A Future Where Everyone has a Family Doctor

One million people in British Columbia do not have a family doctor. Everyone ideally should have a family doctor (#EveryoneDeservesAFamilyDoctor), and BC’s new Longitudinal Family Physician (LFP) Payment Model is a significant step forward to achieve that goal. To help guide us there, the HDC Discover platform can contextualize EMR data to enable us to address the distinctive requirements of each community. By analyzing data on health outcomes, risk factors and demographics, we can identify patterns and trends that guide policy and practice, bridging healthcare gaps and fostering equity.

In the West Kootenay region of BC, the large numbers of unattached patients without a family physician have resulted in wait times of up to 3 weeks for conditions like ear infections (Nelson Star article link).

The Kootenay Lake Medical Clinic (KLMC) in Nelson BC offers both longitudinal and episodic care, serving both attached and unattached patients in the region. During a meeting between David Chan, Clinical Services Manager at the HDC, and Dr. Tom Newth of KLMC, the LFP’s patient attachment requirements were discussed.

To qualify for the LFP Payment Model, physicians must have: (i) a minimum of 250 attached patients and, (ii) less than 30% of the patients can be unattached. Dr. Newth expressed curiosity about how these requirements could affect existing KLMC patients.

  • “…how often do we see our attached vs unattached patients?”
  • “…given our current constraints, what is best for the residents of Nelson?”

With the aid of HDC Discover we delved into Dr. Newth’s inquiries.

Number of Encounters at KLMC – Attached vs Unattached 

Dr. Newth was keen on gaining insight into the overall frequency of encounters for his attached versus unattached patients. This would assist in determining the respective patient complexity required for his attached patients, which would influence the overall capacity to provide episodic services in the coming year.

From the above pyramid, Dr. Newth’s attached patients have visited him more frequently, averaging 15 visits in the last 3 years, compared to the unattached patients who have only visited the clinic an average of 5 times in the same period. From a simple capacity perspective, providing longitudinal services for one attached patient is equivalent to offering episodic services for three unattached patients in his clinic.

Access to this analysis has assisted Dr. Newth in future planning since attached patients would naturally take more time for their longitudinal care, and currently, there are insufficient healthcare providers in Nelson to fulfill this shortfall. While he believes that bringing in more providers and offering team-based care will help alleviate this demand, he plans to continue seeing unattached patients in the clinic.

 “B.C.’s new LFP Payment Model requires physicians have a minimum of 250 attached patients,” states Dr. Newth. “I’m thankful that I already meet this minimum requirement because every additional attached patient I add, results in three unattached patients not receiving medical care.”

Meanwhile, Dr. Newth is more dedicated than ever to monitor and provide services to unattached patients in the Nelson area. As a resident of Nelson, his guiding principle is to do what’s best for the entire community.

“Until we’re able to address the shortage of physicians in Nelson, I believe patient outcomes are improved if more patients receive a little care, versus a small group receiving intensified care,” explains Dr. Newth. “That is what we’re doing at the KLMC. We provide a Patient Medical Home for both attached and unattached patients, until the latter can find a permanent family physician.”

Does your medical clinic include both attached and unattached patients? Is the capacity demand between your attached and unattached patients similar to Dr. Newth’s?

Contact an HDC Clinical Services Manager at info@hdcbc.ca to support your analysis to inform your practice composition going forward.