IMPROVEMENTS/SOLUTIONS


Click on the title to access the full article

B.C. moving private home support services back into health authorities

Rob Shaw March 14, 2019

VICTORIA — The B.C. government is moving privately-run home support services back under health authorities in Metro Vancouver and southern Vancouver Island, largely ending the model of widespread private contracting.

Health Minister Adrian Dix said bringing home support back in-house into the health authorities will improve scheduling, provide more stable hours for staff and seniors, and make it easier to recruit much-needed staff as B.C. looks to accommodate the growing number of seniors.

Home care staff help people — mainly seniors — remain independent in their homes for as long as possible by visiting to assist them in getting dressed, preparing meals, bathing and providing other services. The rationale has been that by employing staff to visit people at home, the government provides better care for seniors, allows them to maintain their independence, and avoids the higher costs and health care complications that would arise if those seniors had to be admitted into hospital or care beds.

“This was a chopped-up mixed system,” Dix told Postmedia News. “The contracts weren’t working very well for anyone, but especially not for clients. So we’re making that change. I think it’s the practical change to make, because of what we’re doing with team-based care.”

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

24/7 mental health support on the way for post-secondary students

News Release (Excerpt)
Victoria
January 28, 2020

Improving mental health in schools is an integral part of government’s actions outlined in A Pathway to Hope, B.C.’s roadmap for making the system of mental health and addictions care better for people no matter where they live in the province.

Implementing A Pathway to Hope is a shared priority with the BC Green Party caucus and is part of the Confidence and Supply Agreement.

“Many students don’t come forward and ask for the help they need because of the stigma that still surrounds mental health issues,” said Judy Darcy, Minister of Mental Health and Addictions.

“This service will meet young people where they are at and provide them immediate access to someone to talk to, without shame or judgement.” 

This mental health service will mean for the first time in B.C., every student – whetherrural, urban, domestic, international, public, private, full-time or part-time – will have access to 24/7 services to supplement services on campus and in the community. As this provincewide program is a new service, the ministry will take the time to engage with students and post-secondary institutions on the design of the service before launch in spring 2020.

Click on the title to access the full article

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Solutions in sight for Parksville Qualicum Beach doctor shortage

With feasibility study funded, group shares vision of ‘campus of healthcare’
EMILY VANCE Dec. 7, 2019
PARKSVILLE QUALICUM BEACH NEWS

While a shortage of doctors continues to grow in Parksville Qualicum Beach, a group of dedicated volunteers is taking steps to ensure a solution remains in sight.
The Perfect Storm Group works alongside the Central Island Division of Family Practice, advocating for better healthcare in the PQB region.
Their vision of an ‘Oceanside Campus of Healthcare’ was recently met favourably by Qualicum Beach town council, with the town voting to commit up to $75,000 in funding to cover the cost of a feasibility study and business plan for the facility.

Marlys Diamond is the chair of the Perfect Storm Group. She says the PSG has recently made two presentations to town council about their vision for the facility.
“We’ve been working towards this model that we have envisioned, and the model is patient-centered, served by a multi-disciplinary team of medical specialists,” said Diamond.

“What we’re doing is planning for the future – something that will be sustainable and long term.”

READ MORE: Doctor shortage in Parksville Qualicum Beach area worsens

The multi-disciplinary aspect would ideally see physicians and nurse practitioners working together with other medical staff professionals such as physiotherapists, nutritionists, social workers and mental health providers.

The facility would also be community-owned and served by a board of directors, something that Diamond says is key.

Community-owned, multi-disciplinary facilities are one of three potential approaches suggested by B.C. Minister of Health Adrian Dix to ease the issue of a lack of primary care in the province.

The group also wants the campus of healthcare to have an educational component, which would be twofold.

First, they hope to have a space that teaches patients to monitor their own bodies as personal healthcare technology increases.

