Selkirk Family Medicine is set to close its doors this Friday after two decades of serving the community.
It was merely three months ago that about 1,500 patients received a letter in the mail regretfully informing of the closure. To many this note had to be read again to confirm this news and then fear of the unknown set in.
Enter the Kootenay Boundary Division of Family Practice (Divisions), which represents all the doctors across the 14 communities in the Kootenay Boundary region. Divisions supported the clinic during this time of transition and much can be said about the collaboration between the medical community that ensued, according to clinical lead Julius Halaschek-Wiener.
“It’s a week until closure, and I think it’s fair to say that most if not all patients who need ongoing care have been referred to a new clinic or to a new family doctor,” he explained.
Almost 1,200 patients needing ongoing care – complex or chronic disease patients, infants, the elderly and frail and those in residential care – have successfully found a new medical home at this time. But there are still about 400 people who were unreachable or either not interested or undecided on the referral.
“The clinic is still open until Friday, so if somebody feels that they have fallen through the cracks or that they have not received a call, there is still time to contact the clinic,” said Halaschek-Wiener.
Finding a home for the majority of orphaned patients was accomplished by existing clinics opening up space for outgoing patients in their home communities. Some clinics brought on more administrative support to manage the handover of large patient numbers and their health records, and some rearranged schedules and practice hours to make it work.
“The clinics and GPs in Castlegar, Rossland, the Beaver Valley and Salmo all came forward to say, ‘We’ll do what we can,’” he said. “They were able to do a lot and were willing to look at their patient panels and see how many they could take and what rearrangements they could do at the clinic to make that happen.”
In Trail, the IH Nurse Practitioner from Selkirk, Chelsea Van Vliet, is moving to Dr. Blair Stanley’s team at Waneta Primary Care with a full practice of all her current patients. A new doctor, Dr. Katie O’Connor, has been successfully recruited to the area and has already welcomed many of Selkirk’s patients. Now, working with the Kootenay Boundary Division of Family Practice, Dr. O’Connor is inviting patients still looking for a doctor to call the A GP for Me Hotline for a referral at 1-844-352-5664.
In the interim, Kootenay Boundary Regional Hospital’s emergency department is dedicated to handling any stray cases. The ER is preparing to institute a fast-track area, separate from emergency, that will handle non-urgent cases like prescription renewals. A triage nurse will determine what kind of care stream a patient will enter at the outset, be it putting someone in the cue for emergency attention or moving them onto the fast track avenue.
“What is really uncertain is whether those 400 patients are still in the area or healthy and really only needing care, occasionally,” Halaschek-Wiener added. “It’s difficult to say what the demand will be for these remaining patients.”
After 41 years of service, Dr. Trudi Toews was in the process of retiring but had to close her practice promptly due to medical reasons.
The news caught the community off guard and quickly communication began between team players.
“All partners came together because no single group had the answer,” said Halaschek-Wiener. “We established a really robust communication strategy, and robust referral process that was streamlined and everybody agreed on it.”
Divisions originally met with Interior Health, all general practitioners and community leaders in the fall to discuss creative ways of expanding patient lists at existing facilities, encouraging part-time physicians to make the leap to full-time work and the need of working through the patient list with priority given to the vulnerable and more complex files.
The roundtable discussion always circled back to a new team-based primary care approach.
Recruitment continues to play out behind the scenes where the future of primary care in Trail is also tied closely to this discussion. Halaschek-Wiener points to a new delivery model in this realm established in the Northern Health Authority.
The “population-based model” piloted in the north is based on the complexity of the patient population that a clinic cares for and with that model the GP can delegate care to other providers.
“Why it will be beneficial for Trail is that a large number of young physicians would be naturally drawn to this environment because they’ve trained in a more team-based approach in their medical training,” explained Halaschek-Wiener.
While this needs to be discussed with the Ministry of Health, it is an exciting possibility for the area and one he said that needs to be investigated with clinics now operating at maximum capacity.
There is only a few more days for patients to visit their clinic before Selkirk wraps up business.
While a free patient record summary is shared with a patient’s new clinic, Selkirk has been in the process of sending its medical records to Docudavit Solutions for the storage and management of all patient medical records.
Individual patients will fork out $80 while a family of four is expected to pay $160 and $50 for each additional member (plus taxes and shipping) only when a receiving doctor decides he or she needs a complete medical record.
The original record can only legally be passed between Docudavit and a clinic, Halaschek-Wiener explained, and, unfortunately, the bill falls onto the patient.