Yesterday a group of 10 of us set off for Prince Edward Island— 4 hour drive up to the smallest province in Canada just north of New Brunswick. As guests of the Prince Edward Island Medical Society and Government of Prince Edward Island, we were on a ‘meet and greet’ tour of some medical/health facilities in the province where we not only had the opportunity to tour some facilities but also to have discussions with physicians there.
It was a great opportunity for us to get out there and see what the province has to offer to clerks (3rd/4th year students) and residents— a position we will find ourselves in less time than most of us imagine. Scary isn’t it? Maybe not for me, but certainly for my patients I know.
Our first stop of the day included touring the Queen Elizabeth Health Centre in Charlottetown, the largest hospital on the island and major referral centre. There we had a family physician, who runs both a private practice and a takes shifts as a hospital-based GP, give us a tour of the facility—a facility that has some significant infrastructure expansion on the cards at the moment. Over lunch, we had the opportunity to speak to several other individuals including a physician recruiter and a 3rd year Dalhousie clerk doing her Pediatrics rotation.
The second facility we visited was a family health clinic run by 4 family physicians and 3 advanced care practice nurses in Summerside. As we sat down with one of the physicians and the centre’s business manger, we had the chance to ask them questions about their unique approach to providing care to the community they serve. What made their approach to patient care unique was their full-fledged support of and encouragement of having nursing staff who work with them in a seamless interdisciplinary manner; patients who call to book appointments, must be triaged by a nurse to determine the nature and severity of the patients’ concern. Based on that triage assessment, patients are given appointments to see a health-care provider. What really interested me was the commitment of the clinic to promote self-management when appropriate—which meant having stuffy noses and tickling throat patients try to ‘handle’ their condition at home as appropriate without having to tie up valuable health-care resources. Now this obviously this doesn’t mean turning away patients, but rather, it means a better, more judicious and efficacious use of limited resources. On top of that, patients may well only be seen by a nurse when they do actually come in—depending of course on the nature and severity of the concern. This naturally leaves more time for the physicians to embrace a more consultative role allowing them to direct their effort/energy into more involved or complicated cases. What does that mean? I think it means saving the physicians from runny noses, scrapes and bumps, stubbed toes and allowing them to make better use of their time, their knowledge and expertise. This model makes perfect sense—particularly in light of the current crises relating to access to medical care that localities across the country are facing—but it is truly shocking to hear that there is actually a fair amount of reluctance to this model. I personally don’t see how ANYONE could object to this set up—its a win-win for everyone; Patients have better access to care (more providers, less overworked providers), nurses are able to pick up much of the workload of physicians—leaving them to focus their efforts on complicated cases, and the province wins because that means greater community based provision of care that doesn’t tie up emergency room time. Oh yeah, and I forgot to mention one thing; patients actually have better health-care outcomes (so the evidence says).
Anyways, so that was a lovely opportunity we had—before we moved on to another medical clinc in Summerside. This facility was a medical clinic housed in a mall—an interesting set up. What we found out when we got there was that this wasn’t just a mall clinic—it was an all-out operation with some 26 physicians on staff. We were given a tour of the facility, which was only a year old and looked beautiful, by the business manager. She explained to us how this was a facility that while it was a publicly-funded practice, the actual facility itself was a result of a group of physicians who got together and spent some big money on building and finishing the space. In fact, the first question I had after seeing the law firm-esque lobby and waiting room, for the manager was “is this really publicly funded? I’ve never seen such a nice facility that came out of the public coffers”.
And then the final facility we saw was the Prince County Hospital, also in Summerside. This nearly brand-new facility was a delight to tour with another family physician who took time to show us around. Apart from seeing the standard wards, theatres and rooms—what struck me was the level of detail that was apparent in the design of the facility. Little things like having 6 jet bathtubs in the maternity suites, a buffet bar where sick children have the opportunity to choose what they’re going to eat from a Thomas-the-Tank-Engine model in the paediatric ward, or the meticulously appointed trauma bay designed for ease-of-access. It became really obvious to me that indeed, small things in the design of a health-care facility really can make life/work/healing that much better. Again, after the tour we had the opportunity to sit down with a number of staff physicians including the chief-of-staff who sat down with us over a light dinner and discussed with us what we could look forward to in our medical education and careers. It was our chance to pick their brains about school, residency, life in PEI and the like.
In the end, I think I thoroughly enjoyed this opportunity to get out of Halifax and not only see the facilities in PEI and talk with physicians, but also get a taste of what it might be like to spend a few weeks doing a rotation or two outside of a tertiary care centre. Sure, maybe I may not move to PEI when I’m done, but at least now I have the experience to say that I know what it might be like if I did.
