Selkirk Family Medicine is working diligently at finding new doctors for outgoing patients, pending its closure set for just a month away.
When the news broke of the facility regretfully shutting down due to a prompt exit of Dr. Trudi Toews, there were upwards of 1,000 people who didn't have a medical plan.
But the medical community has since pulled together to find a solution for more than half of these individuals and continues to pull efforts to complete the task.
The Kootenay Boundary Division of Family Practice (Divisions), which represents all the doctors across the 14 communities in the Kootenay Boundary region, continues to support the clinic during this time of transition.
“It's really amazing how the clinics and the family doctors in the larger Trail area have really stepped up and looked at the patient panels and said 'You know what, we have to make room,'” said clinical lead Julius Halaschek-Wiener Wednesday.
He reports that approximately 500 patients from the surrounding areas – Rossland, Fruitvale, Salmo, and Castlegar – have been accepted at existing facilities in their home communities. And those from Trail in “absolute need”-- moms and babies, the frail and elderly, those with mental health challenges and the complex/chronic patient population – were given priority placement. But the remaining “healthy” Trail people are still awaiting answers.
“Doctors at the Selkirk clinic have gone through their patient list and looked at the complexity of patients and determined who in their patient panels would be a priority,” Halaschek-Wiener confirmed. “There are still a number of healthy patients in the second category to be placed.”
A standardized referral process has been established to ensure a smooth transition is done with care and confidentiality. After clinics indicated the number of patients they were willing to accept, Selkirk then prepared and sent out referral lists. Then Selkirk contacted those who were referred, advising them of the transfer opportunity and instructing them to contact the receiving clinic to register as a new patient or to set up an appointment.
“There is an understanding in the family doctor community in Trail and outside of Trail that those in need, need to find a new primary care home first,” Halaschek-Wiener explained. “Though they have higher needs and may frequent the practice more often, these are the ones that need the care more than others, and that's why everybody agreed to that process and really stepped up to make that work.”
In some communities, the added patient population is startling. Rossland's two clinics are collectively accepting 150 new patients; Fruitvale's only clinic is taking on 145 new people; Castlegar's three facilities will be the new home for 140 patients; and Salmo is acquiring another 14.
“I think the result of this process will be that all the clinics will really be filled to the maximum capacity, and I think that's why we need to plan for a more long-term solution to increase the overall capacity for primary health care in the region,” he added.
That said, Trail and area family doctors did a careful review of patient lists to determine capacity for new patients, with their current patients in mind. Some clinics are bringing on more administrative support to optimally handle the handover of large patient numbers and their health records, and some are re-arranging schedules and practice hours.
While clinics squeeze in patients, there is a continued focus on recruitment (with a few potential candidates interested in the Trail area) and an intensified conversation on increasing local primary care capacity.
Divisions met with Interior Health, all general practitioners and community leaders recently 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 also circled back to a new “team-based” primary care approach.
“One entity doesn't have the solution here,” Halaschek-Wiener explained. “It's a very complex scenario, and that's why we need everybody involved to move this forward and we have the buy-in from all these different stakeholders to build a sustainable plan.”
Trail is not the only place dealing with clinic closures, he added; It's, unfortunately, happening in other communities across the province.
“But we want to be proactive going forward in terms of recruitment and creating potentially new models of care, team-based care,” where family physicians, nurses, and other professionals work alongside as partners.
Long-term care and solutions are in the works but are too premature to touch on at this time, he added.
While possibilities are tossed around, Selkirk patients are asked to visit their doctor to create a medical plan during this time of transition.
The clinic is still moving along with its closure, which includes selling all the equipment in its facility and plans of closing up shop completely Dec. 11. But with the month remaining, there is still hope that recruitment could lead to successfully attracting new physicians eager to take over the keys and streamline the process from both the business perspective but also for the patients still without a doctor.