Here's what N.L. doctors think could patch up the province's ailing health-care system

Dr. Desmond Whalen's emergency room in Grand Falls-Windsor is full to bursting these days.

The doctor says it's a problem of access points. People don't have family physicians and don't live close to a walk-in clinic, so they're showing up to the ER for all manner of ailments.

He's one of a growing chorus of doctors supporting a new health-care model one they say will keep those emergency rooms running smoothly.

Whalen points to a shortage of health-care workers in Newfoundland and Labradorunderpinning long wait times and emergency room closures. That won't be fixed overnight, but Whalen says moving toward a collaborative-care model could ease pressure on the system.

Working in teams, he says, will ease burnout and relieve some of the burden on doctors.

Dr. Shanda Slipp, a family physician in Corner Brook, agrees. Slipp ideally wants a pharmacist in her clinic to prescribe drugs and help guide treatment plans.

"There are so many things [they] can do, potentially better than me," Slipp said.

The way the system's set up now, Slipp would have to pay a pharmacist as a member of her staff. She called the fee-for-service payment model the "biggest barrier" to collaborative care, one that requires a doctor to see every patient who walks in.

Moving toward a salary model would remove that need and free her up to see other patients, she says.

That fee-for-service model, and the challenges of running a practice, is also turning away new graduates from primary care, contributing to the doctor shortage.

Scrapping it, she argues, could encourage newly minted doctors to become family physicians.

Lynn Dwyer, a general practitioner in St. John's, calledthe current system "really not efficient."

A patient who comes in with a mild complaint can't simply see a nurse. Dwyer says she also has to see the patient in order to bill MCP the nurse can't do that themselves.

"We're paid by the number of patients we see, not by the quality of care that we provide," Dwyer explained.

Quick fixes?

Overhauling the province's payment model isn't an overnight fix.

But Dwyer said opening an after-hour clinic in populated areas, like one that operated in St. John's until funding ran dry, is a "viable idea" to divert patients from emergency rooms.

Making bureaucratic changes could ease doctors' workloads, too, she says. Physicians are often faced with mountains of paperwork for insurance companies or workplaces, asked to complete more than 3,000 different types of forms. Dwyer says she loses time writing sick notes when she could be seeing patients.

Slipp, too, says the doctor crunch could be solved in the short-term by undoing a licensing change put in place during COVID-19 lockdowns.

Newfoundland and Labrador depended on foreign-trained doctors for years, especially in rural areas, she says.

"We don't have the same pipeline now that we had always relied on," she said.

Without those changes, Whalen fears he'll keep seeing the number of patients in his ER grow. He likens itto running on a hamster wheel.

But he implores patients to remember that doctors and staff are doing the best they can with the resources they have.

"When we're working, we have the best intentions of every patient at heart," he said.

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