“All of the inventions daily, there’s something fantastic and new coming out. And it will only get more and more. … And so the way of people looking after themselves is going to change. They’re going to be much more aware of their bodies, and be able to monitor it,” said Diamond.

READ MORE: Qualicum Beach council questions allocation of health care dollars

Second, the group hopes it would foster a residency program for medical professionals. Diamond says the group has reached out to the University of Victoria, University of British Columbia and Vancouver Island University and received letters of support.

Third-year medical students are required in their programs to spend time in a rural area, and Qualicum Beach qualifies as such.

She says medical students doing residencies in Qualicum Beach would also raise awareness amongst medical professionals of the benefits of living in the region.

“The residency program will bring these people into our area, and we’ve known from other places who’ve have had residency programs – people tend to come back if they’ve had a good experience wherever they have their residency program,” said Diamond.

Qualicum Beach Mayor Brian Wiese voted in favour of funding the feasibility study, and says he has believed in the PSG’s vision since day one.

READ MORE: Doctor shortage remains ‘critical’ in Parksville Qualicum Beach

“It was an easy one for me to support when the majority of town need it, and I would say all of town support it,” said Wiese.

“This Perfect Storm Group… what they do is amazing. It’s simply amazing.”

Wiese says that healthcare was a major campaign issue, and that the doctor shortage is a critical problem to solve. He also said that a feasibility study and business plan will help establish the PSG as a society under the Societies Act, so that they can start to receive funding and donations from other sources.

“It’s not something we can wait on and say, ‘we’ll save up some money and get it done.’ My opinion was, let’s give them some money. Let’s get this thing started. There’s lots and lots of people in this town that don’t have a doctor,” said Wiese.

Now that the funding has been approved, the PSG will put together a request for proposal to determine which company is awarded the feasibility study contract.

emily.vance@pqbnews.com

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Want more family doctors? Change how they work and get paid says B.C. researcher
Many grads ‘don’t want to run a business — that’s not what they went to medical school for’

Maryse Zeidler · CBC News · Posted: Mar 24, 2019
A Vancouver doctor says the tentative agreement British Columbia recently reached with the province’s 13,000 doctors doesn’t do enough to change family medicine and address what she describes as a crisis in primary care. 

Dr. Rita McCracken, a physician and University of British Columbia researcher, says the agreement doesn’t include newer ways for doctors to work and get paid. 
“The care that has been provided through the old system has, by and large, been pretty good care,” McCracken said. “We’re seeing that other systems might be better for population health.”

Currently, most family doctors in B.C. are paid about $30 per patient visit — whether they’re treating a cold or a complex health problem.
Physicians run their practice as a business, and pay out overhead costs like staff and office space at an average rate of about $60 per hour or more.

McCracken says many doctors want to work instead as part of a team of health-care practitioners like nurse practitioners, physiotherapists and social workers who are paid by salary to provide care for a community. 

The province would fund the clinic and the health practitioners would draw a salary. 
McCracken’s UBC research shows about half of the province’s doctors would prefer that approach — especially younger doctors.
To read more, click on the link at the top

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

In 2018, a three-month long pilot called Pups Assisting Wellness for Staff (P.A.W.S.) was initiated. P.A.W.S. saw a young canine, Dr. Snuggles, visit VGH’s Emergency Department (ED) and Intensive Care Unit (ICU) as an innovative approach in supporting staff who work in these areas that aligned with our value of caring for everyone. 

