The Niverville Heritage Centre held their ninth annual gala on November 7, with about 275 guests attending the black-tie affair. This year’s fundraising emphasis was expanding the primary healthcare clinic in Niverville, both in terms of physical space and the services offered.
“When we first got here, the population of this town was about 1,700,” said Dr. Chris Burnett, who began the clinic in Niverville 11 years ago with his wife, Dr. Mairi Burnett. “It is now shy of 5,000 and we’re expecting to get to 7,000–8,000 by the end of this decade.”
The first version of their clinic occupied just 3 rooms where the Growing Minds daycare is now situated, on the first floor of the Heritage Centre. The Burnetts worked part-time. A few years later, they expanded to a 2,000-square-foot suite on the second floor, began working full-time hours, and recruited additional doctors to meet the growing need.
According to Gord Damon, board chair for Niverville Heritage Holdings, the fundraising goal over the next 5 years will be $500,000 for the new clinic, just over $60,000 of which was raised at the gala.
The new clinic will be housed on the main floor of the new Heritage Life Retirement Living Complex. The clinic will have about 5,000 square feet and all the services will be centralized, including a new lab for bloodwork.
“What we want to do is have a single door entry,” Burnett said. “People can come in through the door, go to a single reception, and depending on what the need is, they then see the best clinician for them.” Burnett clarified that the word clinician includes physicians, nurse practitioners, primary care nurses, and physician assistants.
Among the key improvements are extended hours. Currently, the clinic opens at 8:30 a.m. and closes around 5:00 p.m. Though the changes will be gradual, Burnett predicts that within 5 years the clinic will be staffed from 6:00 a.m. to 10:00 p.m., though not all clinicians will be on hand at all times. He said that the key to longer hours is to stagger the shifts.
Another big change is that clinicians will no longer have their own individual rooms. “From the point of view of staff coming in, there’s no such thing as a person’s room,” Burnett said. The doctors will be mobile, seeing patients in the room that is best equipped to meet the patients’ needs. “We don’t have to have every room stocked for everything, and there is cost savings in that.”
The night’s guest of honour was Dr. Michael Rachlis, a Winnipeg-born medical doctor and private consultant in health policy analysis. He has consulted with the federal government, as well as all 10 provincial governments. In addition to lecturing widely in Canada, he has made presentations to members of the United States House of Representatives and Senate.
“I think that even though it’s kind of trite to compare our system to the American system,” Rachlis said, “some people say that your health system is better than the American system. That’s a little bit like going into a high jump competition against midgets. You’ll win, but the bar is really low.”
Among the differences between the Canadian and American systems is overall cost and efficiency. Canada, like most other wealthy countries, spends approximately 11 percent of its gross domestic product (GDP) on healthcare, whereas the United States spends 18 percent, far more than any other nation. The Canadian system has some flaws that need to be addressed, but Canadians now live an average of 3 years longer than Americans, and our infant mortality rate is 30 percent lower.
The biggest problem in Canada, Rachlis explained, is that we place far too little emphasis on primary healthcare, and the result is that our hospital system is overwhelmed.
“We don’t do a good job of keeping people out of hospital,” Rachlis said. “When we compare ourselves against [other wealthy countries], we have the longest waits for family doctors, the longest waits for specialists, and we’re the highest users of emergency rooms. The only people in these surveys who show up with higher use of emergency rooms are Americans who don’t have health insurance, and that’s because that is the only place that an American without health insurance cannot be denied care.”
Rachlis spoke at length about the virtues of comprehensive primary healthcare, especially the kind of care already available in Niverville and envisioned for the new clinic. “I’m really impressed with the Heritage Centre and how you’ve been growing it. I’m very impressed at the way that you see that health is not just hospitals.”
Dr. Burnett added that building a hospital here is off the table. “We’re never going to have a hospital, and I’m going to go up here on a limb and say that we never want to have a hospital. There is no need to have a hospital in Niverville. We’re surrounded here by 3 very good hospitals, which we have very easy access to.”
Burnett explained that the goal of a clinic like Niverville’s is to effectively deal with the simple things you don’t want to spend hours waiting to treat at the emergency room. “What we’ve found is that when we look at afterhours [medical emergencies]… those are urgent and you need to be calling an ambulance. However, we find that if we can offer you an appointment the next day with your own provider, you can manage to get through the night.”
“I think now that it’s time to really amp up remedial activities,” Rachlis said. This includes effectively treating chronic illness before acute exacerbations send people to emergency rooms. “Tommy Douglas [the founder of Canadian Medicare] all his life talked about the second stage of Medicare. He talked about how the first stage of Medicare was public payment through the old system, focused on doctors, hospitals, and treating people after they got sick. He said the second stage of Medicare would be a different health system designed to keep people healthy. And we’re still struggling to implement that now.”
According to Rachlis, Niverville is on the right track. “I would say that you folks are doing it in Niverville, that this Heritage Centre, and the amazing services that you’re providing, particularly to the elderly in this community, this building is pure second-stage Medicare. You’re doing an amazing job here.”
