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Doctorless clinic has higher costs

Santé Kildare’s very own Dr Michael Kalin recently had an editorial published in the Montreal Gazette!

Re: “Clinics without doctors viable, U de M report finds” (Montreal Gazette, Sept. 11)

The focus of the study, Quebec’s only “doctorless clinic,” registered 1,700 visits over a nine-month period ending in June 2015. In other words, the nurse practitioners assessed less than 200 patients each month or about eight patients per day.

Régine Laurent, president of the Fédération interprofessionnelles de la santé du Québec, concludes, “What this report shows us, is that changing primary care to include more health professionals — not only doctors — really works and greatly improves accessibility.”

In the midst of the Bill 20 ceasefire between the health minister and the province’s family doctors, I am not sure how or why this clinic is being presented as a model for effectiveness and accessibility. The minister’s intentions were clear to the doctors: more patients, faster care.

Maureen Guthrie, a nurse who works at the clinic, comments that many families in the neighbourhood use the clinic “because they have no family doctor.” In fact, according to the researchers, 64 per cent of the clinic’s patients said they had a family doctor. The problem was getting a timely appointment with their own physician.

Of note, the estimated cost of $68 per patient visit in the doctorless clinic is almost 50 per cent more than the cost of a family physician seeing a walk-in Groupe de Médecins de Famille (GMF) clinic.

Working together to improve patient care and accessibility should be everyone’s goal. A multidisciplinary team of doctors, collaborating with nurses and other health-care professionals, as promoted in the GMF model remains the best option.

Michael Kalin, Montreal

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