Access to Primary Health Care has been an issue in the province for decades and one of the legacies of the pandemic has been highlighting the need for health reform. News reports in recent weeks and months have underscored that easy and efficient access to primary health care continues to be a growing issue for New Brunswickers – the number of people without a primary care provider has increased by more than 20,000 over the past six months – a situation that is particularly acute in the Fredericton region.
The lack of primary care is an issue throughout society, including the business community and it is inhibiting our ability to grow and thrive as a province. We see the health issue negatively affecting business and the economy daily in five primary ways:
- Attracting and retaining employees. One of the first questions that a prospective employee will ask is if they can get a family doctor if they move to New Brunswick. They often come with a family and it’s entirely understandable that the health and wellness of their family is first and foremost in their minds.
- Attracting investment. Along the same line as attracting employees, business owners and managers are keenly aware that current and future employees will want to know about access to health care. With the workforce already being the top issue for many businesses, they are wary of committing to a jurisdiction where this question is in doubt.
- Absenteeism resulting from delays in care. We see this in both a short- and long-term sense. If someone is ill or injured and unable to work, every day that passes without the primary care they need is a day of productivity lost for the business. Over time, this lost time exacerbates our provincial productivity rates, which are below the Canadian average (which, in turn, are below other jurisdictions such as the United States).
- Worse health outcomes for employees (and the community). Getting preventative or early treatment care is often the key to avoiding long-term or chronic conditions. We see this play out with wait times for surgeries, appointments with family doctors or accessing mental health resources, amongst other factors.
- Higher costs to the health system resulting in higher taxes. An ounce of prevention is worth a pound of cure remains a true idiom. Much like maintaining a home, dealing with small problems early before they balloon into unmanageable issues is critical. Of course, complex issues are harder (and more expensive to deal with), leading to higher costs to the system – think about the cost of an emergency room visit versus seeing a family doctor during office hours.
These are the reasons why the Fredericton Chamber of Commerce established a Physician Recruitment & Retention Committee in 2009 and are still actively assisting efforts of Horizon Health and the NB Medical Society to attract and welcome physicians to our community, while seeking other ways to expand easy and efficient access to primary care. We approach our role in improving access to primary health care in three main areas:
- Events. Each summer we host a welcome reception for the community’s medical residents – a new cohort of which starts each July 1st. These are the physicians most likely to be retained for the long-term and we want to start making connections to the community right away. More recently, we began host a physician appreciation event for all of the community’s doctors in fall. After not hosting these events in 2020 and 2021, we are back on track this year.
- Advocacy. In recent years, we’ve advocated for Fredericton Downtown Community Health Clinic, the establishment of family health teams, eliminating billing numbers, expanding virtual care, implementing a comprehensive electronic medical records system, expanding the use of pharmacists, NPs, physician assistants in primary care and for receiving demographically-weight health transfers from the federal government.
- We also offer medical residents business basics training sessions during their residency in partnership with the NB Medical Society. Many people don’t realize this, but most doctors essentially become small business owners on their first day of practice. Fee-for-service family doctors are responsible for leasing office space, hiring staff and all the other things that small businesses do and they receive very little if any training on this aspect of practice during medical school.
More recently, we’ve partnered with Ignite Fredericton to engage with a broader group of local stakeholders to identify gaps in the system and where we might have an impact collectively. The main idea is for the community to get more involved in recruitment – but especially retention. We leave the recruiting to the professionals, but we want to make sure the community (and particularly our support organizations) is ready to provide whatever support is needed. To use a business term, you can think of it as on-boarding as a community. The better job we can do helping physicians get settled in their practice and in their community, the better chance they’ll stay for the long term
The provincial government deserves kudos for introducing the Fair Registration Practices in Regulated Professions Act. Just about every sector is looking at immigration as a means to fill human resource gaps and credential recognition in healthcare has been a particularly difficult issue for decades. We are hopeful that this legislation will smooth the process for recruiting needed health professionals, in turn allowing businesses to recruit the talent that they need to grow and fuel the province’s economy. While the act includes all self-regulating professions, credential recognition in health care has been a key stumbling block amongst various health care practitioners – physicians and nurses may be the most apparent and pressing, but the effects of this legislation extends beyond these two fields of practice and contributes to improving access to primary care.
Finally, we should recognize the efforts of the current health care professionals in the province. The challenges of the pandemic have exacerbated their stress and exhaustion but also their resolve and commitment to their fellow New Brunswickers. The issues we are facing today are not due to a lack of effort or care on their part – indeed it is them that have held the system together for as long as they have – it’s up to the rest of us to get them the support they need to keep going.
Krista Ross is CEO of the Fredericton Chamber of Commerce, a nationally accredited organization with more than 1,000 members, is an active business organization engaged in policy development and advocacy that affects the competitiveness of our members and the Canadian business environment. The Chamber’s vision is ‘Stronger Community Through Business Prosperity’.