Qualitative data demonstrated that even a brief interaction with the therapy dogs made them feel better. Additionally, the qualitative data further demonstrated that interactions with the canine were considered by several staff members as a highlight of their work day. It has been heartwarming to see how the therapy dogs can brighten the day of both staff and patients at VGH.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Cyber patients are training the world’s future doctors
Nov. 4, 2019
How a made-at-UBC technology could shape the future of medical education.
Excerpt: Thanks to a web-based learning platform known as CyberPatient, students will be able to gain the confidence they need by interacting with animated patients in a virtual world.
“This is a one-of-a-kind, UBC invention that has the power to really revolutionize medical education here in Canada, but also around the world,” says Dr. Karim Qayumi, a professor in the UBC faculty of medicine’s department of surgery and the platform’s creator.
With the new tool at hand, users — ranging from medical students to health care professionals — can enter into a virtual doctor’s office or emergency room that mimics the real-world experience.
Over the course of a single cyber training session, users follow their patients through the continuum of care, taking medical histories, performing physical exams, ordering tests and ultimately diagnosing and offering a comprehensive treatment plan. At the end of a session, users are scored and given thorough feedback on every step — or misstep — they’ve made.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Palliative Care Training for Paramedics
Aug 22, 2019
With this new training, paramedics can now potentially care for patients at home if it’s the patient’s wish, work with their palliative care team and assist them with taking their already prescribed medications after consultation.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Two private MRI outpatient clinics purchased by Fraser Health
2019, May 2
At the start of this year, 10 of B.C.’s 33 MRI machines were running around the clock, compared to one in August 2017.
Residents of Terrace, Fort St. John, Fort St. James and Vanderhoof can now expect the same service they would receive in Victoria or the west side of Vancouver, Dix says.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Budget gets thumbs up from Seniors Advocate

Hospital Employees’ Union and B.C. Nurses’ Union also voice approval

Sandra Thomas / Vancouver Courier
February 20, 2018
The Seniors Advocate for B.C. calls the 2018 provincial budget announced today by B.C. Finance Minister Carol James a good one for seniors.

Isobel Mackenzie, who heads up the Office of the Seniors Advocate, told the Courier Tuesday afternoon that it’s seniors who will likely benefit most from the announced elimination of Medical Services Plan premiums by 2020 to be replaced by a payroll health tax for businesses.

Mackenzie also welcomed news that low-income seniors will benefit from an increase to the Shelter Aid for Elderly Renters (SAFER) program and Rental Assistance Program. The province is pledging $116 million over three years to the program and raising the ceiling to include those who have annual household incomes of $40,000 up from $35,000.

The advocate is particularly pleased with a promise to increase care hours for seniors living at home and in residential facilities. Funding of $548 million over three years has been committed to improve care for seniors.
To read the full article, click on Budget gets thumbs up from Seniors Advocate

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Doctors and health providers treat loneliness by prescribing yoga and crochet lessons
Aug 13, 2019
Research out of the United Kingdom, an early adopter of social prescription programs, has showed promise on this front. A review of UK projects found that these referrals led to a 28 per cent drop in demand on GP services and a 24 per cent drop in emergency room visits, according to the same report.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

https://enews.rccbc.ca/2018/10/24/codi-is-live/
CODI is a secure iOS smartphone app that provides ER physicians in rural and remote BC with instant support and collaborative assistance in the ER. It directly connects a rural physician to an intensivist using technology similar to a FaceTime call.  Enhanced patient outcomes and reduced out-of-community transfers are potentially positive outcomes. CODI’s virtual, 24/7 presence in the pocket of a physician will lessen anxiety, build confidence, enhance quality of life and positively impact recruitment and retention in rural and remote BC (and ultimately, all of Canada). Enhanced patient outcomes and reduced out-of-community transfers are other potentially positive outcomes of CODI.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Thunder Bay’s Rapid Access Clinic for hip, knee conditions cuts wait times from years to weeks
Cathy Alex · CBC News · Posted: Oct 14, 2018
Patients are referred by their family doctor to the clinic, which then acts as a one-stop shop for consultations with orthopedic specialists and ultimately surgery if required.
Once enrolled in the program, the patient is assessed and then agrees to be cared for by the next available doctor from a pool of orthopedic surgeons, who also take turns working in Dryden, Fort Frances and Kenora.
Putting aside the natural competitive instinct between surgeons was key to developing the program, said Puskas.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

BC to improve access to dental care with $3.6 million to non-profit clinics.
2019, March 20
Minister of Social Development and Poverty Reduction Shane Simpson announced a commitment of $3.6 million in funding over three years, which will be distributed by the British Columbia Dental Association to the province’s 24 dental clinics.
“Poverty requires a multitude of solutions and too many people are denied opportunities because of physical, social, financial and structural barriers,” Simpson said at the Mid-Main Community Health Clinic on Wednesday. “Dental care can be one of those barriers.”

