While there is a lot of potential to enhance the province's Primary Care Networks (PCN), it's still too soon to tell how their role might be expanded in the future, said local family physician Dr. Darryl LaBuick.
"I think that they're structured in a way that we've got some great opportunities to enhance the primary care of citizens in our area very much. As to how and why, that still had to be sorted out," he told the Gazette on Monday.
LaBuick has worked in the community for 16 years and will step into the role of president of the St. Albert and Sturgeon Primary Care Network on Jan 1.
As such, he will chair the board and address any physician issues or concerns that might arise. Dr. Wayne Daviduck has been president of the local PCN for the past two years.
PCNs are teams of health professionals, led by family physicians, who work collaboratively to improve aspects of primary care. Funded by Alberta Health Services, they are a joint venture between the province and physicians who decide how best to utilize funding in order to enhance primary care.
Currently, there are 38 PCNs in Alberta. The St. Albert and Sturgeon Primary Care Network was created in 2005 and includes 15 clinics.
Here in St. Albert, a number of people have been hired by the PCN to assist family doctors in delivering care, including pharmacists, nurses, dietitians, physiotherapists, technical assistants and computer experts. Together they deal with numerous issues, including chronic disease management and mental health, for which the PCN has several mental health co-ordinators.
"All of those things that can backlog the system in other ways and help patients access the need that they have," LaBuick noted.
Primary Care Networks and emergency rooms
Asked whether PCNs could potentially play a role in reducing emergency room wait times, LaBuick said the ER situation is a symptom of the entire system, not simply a primary care issue.
"When we deal with the backlog in emergency rooms, we deal with a lot of problems with long-term care facilities, we deal with problems with acute care management and shortage of operating room resources. There is a multiplicity of issues that deal with the emergency department," he explained.
"To reduce waiting times in the emergency department from the primary care roles, there are probably some roles that can be played by improving access to family physicians but it's still indeterminate to say how much impact that will make," he added.
"We'd like to think it would make a difference."
If the province decides to expand resources outside of hospitals, it could present an opportunity to reduce wait times, LaBuick said. Specifically, that would mean providing more after-hours services, such as X-rays and labs.
"Like what we had here in the Grandin clinic years ago," he said.
Over the last five to 10 years, LaBuick said there has been a move in primary care towards working in more collaborative environments, something that he said enhances patient care.
"We have a better ability to manage our diabetics better, we have a better ability to monitor medical conditions for patients. We have a better ability to communicate with patients," he said.
Looking forward, LaBuick said the big question for those in primary care is how PCNs will evolve. Any enhancement, he said, will require a considerable increase in funding.
"When you get more funding and you get more responsibilities, that creates a whole other load of work involved with it too. Those are some of the unpredictable things that they have," he said.
On Tuesday, Alberta Health Services said strengthening primary health care was one of five key strategies in its 5-year Health Action Plan.
One possibility that concerns LaBuick is the possibility Alberta Health Services will remove physicians from PCNs.
"There is discussion out there that they may not want the doctors involved in how the primary care network is run," he said, adding that he doesn't see many advantages should this happen.
"I think it's going to disengage the exact people that can improve the care of the patients. It's a little bit paradoxical that they want to do this but there is that talk, they want to make them into a regional authority again and we all know what happened with regional authorities and the success they had," LaBuick said.
"We hope they don't go down that road."
