Collaborative-care clinics a hit with doctors, but slow rolling out

As the governmentworks to recruit doctors to practise in the province, a director with Doctors Nova Scotia says more flexibility during the changeoverto collaborative-care centres could help the thousands of patients who currently don't have a family doctor.

Kevin Chapman says "it's a long haul" getting a family physician for everyone, even thoughthe move toward collaborative centres is happening as fast as it can.

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There are 50 such practices across the province in various stages of readiness, including 14 that are in development and the eight collaborative emergency centres set up by the former NDP government.

But getting to the point where everyone who needs access has it is years away.

'We can't be overly dogmatic'

That's why Chapman would liketo see more flexibility in the system to allow doctors to set up in areas where there's patient demand, even if it doesn't fit the health authority's desired long-term structure.

To Chapman, it makes more sense to prioritize getting doctors here now, and then integrating them with the collaborative system later.

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With anywhere from 25,000 to 90,000 NovaScotiansstill waitingfor a doctor, it's a process he saidcould use multiple approaches.

"We can't be overly dogmatic about this," he said. "I think it's a buyer's market right now for docs."

The health authority has said the collaborative model is meant to bring together a variety of health-care professionals a family doctor, nurse, nurse practitioner, dietitian, psychologist and others to provide better care and free up doctors to spend more time with patients who need to see them.

What doctors want

Health-care officials have said working in team-based medical care is what most new doctors want, in part because it's the environment in which they train and because it also gives them a better semblance of work-life balance.

Dr. Pamela Lai, who is about to complete her family medicine residency, said the idea of having colleagues to provide support, especially at the start of one's career, is attractive.

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"I think that if you were to poll current residents in family medicine, the majority would rather work in a group than in a solo practice."

Dr. Adam Aleksis isa Dalhousie University grad who devotes part of his time to a clinic at Truro's ColchesterEast Hants Health Centre that is a prototype of the collaborative family practices Nova Scotia is shifting toward.

'The future of medicine'

Aleksisis alsoa fan of the approach.

"People assume that physicians are knowledgeable in all areas, and that's not necessarily very true. There are many experts that are good health providers."

Similarto Chapman, Aleksis doesn't want a cookie-cutter approach to collaborative care.

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He believes thecollaborative model is "the future of medicine," but his one concern would be if there is a push for a one-size-fits-all model.

"It's almost like a treatment for an area," he said. "And you want to tailor the treatment to the people that live there."

Lynn Edwards, the health authority's director of primary health care, said efforts to do just that are happening, with community meetings over the last six months being used to determine the needs of an area that will eventually get a collaborative clinic.