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Health Workers Celebrate Repeal of Bill 29 and Bill 94 
Nov. 19, 2018
16 years ago, the BC government passed two bills that opened the gate to an era of privatization in the health-care sector.
Bill 29 made it easier to contract out services to companies and removing provisions that protected workers who were laid off.
Bill 94 was intended to “facilitate development and implementation of public-private partnerships in the health sector, enabling improved delivery of cost effective non-clinical services to the public.”

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Victoria increases respite care for home caregivers by $75 million
June 18, 2018
Respite care: caregivers will be able to take the person they’re caring for to a residential care facility (nursing home) for a day or several days. A day program is where someone with dementia can spend a day getting health-care and personal services such as nursing and bathing, have lunch and take part in group activities.
Dix said the $75 million over three years will go to help reduce stress experienced by family members and friends who provide unpaid caregiving at home.
Kevin Griffin. Vancouver Sun

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

B.C. government’s primary health-care strategy focuses on faster, team-based care
Thursday, May 24, 2018
The B.C. government is launching a new primary health-care strategy to deliver faster and improved access to health care for British Columbians in all parts of the province, Premier John Horgan has announced.
Initial priority will be on addressing the shortage of general practitioners in the province by:
– Providing funding for up to 200 new general practitioners to work in the new team-based care model.
– Offering opportunities for every family medicine resident to work in a renewed primary care system that allows them to focus their time and energy on practising patient-centred medicine.
The government will be putting in place: primary care networks, urgent primary care centres, and community health centres.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

How Ontario’s next government could relieve overcrowded hospitals
By THERESA BOYLE Health Reporter Sun., June 3, 2018
The number of patients who occupied hospital beds even though they no longer required hospital care hit a record level in Ontario this past winter, the Star has learned.
As a result, emergency room wait times also hit an all-time high.
Almost 5,000 patients, most of them frail and elderly, were stuck in hospital beds because long-term-care homes were full or because it was unsafe for them to return home without more support, according to newly audited data from the Ontario Hospital Association (OHA) and the province’s Health Ministry.
Dr. Danielle Martin, vice-president of Women’s College Hospital, says Ontario’s health system is built upon a “20th-century model” and requires “21st-century solutions” to work better. She said there are many demonstration projects and areas of excellence that should be scaled up. They achieve the triple aim of reducing costs, improving patient outcomes and enhancing patient experiences, she said. One solution to improving hospital wait times is, interestingly, not investing in hospitals but instead building community resources such as “transitional spaces” for patients who no longer require hospital care and are waiting to move into long-term-care homes or other settings.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Dr. Eric Cadesky: B.C. doctors working to improve care for residential-care patients
The Vancouver Sun’s series on seniors’ care in B.C. brings to light challenges in how we care for people who bear the greatest burden of chronic disease. The provincial government has offered solutions such as hiring more care aids, opening additional long-term care beds and increasing support for seniors living at home. Readers should also be aware that B.C.’s medical doctors are working with the provincial government on the Residential Care Initiative.

Through non-profit organizations called Divisions of Family Practice (also funded by Doctors of B.C. and the provincial government), family doctors are creating local, grassroots residential-care solutions that reduce unnecessary hospital transfers, improve care experiences for patients and providers and reduce costs to the system while improving quality of care. All divisions have RCI projects, meaning that 99 per cent of the eligible 30,000 residential-care beds in the province now benefit from RCI work in some way.

