Family doctors are ‘drowning’ as Fredericton struggles to recruit

In the second quarter of this year, Horizon Health Network hired 44 new physicians in the province’s cities — but only one of them went to Fredericton. 

Over the same time period, data from the regional health authority shows the capital region lost three family doctors. 

Will Stymiest, a physician who also chairs the family practice section of the New Brunswick Medical Society, is not surprised by the net loss.

He said recruitment and retention has been a problem in the Fredericton area ever since he began his residency in family medicine 10 years ago.

“Over the last five years we’ve had a half dozen or more, maybe even close to a dozen, young, new, in-practice physicians who started a community family practice and have left,” he said of the doctors he has seen pass through.  

“And there’s numerous reasons for that, but a lot of it comes back to feelings of lack of support. Feelings that their time is more valued elsewhere, in other parts of the health-care system and sometimes in other provinces.”

Stymiest said the remaining family doctors in the region are struggling to keep up.

“We are, as a group, drowning because of lack of support,” he said.

“That’s why people aren’t choosing family practice, that’s why people aren’t staying in family practice.”

N.B. Health Link unable to keep up with demand

Measures introduced by New Brunswick’s Department of Health, such as N.B. Health Link, which connects patients without a doctor or nurse practitioner to primary care at local clinics, are also failing to meet the demand.

As of June 30, according to the department, there are 61,173 New Brunswickers able to access appointments through that portal. Only 7,700 of those are Fredericton-area residents.

The province also has 35,600 patients on a waiting list to access N.B. Health Link. Of that group, 60 per cent live in the Fredericton region.

Stymiest says the government programs are well intentioned, but ultimately the health-care system won’t work unless more doctors are hired.

The Department of Health deferred questions about N.B. Health Link to Extramural New Brunswick, where spokesperson Christianna Williston said the program is designed “to maximize existing resources within the system.”

Dr. Ravneet Comstock, who oversees primary care at Horizon, said the measures are meant to boost access in the short term, while the health network improves service in the long term.

In a news release last week, Horizon acknowledged the ongoing high need in the capital region.

It announced a partnership with Extramural New Brunswick that promises to “increase access [to care] for unattached patients” in the Fredericton region, “where the wait list is currently longest.”

“Horizon will identify opportunities where physicians, nurse practitioners, registered nurses and other allied health care providers may support the NB Health Link network,” the news release said. 

Neither Horizon nor Extramural New Brunswick responded to questions about whether the agreement would add any new staff or other resources to the Fredericton region.

Fredericton steps up recruitment efforts

Stymiest declined to comment on the announcement because of the lack of details, but said New Brunswick should take note of updated service agreements struck over the past year in neighbouring provinces. 

Nova Scotia and Prince Edward Island introduced new funding models specifically for family physicians — with added compensation and simplified administrative processes for billing.

But Stymiest says it isn’t all about compensation.

The agreements also provide funding for family physicians to hire “allied health-care providers,” a step he says is critical, as family medicine has evolved to deal more with chronic, complex disease management. 

“Getting the people the care they need, where they need it, from whom they need it, I need help doing that, I can’t do that by myself,” he said. 

“If I am trying to do it by myself I’m not going to have the time to take on more patients. And if I’m earlier in my career, I might not continue.”

Although health care is a provincial responsibility, this year Fredericton Mayor Kate Rogers said the municipal government saw the growing problem — and put its hand up to help.

“The fact that people were not able to access primary health care was a real impediment to us delivering the quality of life to our residents that we want,” she said in an interview. 

“We sort of inserted ourselves in conversations they were having about how to recruit to the region, and we said, ‘nobody can sell our city better than we can.'”

While Horizon organizes visits to the hospital site, city staff now also ask potential recruits to fill out a “getting to know you checklist,” which is then used to tailor a longer visit to the interests of each physician. 

Rogers said the city is also working with local economic development agency Ignite on a guide to bylaws for doctors looking to open their own office in Fredericton.  

Ultimately, Stymiest said listening to physicians practising in the city is a simple step that goes a long way.

“If we’re truly interested in changing the landscape of primary care in this city … we need to listen to what recruits are telling us and make decisions that track with that way of thinking,” he said.

“Otherwise, we’re going to continue to be unsuccessful.”