Getting on track with primary care

A letter from the Winnipeg Health Region

Winnipeg Health Region President & CEO
Wave, September / October 2010

Arlene Wilgosh

When you or someone you care about becomes ill, where do you go for medical help? If you just can't shake a fever or you're concerned about changes in your body, who do you turn to for advice?

Traditionally, the first point of contact for health care has been the family doctor. Back in the day, they would even make house calls if their patient couldn't make it to the office. While most people still rely on a family physician to be their primary-care provider, modern practice has changed. Most doctors no longer make house calls, and even finding a family physician can be a bit of a challenge.

I got a first-hand look at the difficulties of finding a family physician a few years ago. Shortly after my daughter turned 18, she became sick with a serious case of pneumonia. She was no longer a child and needed to find a family doctor to replace the pediatrician she'd had for years.

I remember making trips to numerous health-care clinics, searching for a family doctor for my daughter. Like many others faced with a similar challenge, I felt like there was no one to turn to.

Eventually, we found a doctor, but the experience reminded me of the importance of primary care - and making sure all Manitobans have access to it.

That point was made again earlier this year by the Winnipeg Health Region's Community Health Advisory Councils. The Councils issued a report identifying some key expectations of the health-care system.

On their list was the right to primary care; fair and timely access to specialists, diagnostics and treatments; more resources for disease prevention; and health promotion.

Of course, providing ready access to health care is easier said than done. Part of the problem is that human and financial resources are not infinite. Still, things can be done to improve access to care within our existing budget framework. Across the country, a lot of work is being done to improve primary care and ensure that everyone has appropriate access to the services they need.

Here in Manitoba, the provincial government and the Winnipeg Health Region are collaborating on ways to further develop our primary care-system. In fact, the Region executive has just approved a proposal to explore additional ways of supporting the "building blocks" of our primary-care system. The goal is to support family doctors and others in making quality care more accessible. Going forward, our staff will work in collaboration with Manitoba Health and key stakeholders, including family physicians, to determine a plan of action. Public input has been and will continue to be crucial in this work.

Fortunately, we already have many health-care "pieces" to build on, including a dedicated workforce of highly trained health-care providers. Our focus moving forward must be to co-ordinate our efforts to enhance access and the health-care experience, and create better value for the growing health-care dollars that are spent.

One key objective in all of this is to ensure people can access the right care by the right provider in the right setting.

A story in this issue of Wave about PRIME offers one example of how we are working to provide primary care to those in need. The Physician Integrated Networks (PIN) initiative is another example of how we are collaborating with some family physician groups to improve care. Since 2007, approximately 130 family doctors working in group practices throughout Manitoba, including 62 in Winnipeg, have been addressing key issues such as access to quality primary care. With this initiative, PIN group practices have access to Quality Based Incentive Funding, which can be used to offset the costs of bringing in other medical professionals to assist with various aspects of caring for their patients.

Click here for more information on PIN

Another initiative to enhance access to care involves the creation of communitybased Access Centres. These sites have teams of doctors, nurses, health educators and counsellors - all under one roof, making it easier for people to connect with the right individual and the right information. In addition, Access Centres house family services and provide an excellent opportunity to address other issues as required.

Access Downtown officially opened this month at 640 Main Street, providing people in the community with a new centralized place for health and social services. Three Access Centres (Transcona, River East and Downtown) have opened, and a fourth, Access Nor'West, is set for construction on Keewatin Street and will serve the residents living in the northwest part of the city.

Part of improving access to primary care also involves looking at who exactly provides that initial connection to the healthcare system. The right provider at the right time isn't always a doctor. In some cases, the best avenue for primary care is a nurse practitioner - a registered nurse who has been specially trained to do many of the things that a doctor does, such as assessing and diagnosing patients, ordering screening and diagnostic tests, prescribing drugs and performing minor surgical procedures like suturing wounds.

Nurse practitioners work with other health professionals, such as family physicians and pharmacists, and are becoming more common in Canada. There are now about 50 nurse practitioners working in the Winnipeg Health Region, providing primary care in places such as Access Centres, community health centres, emergency rooms, specialty clinics, personal-care homes and acute-care facilities.

These are just some of the ways we here at the Region are working to improve access to primary care. There are more plans in the works, and we will be telling you about them in the months ahead. We know primary care is the foundation of our health-care system. It needs to be strong in order to support the health and wellness of people today and of future generations. There is a lot of work ahead, but we're on the right track.


About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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