RCI projects around the province provide residential-care patients with access to comprehensive care from their family doctor through regular visits, after-hours on-call coverage and care team meetings. Strong doctor/patient relationships play an important role in improving patients’ overall health and quality of life, especially when a patient has complex needs such as dementia, diabetes and heart and lung disease.

Providing patients with regular physician visits in local facilities has reduced unnecessary hospital transfers significantly in many regions. For example, transfer rates have been reduced in Mission by 33 per cent, in Kootenay Boundary by 34 per cent and 31 per cent in Salmon Arm.

Meaningful medication reviews are another component of RCI projects. Care teams — which can include doctors, pharmacists, nurses, care aids, family members and the patients themselves — review the goals of care and the current plan in order to avoid negative medication interaction, eliminate unnecessary prescriptions and investigations and reduce the number of patients prescribed antipsychotic medications (an issue outlined in the Vancouver Sun series’ fourth instalment, entitled, The problems with residential care.)

Physician-organized medication reviews in the Kootenay Boundary region have reduced the number of patients on antipsychotics without a diagnosis of psychosis by 28 per cent and reduced the number of patients on nine or more medications by 15 per cent. Medication reviews in Mission have also helped reduce the number of patients on nine or more medications by 18 per cent. Reviews in Abbotsford facilities have reduced the number of patients on multiple medications by 6.7 per cent and the number of patients being prescribed antipsychotics by 8.7 per cent.

These early data represent a small fraction of the results, as meaningful medication reviews are underway in facilities in Vancouver, Victoria, the Fraser Northwest and Shuswap-North Okanagan regions and in other communities around B.C.

To ensure value, RCI projects undergo in-depth evaluation and the early results are encouraging. While the RCI will not fix all of the systemic challenges facing our aging population, we commit to continuing to improve our patients’ quality of life through this work. Further evaluation of local RCI projects will identify which initiatives can be scaled to residential-care patients in communities around the province. It also shows that when we all work together — doctors, government, health authorities, health providers and patients — we can truly make a difference in the health of our patients and communities.
Dr. Eric Cadesky is president of Doctors of B.C.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Chris Pengilly: Let’s declare a family-practice emergency
Times Colonist
September 28, 2017
Excerpt:
I am particularly sensitive to the subject of orphan [unattached nk] patients at the moment because I retired from family practice early in 2015. After great difficulty, I found a physician to continue the care of my patients, but because of a serious medical condition she was unable to continue.

I have approached several colleagues asking them to adopt these patients, but they really are full. They think, quite appropriately, it would be unsafe to take on more than their current patient (over)load.

What we need to do now is to make the current physicians more productive, and less burdened by unnecessary paperwork and bureaucracy — until the community health centres are up and going.

These suggestions could begin to be effective by the end of this year:
• Provide each physician with a typist service, as has long been provided to hospital physicians.
• Compensate family physicians a quarter of an office-visit fee for the responsibility and time involved in repeating prescriptions of their own patients; these are more safely prescribed by the family physician who has access to the medical record, and not infrequently the patient might not need to come to the office.
• Encourage physicians to form groups of four or more doctors (which are proven to be more effective and more efficient) by offering a one-time grant to cover the cost of amalgamating and moving offices.
• Integrate and co-ordinate public-health nurses to work in close liaison within group practices.
• Eliminate, or at least simplify, the form-filling needed for a patient to access “special authority drugs.”
It will not be cheap — but it will be less expensive than graduating more and more physicians who might even then fail to embrace family practice. Most family physicians want to reduce the number of “orphans,” and they can do it if bureaucratic barriers are smoothed out, and out-of-date patterns of practice and remuneration are energetically reviewed.
Chris Pengilly, formerly of Tuscany Medical Clinic, is a part-time family physician.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Why isn’t there a single medical licence for all doctors in Canada?
ANDRÉ PICARD
Published JANUARY 4, 2019

Monika Dutt has worked as a doctor in Nova Scotia, Saskatchewan, the Northwest Territories and Ontario.
Although she has been practising medicine since 2005, a combination of family medicine and public health, each move has required Dr. Dutt to go through the “frustrating and expensive” process of getting a new medical licence.

