Primary Care for All
Last night, we held our final of three Family Medicine Town Halls. Across the three events, we had nearly 100 participants with very thoughtful discussion and constructive feedback to help renew family medicine and address the crisis in primary care. One clear theme that has emerged is that there is no one solution, no single silver bullet, that will help all family physicians, and therefore a variety of funding mechanism and supports are needed to help family physicians thrive with their longitudinal care practices.
In fact, a report was released recently by the Public Policy Forum called “Primary Care for Everyone: An Urgent To-Do List for Reform.” You can read it here. Signatories include Dr. Alika Lafontaine, Dr. Jane Philpott, and others. The report included a
to-do must-do list to reform family medicine and primary care, which reinforce a lot of the advocacy underway here in Manitoba. This includes, for example:
- Accelerating the adoption of team-based primary care. Of course, this needs to be done with continuity in mind to better serve family physicians’ patients.
- Reforming compensation models to better fund the clinical, infrastructure and administrative requirements of the primary care team.
- Implementing a “one patient, one chart” concept.
- Cutting the administrative workload for family physicians and primary care providers.
There’s no question change is needed. Family physicians have been facing escalating costs, growing administrative burdens, and increasing patient complexity in their practices, and provincial funding has not kept up to help meet these demands. Here are some recent stats that illustrate how these challenges are leading to bigger issues:
- Family Physician Shortage: Manitoba has the 2nd biggest shortage of family physicians in the country based on FPs per capita, as reported by the Canadian Institute for Health Information.
- Great Medical Resignation: Our preliminary analysis of the 2023 Annual Physician Survey finds that 52% of family physicians are planning on retiring, leaving Manitoba, or reducing their clinical hours in the next three years. The top reasons cited by for these plans are system or institutional in nature, and could be addressed.
- Clinics Struggling: Two thirds of clinic owners reported they are very concerned or somewhat concerned about keeping their clinic open over the next three years.
- Interest in Family Medicine as career declining: After years of neglect, it’s no surprise that interest among medical students in pursuing a residency in family medicine has declined in recent years.
These trends are concerning, to be sure, but they can be reversed with better funding and supports for family medicine. That’s why Doctors Manitoba is advocating for family medicine renewal every step of the way, and we appreciate your support.
Please continue to connect with us at firstname.lastname@example.org, to share the challenges you are facing and your ideas to renew family medicine so you can thrive in your practice.
Surgical/Diagnostic Backlog Update
We understand that a new call for proposals is coming later this Spring, to add more capacity towards eliminating the surgical and diagnostic backlog that accumulated during the pandemic. We will keep you updated on this as we learn more, as this process offers physicians a rare opportunity to propose new ways to expand capacity both in their independent practices or in the hospitals in which they work. The government is anticipating adding 120,000 additional procedures in a number of areas over the next two years.
We’ve heard from physicians that they want to be better prepared for the next call for proposals from the provincial government, so we are signaling now that we understand this is coming and we are working with the Diagnostic and Surgical Recovery Task Force to provide more information before the call for proposals is issued.
This week, the government announced a $5 million boost to surgical care staffing to add 70 new operating room assistants. With a combination of education, training and orientation, operating room assistants will provide vital support to patient care teams in a number of ways. Responsibilities will range from decontaminating rooms and disinfecting equipment, to transferring and preparing patients safely for surgery, readying instruments and equipment during procedures, and cleaning post-procedure. A 12-week course started in January with 29 students, with graduates expected to move into the health workforce soon. OR assistants will be added first at HSC, Victoria, Misericordia, Grace, St. Boniface, and Selkirk hospitals and at Pan Am Clinic.
Earlier this year, the province provided an update on the progress being made to eliminate the backlog. Key highlights of this update include:
- To date, 52% of the “known COVID-19 backlog” has been eliminated. This includes backlog in 20 areas where reliable data is available, though there are an additional 13 service areas where they are still compiling information to measure the backlog.
- The Task Force indicates that the pandemic backlog has been eliminated for cataract surgeries, cardiac catheterization, pacemakers, and ultrasound.
- Significant progress has been made in reducing the backlog, but not yet eliminating it, for orthopedic (shoulder, foot, ankle and spine) surgeries, CT scans, and cardiac surgery.
Again, this progress is against the pandemic backlog. the Task Force has acknowledged that backlogs and long wait lists in many area existed before the pandemic.
