The Town of Niverville is investigating what form their involvement should take in helping the Niverville Open Health medical clinic stay open. Since Drs. Chris and Mairi Burnett went public about their personal health crisis, the clinic’s struggle to remain open has become an issue of significant importance.
Dr. Mairi will not be continuing at the practice for the foreseeable future and Dr. Chris needs to reduce his hours to care for her in the wake of her cancer diagnosis. The pair has also chosen not to renew the contract of one physician assistant who was practicing under a teaching and observation arrangement, and who required their availability in order to practice at Open Health.
Since Dr. Chris first spoke with the board of Niverville Heritage Holdings Inc., the various organizations involved have been coordinating. The Town of Niverville has also spoken with Dr. Chris and is currently pursuing a feasibility study before deciding if and how they can get involved.
According to a town communiqué regarding Open Health, council has engaged Kathy McPhail, former CEO of Southern Health-Santé Sud, as an independent expert to produce the report. The report will focus on assessing the short- and long-term sustainability of Niverville Open Health and provide recommendations for action.
The report will be provided to council on or before February 14, and the town plans to release more information on February 17.
“At this stage, a lot of what the town is doing is waiting for the report,” says CAO Eric King. “Ms. McPhail has started meeting with people and the town would not want to skew the outcome of the report. So at this stage we are waiting the couple of weeks to see the recommendations that come from her report. We have full faith in Ms. McPhail providing an independent report that will help improve the sustainability of healthcare services to our region.”
McPhail has more than 45 years of experience in healthcare. She trained and worked as a nurse and eventually moved into administrative roles, acquiring more education and knowledge along the way.
In May 2012, McPhail took on the role of CEO of Southern Health-Santé Sud until her retirement in April 2017. Over her career, McPhail spent more than 10 years as CEO of a health region.
Funding Model
The current funding model in place to support Open Health is complicated. According to the clinic’s website, the organizational structure is described as “a special cooperation between the Town of Niverville, who had the vision, and [Southern Health/Santé Sud], who provided the staff.”
When asked for clarification on the existing cooperation between the town and the clinic, King says, “The town does not provide any funds to this private enterprise. The clinic is owned and operated solely by the doctors. No funds have ever been granted to them.”
Southern Health pays for the salaries of provincial healthcare staff who work out of the clinic but does not contribute other financial support, such as in the form of rent.
“The mental healthcare and public healthcare workers at Open Health, as well as the dietician and chronic disease nurse, are Southern Health-Santé Sud employees,” says Alan Wiebe, media specialist for Southern Health. “Southern Health does lease half the space from Open Health and… pays for half the salary of one admin support position.”
Niverville Heritage Holdings Inc. would not comment on the leasing structure of the clinic space.
It is not uncommon for doctors to bear the bulk of the overhead costs associated with running a clinic. Doctors are paid by either fee-for-service (where they bill the province for services rendered) or salary (paid by the province), or a blend of the two. According to the Canadian Institute of Health Information (CIHI), for most doctors the fees billed to the province are used to cover the cost of running their practice and do not directly translate into actual take-home pay.
There is some question as to whether there exists a precedent for a town or rural municipality to enter into any type of arrangement for temporary or ongoing financial support of a medical clinic.
In a 2015 report conducted by the Rural Health Services Review Committee under the Government of Alberta, “many communities reported spending significant municipal dollars on such things as buildings, retention bonuses, housing, and relocation for physician recruitment with varying degrees of success.”
In that report, communities described a number of obstacles hampering their efforts to recruit and retain healthcare professionals. Overall, the biggest obstacle to a successful practice was seen to be lack of coordination and cooperation among existing healthcare services, government service planners and providers, and other bodies.