That’s because, while there is a standard set of requirements physicians need to meet to apply for a full licence to practise medicine in Canada, all 13 provinces and territories have separate licensing requirements and fees.

“The Ontario application required 42 documents, right back to my medical-school transcripts,” said Dr. Dutt, who is now the CEO of the Timiskaming Health Unit in northeastern Ontario. There were also thousands of dollars in fees.

For example, the Nova Scotia College of Physicians and Surgeons has an annual fee of $1,950, plus an additional $975 if the fee is paid after July 1. A temporary licence costs an additional $850. There are also fees to review qualifications, $550, and a documentation fee of $450. A copy of a diploma costs $75 and a letter confirming a physician is a member is $40. Physicians who do locums (temporary postings) pay $250 more a month. Other provinces have similar fees. Universities and hospitals also charge fees for documentation.

“It really adds up,” Dr. Dutt said.

She said she understands why rigorous licensing is necessary – “to weed out the small number of physicians who have done awful things” – but it is not clear why the provinces and territories don’t recognize each other’s licences.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

UBC Master of Occupational Therapy program expands to northern BC
May 25, 2019
The occupational and physical therapy programs at UBC’s Faculty of Medicine, in partnership with the University of Northern British Columbia (UNBC) are expanding, thanks to $3.3 million from the provincial government.
The addition of new training seats will ensure more patients get access to care that will improve their quality of life, while more students can train closer to home.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Action plan to provide faster care for people with Parkinson’s
Beginning April 1, 2019, people with Parkinson’s disease whose symptoms can no longer be controlled with medication will have improved access to deep brain stimulation (DBS). DBS uses electrical impulses to stimulate a target area in the brain. The stimulation affects movement by altering the activity in that area of the brain. The procedure does not destroy any brain tissue and stimulation can be changed or stopped at any time. Surgery is required to implant the equipment that produces the electrical stimulation. 

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

A welcome second chance for BC medicare protection
April 10, 2018
Colleen Fuller – health policy researcher
Seth Klein – B.C. Director of the Canadian Centre for Policy Alternatives.
In 2003, the B.C. government brought in the Medicare Protection Amendment Act (Bill 92) to prevent unlawful extra billing as required by the federal Canada Health Act. These provincial and federal laws ban doctors and private clinics from charging patients for medically necessary surgeries and other procedures covered by our public health care system.  
Last week’s announcement by health minister Adrian Dix that Bill 92 will finally be proclaimed is welcome news.
Doctors found to have unlawfully billed patients can be fined up to $20,000 and multiple violations could mean de-enrolment from the public system, meaning no more public funding. Patients who believe they have been inappropriately billed can apply to the provincial government to recover those costs.
B.C. is the only province that Ottawa has repeatedly fined for unlawful extra billing. Bill 92 aligns us with the rest of the country.
Doctors remain able to leave medicare entirely and charge patients who are able and willing to pay.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Government expanding coverage for insulin pumps, eliminating age restriction
June 12, 2018 The provincial government is expanding insulin pump coverage, so any British Columbian requiring one to manage diabetes will have access under PharmaCare, announced Adrian Dix, Minister of Health.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

B.C. doctors working to improve care for residential-care patients – Dr. Eric Cadesky
June 30 – 2018
Through non-profit organizations called Divisions of Family Practice (also funded by Doctors of B.C. and the provincial government), family doctors are creating local, grassroots residential-care solutions that reduce unnecessary hospital transfers, improve care experiences for patients and providers and reduce costs to the system while improving quality of care. 
Providing patients with regular physician visits in local facilities has reduced unnecessary hospital transfers significantly in many regions. For example, transfer rates have been reduced in Mission by 33 per cent, in Kootenay Boundary by 34 per cent and 31 per cent in Salmon Arm.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

