A GP for Me was a Doctors of BC (DOBC) and Ministry of Health (MOH) initiative. Its aims were to:

• Strengthen the continuous family physician-patient relationship
• better support the needs of vulnerable patients
• enable patients who want a family doctor to find one
• increase the capacity of and improve the delivery of primary care

The initial member communities included Creston, Cranbrook, Kimberley, Fernie, and Elkford. Sparwood, Invermere, and Golden joined later.
 

Project Profile

Our A GP for Me initiative implemented four strategies based on member community input:

• practice facilitation
• health promotion
• team-based care
• recruitment and retention

The Government of BC and Doctors of BC (DoBC) funded the project through to March 31, 2016, with implementation of the following four strategies:

 

Practice Facilitation

The Practice Facilitation strategy covered all member communities. The consultants worked with general practitioners (GPs) and their medical office staff to improve office efficiencies, workflow and optimize electronic medical records (EMRs).

The project facilitated proactive care of patients with chronic medical conditions. The goal was to increase GPs' capacity to care for complex patients, see more patients, and improve work-life balance. This was achieved through better complex-care management flow and streamlined office processes.

 

Health Promotion

The A GP for Me health promotion strategy supported all the identified strategies, focusing on healthy lifestyle choices through incentives, education, and reducing barriers. Kimberley was the prototype community, and they have partnered with SCOPE BC through BC Children’s Hospital, and shared the Live 5-2-1-0 messaging throughout the community. In addition, the project has led to increased cooperation among various health providers and community agencies to support healthy families.

The project is ongoing with grants from BC Healthy Communities' Plan H and the City of Kimberley.

 

Team-based Care

Our Team-based Care strategy was implemented in five of the EK communities, identified in the early assessment and planning stages. The project contracted three social workers, for Creston, Cranbrook, and Fernie/Elk Valley, as well as a life skills worker in Cranbrook.

The social workers are funded by the Division until September 2017. The life skills worker contract ended in June 2016.

The social workers have supported patients by connecting them with:

• resources (income, housing, job),
• counselling, and
• assistance addressing the social determinants of health.

 

Social work support has also released GP time from the coordination of social, behavioural and financial needs of the patients, allowing the GPs to focus on the medical needs.

Social work has emerged as an important component of team-based care in East Kootenay. We continue to advocate for ongoing funding and support with Interior Health (IH) and Ministry of Health (MoH).

 

Recruitment and Retention

The Recruitment and Retention Coordinator partnered with existing resources in BC and Interior Health (IH).

One goal was to work proactively to prepare for physician attrition, and identify existing gaps to address needs for patients with poor GP access to facilitate their continuous, long-term relationship. We also looked at issues around locum tenens recruitment.

A second goal was recruiting and retaining GPs to address issues for patients who were unable to find a GP and were unattached. This strategy was successful with the addition six GPs in Cranbrook, two in Invermere, one in Kimberley and one in Fernie. In addition, at least four, long-term, locum tenens have been recruited, several of whom are planning to take over practices from retiring physicians.

GP recruitment and retention is still an ongoing need for all communities. The Recruitment and Retention Coordinator, Patti Phillips, as well as each community, will continue to support this strategy.

 

Conclusion

The A GP for Me initiative was successful in East Kootenay, as we supported GPs and their staff in addressing some of the challenges and gaps they identified. The four strategies helped to:

• optimize office and complex care practices,
• strengthen medical clinic teams to support patient needs with appropriately skilled professionals,
• support healthy lifestyle choices within the community, and
• ensure adequate numbers of GPs.

  This helped us achieve our overall goals of strengthening GP-patient relationships, enhancing capacity of the primary health care system in the EK (including better support for the needs of vulnerable patients), and enabling patients who want a family doctor to find one.