Pearl Lorentzen
Lakeside Leader
This is the final article about the health care situation in Slave Lake, including information from an interview with a senior Alberta Health Services worker.
There’s a vocal element of public opinion which suggests that the Family Care Clinic model itself is the problem with health care.
Cindy Harmata is the senior operating officer for the rural east of AHS north zone, which includes Slave Lake.
Harmata lives in Slave Lake, so she is familiar with the complaints about Slave Lake health services.
Harmata claims the problem is the clinic is under staffed and that the FCC model helps with recruitment and doctors can start their own clinic if they want.
Evaluation, does it exist?
Since the clinic was started as a pilot project, some people wonder when and why it became permanent.
The Slave Lake Family Care Clinic was started in 2012 as a pilot project. It is one of only three in the province. The other two are in Edmonton and Calgary.
The family clinic model is evaluated on an ongoing basis, Harmata says. AHS provides an annual report to the government which is available at alberta.ca.
However, there are only three references to family care clinics in this document all of which merely state their existence.
Another way the family care clinic is evaluated is through patient surveys.
“Satisfaction rates are really quite high for people who use the service,” Harmata says.
The Alberta Medical Association – albertadoctors.org – has a frequently asked question sheet about FCC dated June 21, 2013.
“While the FCC can be seen as a holistic, robustly resourced and team-based collaborative approach, it is also a fundamental shift in how most physicians currently practice,” says the AMA sheet. Questions centre on issues of income (different under this model), data stewardship and physician autonomy.
The stated goal is “to identify key areas for physicians and primary care networks to consider before pursuing a family care clinic (FCC).”
This suggests that in 2013, there was discussion about making more FCCs in the province. However, the reasons this didn’t happen is not clear.
A worldwide rural problem
Slave Lake is not the only rural community with trouble retaining health care professionals.
Trouble keeping doctors in rural areas is a worldwide phenomenon, says an employee at Rural Health Professionals Action Plan (RhPAP), a Government of Alberta non-profit which helps recruit rural youth to medicine and rural communities to retain doctors.
The ‘AHS Physician Workforce Plan and Forecast Report 2018-2028’ was completed on Sept. 24, 2018.
“Rural and remote areas in Alberta have challenges in recruiting physicians who did their postgraduate training in Canada,” the report says.
“Challenges remain in north, central and, to a lesser extent, south zones as illustrated in their higher relative replacement recruitment requirement in comparison with other zones,”says the report. “This speaks to challenges in both physician distribution as well as retention that it is hoped will be addressed by work of the Physician Resource Planning Advisory Committee to the Minister of Health.”
North, central and south zones are predominately rural.
From 2017 to 2018, the north zone decreased from 340 family doctors to 332, which was less than the year before, says the report. The total number of exists in 2018 were south five, Calgary 41, central 22, Edmonton, 20, and north 11.
“For the second year, the north zone had the highest proportion of vacancies – 10 per cent – and the lowest proportion of their core workforce in the age group of 55-64 showing a younger than average family physician population,” says the report.
This suggest that the problem is across rural Alberta and more intense in the north, which most people in Edmonton and south classify as anything north of Edmonton.
AHS says the family care clinic helps with recruitment
“The family care clinic model seems to allow us to recruit health care professionals,” Harmata says. “which is some of the reason the model was started in the first place.”
“I wanted that holistic, comprehensive interaction with patients, so I thought the FCC model fit best into my style,” says Dr. Frank Akwa quoted in a August 10, 2017 Edmonton Journal article: ‘A remnant of the Redford years, Slave Lake’s unique health clinic proving a success’.
Both Dr. Akwa and Dr. Keith Martin were interviewed in this article. They had positive things to say about FCC and are still active in Slave Lake.
“Health care professionals do like to work in this (family care clinic) model,” Harmata says. “It is a team based model. The nice part of that is the warm hand-over,” the ease in which a doctor can connect a patient with a dietitian, physiotherapists etc.
AHS says doctors can start their own clinic
There is the “option for physicians to open their own practice,” Harmata says. “We would not limit that. In areas with multiple clinics, we introduce potential recruits to all three clinics.”
“The only requirement is licensing privilege,” Harmata says. “It doesn’t matter where they practice out of.”
Licensing appears to be done through new physician orientation. AHS verifies doctors credentials and grants clinical privileges.
However, rumor has it that at least one doctor practicing in the area does not have hospital privileges.