B.C. should allow physician assistants
May 27, 2018 
PAs work independently under the supervision of a physician and are able to diagnose, develop treatment plans and work closely with patients throughout their care. PAs practice in Alberta, Manitoba, Ontario, New Brunswick and in our Canadian Armed Forces. They are also critical members of the health-care team in the U.K., the Netherlands, the U.S. and elsewhere.
They’re used in all of these jurisdictions because evidence proves that PAs reduce wait times, improve care and save money. It’s time for B.C. to introduce PAs so that patients and families can benefit from their skills as part of the health care team.
Trevor Stone, President Canadian Association of Physician Assistants

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

North Vancouver’s HealthConnection Clinic lauded for its innovative approach in treating vulnerable patients
In its most recent national newsletter, the College of Family Physicians of Canada highlights the innovative work of North Vancouver’s HealthConnection Clinic and how it cares for vulnerable patients.
Established in 2013, the clinic is a unique partnership between VCH and the North Shore Division of Family Practice. Its goal when it opened was to improve the care for high-needs, medically complex and vulnerable clients who were unattached, difficult to serve and who had high rates of hospital admissions by providing team-based primary care.
Highlighted in the College’s article was the clinic’s addition of a team-based learning site for all associated disciplines and the creation of the Complexity Assessment Tool, also known as AMPS (Attachment, Medical, Psychiatric, Social determinants), which is helping improve patient care.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

The Fix: Dementia Project in Peel

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Free up money to solve doctor shortage – Perry Kendall
August 1, 2018
Re: “Weighing the value of family physicians,” comment, July 29. In B.C., we are facing the prospect of significant numbers of family practitioners entering the retirement-aged cohort. Pengilly is one such. The outcome will likely be even more British Columbians who are unable to find a primary-care attachment.
We also see that these retiring physicians are unable to sell their practices and recruit successors. As Pengilly notes, most newly graduating family-medicine specialists do not, on the whole, wish to be small-business owners. They would prefer alternative ways of being remunerated; they would also prefer to work in team-based practices. I also agree that the Doctors of B.C. (formerly the B.C. Medical Association) needs a fundamental change of heart.
Government and the Doctors of B.C. should get together to agree that the fee-for-service dollars that are “freed up” as older family practitioners retire should be “retired” from the fee-for-service “pot” and redirected to a variety of alternative payment plans that can be used to support new family-practice specialist graduates and ancillary health-care professionals entering the primary-care arena.
Dr. Perry R.W. Kendall served as B.C.’s provincial health officer.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Vancouver health authority ends contract with private surgery centre over patient-pay issues
PAMELA FAYERMAN Updated: August 30, 2018
Vancouver Coastal Health is ending a contract with False Creek Healthcare Centre, and as of next week 115 surgeons and anesthesiologists with privileges at regional public hospitals won’t be able to use the operating rooms at the Vancouver clinic.
The change comes a month before new legislation comes into effect imposing harsh penalties on private clinics and physicians where medically necessary services are paid for directly by patients seeking faster treatment. Private clinics have gone to court seeking an injunction to block the bill that will be effective as of Oct. 1.
Other health authorities are not severing contracts with private clinics and health minister Adrian Dix told Postmedia that “a significant role for private surgical clinics” remains, as long as they don’t charge patients for surgeries that are typically publicly funded. 

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Government adds pharmacists into primary and community care
June 5, 2018
The Ministry of Health is adding 50 new clinical pharmacists as part of primary-care network teams around the province. The ministry is supporting this new developmental program, with $23 million over three years, and is working with University of British Columbia’s faculty of pharmaceutical sciences to manage the program.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Pharma companies could be forced to reveal payments to B.C. doctors
Bethany Lindsay