The update notes that work continues on addressing the backlog in other ways:
- mitigating the endoscopy wait list by expanding the use of fecal immunochemical tests (FIT);
- expanding access to gynecological surgery through outpatient surgeries at Maples Surgical Centre/Clearpoint Health Network;
- developing the Anesthesia Clinical Assistant Program to help address the global shortage of anesthesia providers;
- providing operating costs for the new Surgical Wait Information Management System (SWIM) to centralize wait lists in Manitoba and make wait list management more efficient;
- expanding the Spine Assessment Clinic at HSC to a provincial resource;
- expanding orthopedic surgery capacity by opening a fifth operating room at Concordia General Hospital;
- expanding diagnostic imaging capacity Manitoba-wide through additional staff; and
- expanding hours for MRI and CT scanning, and by purchasing one new mobile CT and one new mobile MRI.
As of early February 2023, there are 22,335 patients who were supported by the task force through short-term Request for Supply Arrangement (RFSA) contracts to receive the care they require.
Source: Province of Manitoba
Last month, the Canadian Institute for Health Information released an updated estimate to September 2022 on the pandemic backlog for surgical procedures. They found in Manitoba 48,327 fewer surgeries were performed during the pandemic compared to pre-pandemic volumes, or an 18.5% decrease. This is the second largest backlog in Canada, and much higher than the national average of 13.6%.
Change in Surgical Volumes During Pandemic (Mar 2020 to Sep 2022)
Source: Canadian Institute for Health Information
The CIHI backlog estimate of 48,327 surgeries from Sept 2022 is higher than the last Doctors Manitoba surgical backlog estimate from June 2022 of up to 39,674 procedures. We are also keeping an eye diagnostic and other procedures that have accumulated backlogs during the pandemic, and have lengthy wait lists for other reasons.
You can see progress reports from the Diagnostic and Surgical Recovery Task Force on their website here.
CME Rebate and Grants
We have two updates on continuing medical education.
First, the annual application for your CME rebate will open very soon. Watch your email for a separate message on this, likely next week. We are working on making this process more streamlined this year, with an easier online application form and the option of direct deposit to get you an expedited rebate payment.
Second, we are still accepting applications for Group CME Grants. The 2023 Group CME Program was launched in last month and is separate from your annual CME rebate. This group learning initiative provides grants up to $20,000 for projects that deliver continuing medical education to a group or team of physicians in Manitoba. A total of $450,000 is available this year in three different streams: GFT physicians, Rural and Northern physicians, and Community-Based physicians. Any eligible physician in Manitoba can apply.
Eligible applications will be approved as they are received on a first-come first-served basis. The grants can cover eligible expenses for accredited continuing medical education that occurs in Manitoba before the end of 2023. Funds can be used to cover accreditation costs, speaker fees and accommodation or travel or other expenses necessary to deliver the education to a group or team of physicians. Previous grants have been provided for point-of-care ultrasound training, multi-topic primary care and surgical CME, and anti-racism CME.
You can learn more about the new CME grant initiative here, or contact Barry Hallman at email@example.com for more information.
One of the most frequently visited sections of our website is our Practice Opportunities hub, where opportunities can be posted and viewed. Dozens of opportunities are currently listed, including a unique professorship opportunity with the UM Department of Family Medicine: Professorship in Family Medicine Research & Innovation. The goal of the three (3) year professorship will be to provide leadership, scholarship and mentorship in the areas of quality improvement and patient safety in Family Medicine/Primary Care. Academic work will focus on research leading to innovation in the approaches to improve the quality and safety of healthcare delivery and building capacity to strengthen the culture of quality improvement within Family Medicine and Primary Care practice settings.
Nurse Therapist Opportunities with Physicians at Risk
Doctors Manitoba recently successfully advocated for more resources to support physician health. Doctors Manitoba is looking for two nurse therapists to enhance and diversify the existing services through the Physicians at Risk program. Please encourage those you think would provide excellent service to all Doctors Manitoba members to apply.
Physician of the Week, Dr. Michael Coodin
Meet our Physician of the Week, Dr. Michael Coodin. A Family Physician working in Winnipeg, Dr. Coodin is described by colleagues and patients as warm, trustworthy, friendly and approachable. He says he “genuinely enjoys caring for his patients and in his 15 years of practice he has had many of the same patients since the beginning of his career.” With a strong focus on connection, Dr. Coodin goes above and beyond to reach patients with test results after hours so they are not left waiting for a diagnosis.
