Resident clinic to provide critical link to doctors
Health: Changes provides patients improves access to care
By: By Tanya Kostiw
| Posted: Wednesday, Jun 06, 2012 01:13 pm
A new resident doctor clinic opening in Black Diamond will match 100 people without family physicians to critical care.
Four resident doctors will practice at a new clinic opening in July at the Foothills Family Medical Centre and take in 100 patients who currently don’t have family doctors.
Resident doctors from the University of Calgary’s family medicine program currently spend four months at the medical centre in their first year and take part in a call-back clinic two days a month in their second year. Under the new program, resident doctors will spend two days a week for eight months each year at a dedicated resident clinic with their own patients under the supervision of preceptors, who are instructor physicians.
The new model will better enable a resident clinic to develop at the medical centre because the resident doctors will be around more often, said Dr. Brian Siray, program co-ordinator and physician at the medical centre.
“We’ve always tried that in the past, but have never been successful because of the fact that in order to run a resident clinic you have to have the (resident doctors) here on a consistent basis so that they can consistently follow a sub group of patients in a regular fashion,” said Siray, who has been a preceptor for nearly 25 years.
The clinic’s purpose is to allow residents to develop their own group of patients and to provide continuity of care, he said.
Under the former model, resident doctors might not have been around to follow up with a patient who they treated. The new approach will increase their interaction and Siray said he thinks it will give the new doctors more responsibility.
“In order to develop confidence in your decision-making process, you’ve got to make sure the decisions you’re making are having positive results and the only way you can do that is to follow the people you see,” he explained.
Dr. Thomas Bouchard is finishing his residency at the medical centre and said the new program sounds interesting. Bouchard has worked in resident clinics in Drumheller and Chilliwack and supports the model. Other resident doctors have shared his opinion, he added.
“They really like that – having your own mini practice and taking that ownership over patients,” he said.
Patients also benefit from this relationship, according to both doctors.
Patients will view their resident doctor as their physician, not just as their doctor’s resident, Bouchard explained. When he worked at a resident clinic in Drumheller, patients told him they enjoyed seeing resident doctors because they had more time to spend with them and it was easy to get an appointment.
Siray said there are many people who don’t have family doctors and this initiative also aims to help serve this need. People without family physicians often go to the emergency department, a drop-in clinic or the Okotoks Health and Wellness Centre and see a different doctor each time, which results in fragmented care, he explained.
Siray added it is less costly for the health care system when a patient sees a physician at an office rather than at the emergency department.
However, when patients join the resident clinic, they are tied to a resident doctor.
“They’ll be able to develop that relationship of doctor and patient and that follow up and that continuity of care, which is the critical part,” Siray said.
The resident clinic will also serve the medical centre’s existing patients who want to be seen on a more urgent basis, but aren’t able to secure a timely appointment with their doctor.
This could help ease some of the burden on the urgent care services at the Okotoks Health and Wellness Centre and the emergency department, which is where patients typically go if they can’t be seen at the doctor’s office, said Siray.
Resident doctors will reduce their time with specialists to accommodate the additional time they will spend at family medicine clinics.
Bouchard said time with specialists is important, but it is not what family medicine residents will pursue and it shouldn’t be emphasized as much as time at family medicine clinics.
“Most of your time should be spent doing and learning what you’re going to be doing when you’re out, rather than doing things that you’re interested in for your patients’ sake,” he explained.
This new shift is part of the change the University of Calgary’s family medicine program is undergoing this year. Theoretically, resident clinics will be implemented in seven other sites in Calgary affiliated with the program, said Siray. This change is a mandate coming from the Canadian College of Family Practitioners and the shift is happening throughout the country.
How resident doctors are evaluated is also changing and proof they are competent in different areas will be required, he said. This approach requires preceptors to see residents more than in the previous system, which needed to be revamped and didn’t always give resident doctors the information and feedback they needed, he added.
However, Siray said moving forward with the new program puts added responsibility on preceptors to teach the residents and continuously monitor them.
“Whenever you make radical changes in a program there’s no doubt about it I think there’s going to be bumps in the road,” he said. “It’s going to be a learning curve. It’s going to have its ups and downs.”
Siray said his biggest concern with the program is resident doctors will have to leave the clinic and their patients after two years. However, this will need to be clearly communicated to patients and the clinic won’t discourage them if they want to follow their resident doctor once they establish their own practice, he said.
Anyone who does not have a family physician and is interested in seeing a resident doctor can contact Glenda at the Foothills Family Medical Clinic at 403-933-4368.