CBC News – Jun 25, 201
Ministry of Health launching consultations on a health sector payment transparency program. If it goes ahead, the province’s proposed health sector payment transparency program would cover payments and services handed out by pharmaceutical companies and equipment manufacturers.
“I think what it does is it puts the patient more at the centre of health care, so the patient has knowledge and responsibility,” Health Minister Adrian Dix told CBC.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Legislation will prohibit payment for blood and plasma collection
April 26, 2018 
Health Minister Adrian Dix today introduced the Voluntary Blood Donations Act, which will help preserve the integrity of Canada’s public blood and plasma collection system by preventing payment for blood and plasma collection in British Columbia.
Currently in Canada, there are private for-profit organizations paying individuals for plasma, and then selling that plasma on the global market. By preventing these businesses from operating in B.C., this legislation will ensure that blood and plasma collected in B.C. stay as part of the national supply system run by Canadian Blood Services (CBS). 

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Universal Pharmacare and Federalism
August 12, 2018
Canada is the only OECD country with universal health insurance that does not include coverage of prescription pharmaceuticals. Some provinces have taken steps to provide drug insurance coverage for the poor, the elderly and people facing catastrophic costs (there are some 70 drug funding programs across the country).
 It is estimated that approximately 20 percent of Canadians have no drug insurance. 

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Premier John Horgan opens door to including dental coverage within B.C.’s health care system
December 13, 2018 
The plan would cover basic procedures such as dentures, exams, X-rays, fillings, cleanings and restorative work.
“It would take pressure off of our doctors’ offices, and off of our hospitals, where people are now forced to go when they’re in absolute crisis when it comes to their mouth and their oral health and their dental needs,” NDP leader Andrea Horwath said during the election campaign.
Richard Zussman, Global News, December 13, 2018

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

New UBC chair to advocate for rural health care in B.C.
November 15, 2016
Health Minister Terry Lake announced a $5-million endowment to establish a new chair at the University of British Columbia (UBC) to help enhance the delivery of rural health-care services throughout the province. The $5-million endowment is funded through the Joint Standing Committee on Rural Issues, a partnership between the Ministry of Health and Doctors of BC that advises the Province on matters related to rural medical practice.
Dr. Dave Snadden has been appointed as the founding rural doctors’ UBC chair in Rural Health. Based out of Prince George, Dr. Snadden will provide academic leadership in rural affairs, establish relevant research, and address rural physician recruitment and retention.
The chair was created following a proposal by the Rural Coordination Centre of BC, which works on behalf of the Joint Standing Committee, and seeks to improve rural health education and advocates for rural health in British Columbia.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

The B.C. government will be implementing strategies that will increase access to surgeries such as hip and knee replacement.
March 21, 2018
B.C.’s wait times for some key surgeries are among the longest in the country – and have grown in recent years.
The provincial surgical strategy includes:
• Funding for 4,000 more hip and knee surgeries this year. Ongoing targeted funding of $75 million starting in 2018-2019 and increasing to $100 million in 2019-2020.
• Five specialized hip and knee replacement programs throughout the province designed to support increased surgical volumes, reduce wait times, and improve continuity of care for patients.
Centralized intake, assessment, and triage with a single point of access so that people have the option of seeing the first available surgeon.

<<<<<<<<<<<<<<<<<<<<<<<<<<<<

Specialist Doctors for Princeton B.C.

Sept. 2015 – Phase I
An interdisciplinary project team, including representatives from Princeton family physicians, Penticton specialists, their MOAs, Princeton General Hospital (PGH) management and staff, Community Integrated Health Services administration, and Shared Care project sta set out to:

• Develop, implement and test outreach clinic formats to provide appropriate specialist care in Princeton
• Provide Princeton physicians with customized education and relationship-building opportunities through on-site CMEs (Continuing Medical Education) with visiting specialists
• Engage feedback from physicians, healthcare providers and patients about their experience with the new approaches to care

INTENDED OUTCOMES
• Improve processes, knowledge transfer, and relationships between specialists, family physicians, other healthcare providers and patients
• Improve physician, healthcare provider and patient experience
• Increase number and variety of specialist clinics in Princeton

<<<<<<<<<<<<<<<<<<<<<<<<<<<<