Health System Updates
CCMB Cancer Screening Competency Training
Registration is open! BreastCheck, CervixCheck, and ColonCheck host training for healthcare providers (e.g. registered nurses, advanced practice nurses, licensed practical nurses, physicians, midwives, physician assistants or clinical assistants) in Manitoba seeking to:
- initiate or refresh learning and competency about cervical cancer screening, or
- mentor colleagues to become competent in screening for cervical cancer, and
- initiate or refresh learning about BreastCheck and ColonCheck.
Training sessions are planned for May 9 and 10. Learn more and register here.
MACHP Members Vote to Strike
Allied health professions represented by the Manitoba Association of Health Care Professionals have voted to strike. This includes paramedics, lab technicians, physiotherapists, occupational therapists, perfusionists, and others working in the public system. Many have been without a contract or wage increase for several years.
While the vote will likely be covered widely in the news, a strike vote does not mean there will be a strike. Unions often use a strike vote to strengthen their position while negotiating. Even if a strike is declared, long-established Manitoba law prevents those health care employees who provide an “essential service” from walking off the job.
Doctors Manitoba will monitor developments. We will report back to our members with developments, particularly those that could impact the care you provide to Manitobans.
We have a lot of exciting event opportunities for members to highlight. Please take a look below.
Doctors Manitoba AGM • May 11 at 6:30PM
Join us for our Annual AGM. We will kick off with an exclusive and candid conversation with Senator Dr. Gigi Osler. Senator Osler will discuss the importance of equity, diversity and inclusion in medicine and physician leadership with her unique perspective as a woman of colour in surgery, a former President of the CMA, and now a Senator in Ottawa. We will also have the opportunity to hear her insights and experience in her new role in the Senate.
It’s easy to join the AGM this year, with in-person and virtual options. Plus there’s also a fabulous door prize — a $500 Visa cash card!
The AGM will include an update from outgoing President Dr. Candace Bradshaw and from CEO Theresa Oswald. The agenda also includes a vote on foundational changes to our by-laws that aim to strengthen our decision-making, ensuring members are at the heart of everything we do. The changes also seek to modernize our governance, including supporting a Board that is more inclusive and representative of our broader membership, including members’ professional and personal attributes. Learn more and register today!
Exclusive Financial Wellness Webinar for Members • April 18 at 6:00PM
We are teaming up with Enriched Academy to offer an informative, 60-minute live stream full of practical advice you can start using right away to improve your financial acumen. This free session will cover 8 factors for better financial wellness. Enriched Academy has worked with other elite professionals from health care to professional athletes. Learn more and register now.
Equity in Leadership • April 20 at 6:30PM
On April 20, we will be hosting Dr. Julia Chronopoulos for her session on 2SLGBTQ+ Health. Dr. Chronopoulos’ talk focuses on how to make health spaces more queer-friendly. This involves an overview of terminology in the 2SLGBTQ+ community, as well as approaches to challenging norms that are the foundation of medical teaching. Click here for more information, and to register for the session.
Retirement Webinar with MD Financial • May 4 at 7PM
Doctors Manitoba is co-hosting a webinar with MD Financial Management focused on Practical retirement planning and saving strategies for physicians. Learn more about the webinar and register here.
Department of Family Medicine Gala – 50 Years • May 26 at 5:30PM
We are excited to celebrate and reflect on our history and honor how far we have come since 1973. Early bird tickets available! At the gala, we will listen to brilliant speakers and award our talented colleagues while enjoying lively music from the Ron Paley Big Band. Learn more and buy tickets here.
Connection Event for Black Physicians, Residents and Medical Students • May 4 at 6PM
In partnership with the UManitoba Black Medical Students Association, Doctors Manitoba is hosting a social event for Black Physicians, Residents and Medical Students. Please join us on May 4 from 6:00 – 9:00 for an interactive cooking class being held in-person at The Food Studio on Roblin Blvd in Winnipeg. Don’t miss this opportunity to connect and network with other Black physicians and medical learners. Seats are limited. Click here for more information and to register!
What’s Next: The COVID Aftermath with André Picard • May 26 at 12:00PM
What lessons have we learned to do things better? Hear from one of Canada’s top health observers and commentators on this important topic. Learn more and register here.
You can always see our complete upcoming events calendar here.
Last week, our President Dr. Candace Bradshaw offered an update on our Master Agreement. The existing agreement expired March 31, but work is well underway on negotiating our next agreement. Read Dr. Bradshaw’s update here.