similarly, Dr. Poenn is the medical director of Manitoulin Centennial Manor and Dr. McDonald also goes there and shares the responsibilities of taking calls from the nurses when a physician is not present.
“Collectively, we have just under 6,000 patients in all our practice locations, not including the nursing homes,” Dr. McDonald explained. “Dr. Quackenbush goes to Aundeck Omni Kaning (AOK), Drs. Cooper and Meikleham to Whitefish River First Nation and we all go to Wiikwemkoong regularly to see our patients. Patients who live in Sheguiandah First Nation and most of the patients in AOK come to the Little Current clinic to see us.”
Drs. Quackenbush and Barss (with the help of Dr. Gillanders from Mindemoya) run maternity/obstetrics clinics twice a week for the whole Island and beyond and are on call for delivering babies.
Other than the possibility of Dr. Barss unrostered patients losing all services at the FHT, “there is no plan for any of the rest of the physician group to change physician services to any of the communities within our catchment area which includes NEMI, Whitefish River, AOK, Sheguiandah and Wiikwemkoong,” Dr. McDonald assured.
“Most, if not all of the First Nations clinics have their own community health nurses not affiliated with family health teams who can provide pap tests, immunizations/injections, well baby care, etc.,” Dr. McDonald continued. “Homecare services and wound care by nurses are also separate from the family health team. Noojmowin Teg also has nurse practitioners and doctors that go to all the First Nations and we encourage patients to reach out to them if they are Indigenous and wish to access their services.”
“We want to be able to service everyone but there just aren’t enough hours in the day,” she added.
“Money’s not the problem, it’s the bodies,” said NMFHT director Judy Miller. “The group is burning out.” Ms. Miller noted that the Little Current emergency department was staffed throughout January by locum physicians from Alberta. “Come March, we’re back to bare bones.”
Recruitment
Next month, Manitoulin Health Centre (MHC) will play host to a community site visit through the Practice Ready Ontario program.
“Practice Ready Ontario streamlines the process for internationally trained family physicians or general practitioners who have completed post-graduate training and have an established track record of work in another country to practice in Ontario,” the Touchstone Institute website states. (The Touchstone Institute has been tasked with implementing the program.) The aim is to see 50 new physicians practicing in Ontario by the first year of the program.
Dr. McDonald explained that there are 31 candidates and 41 sites approved under the program, MHC being one of them. Should a physician candidate choose a site, they are given three months to test it out. If they wish to sign on, they must sign a contract for a three-year return of service to that site. The candidate would hold a restricted licence with the Ontario College of Physicians and Surgeons and be assigned a supervisor until they pass the Ontario exam (any time within the three-year timeframe).
And as always, the MHC recruiter has been working tirelessly to entice new physicians, as well as locums, to Manitoulin.
“We will continue to work ferociously on the recruitment of new physicians who can help provide care again to any patients who are affected by this and future retirements,” Dr. McDonald said. “Part of our recruitment strategy is to make sure the job we are asking new physician hires to do will be sustainable so that we are able to retain them long term.”
Community involvement
Dr. McDonald and Ms. Miller are hoping to resurrect the NMFHT community advisory committee with potentially new faces to the mix. The goal is to have a range of community members that could assist with new recruits and their families, people who can help answer questions about the programs and services on Manitoulin as well as to offer suggestions on how to get involved, help spouses find work, childcare, recreation etc.
“A new graduate won’t have a lot of finances at the start,” Dr. McDonald explained, pointing to the cost of schooling and, in the case of Practice Ready Ontario, the fees involved there.
Dr. McDonald shared with NEMI council that some communities offer welcome packages to new physicians. She pointed to The Expositor’s free one-year subscription to those who have just moved to Manitoulin as an example. Gift certificates from businesses, a break on rent until they become established, a signing bonus from the municipality are some techniques other communities use, she shared.
Patients of Dr. Barss will be receiving their letters in the mail or electronically soon. To read the formal notice, please see Page 18 of this newspaper.
