Doctors Chris and Mairi Burnett are always on the hunt for new doctors to join their team at Niverville Open Health. Within the past month, two part-time physicians have settled in.
Dr. Kyle Curtis has been providing medical services at the clinic every Wednesday from 1:00 p.m. to 8 p.m. since the beginning of August.
More recently, Altona native Dr. Lauren Martens is on staff four days per month. Much of the balance of her time is spent at clinics in Churchill and Thompson. She is currently accepting new patients in Niverville.
Many patients are keeping their fingers crossed that Dr. Mary Coutts will return as a full-time physician in spring following her maternity leave. The Burnetts say other hopeful leads are in the wings as well, but attracting full-time doctors to a small town for an extended period of time hasn’t been easy.
“I think if you look at a lot of clinics, that’s what’s happening,” says Dr. Chris Burnett, referring to doctors who choose to pick and mix alternating schedules at different clinics.
With the current mix of medical staff, Niverville Open Health has two full-time and two part-time physicians, one physician assistant, and two nurse practitioners.
The physician assistant operates as an extension of the home physician. They don’t have their own list of patients and are limited in what they can do independently. Their work is always supervised by an in-house doctor.
Nurse practitioners, on the other hand, work completely independently and can take their own patients.
Not a Walk-in Clinic
Burnett would also like to dispel some misconceptions out there regarding “walk-in” or “drop-in” appointments at the Niverville clinic. While there are some Winnipeg clinics that offer walk-in privileges, that is not necessarily the case at Niverville Open Health.
For many, the terms walk-in or drop-in leave the impression that if you walk through a clinic’s door and check in with the receptionist, you will be seen that day, guaranteed.
Open Health, on the other hand, is not your traditional walk-in clinic. They do, although, provide same-day appointments to a limit. Each day, staff determine the number of appointment slots to be delegated as unassigned, meaning they are not prebooked.
This allows for patients requiring short-notice appointments to use those spots. Once they have been taken, whether through online booking, phone calls, or simply dropping in, they are taken and no further appointments can be accepted that day.
“Primarily… if we’ve got spare appointments, then people in the [area] can use that,” Burnett says. “But we really don’t want the connotation of a ‘walk-in’ clinic. I see them as a necessary function but it’s far away from what we want to be in a family medical centre.”
Burnett says Steinbach Walmart provides a good example of a walk-in clinic, where staff doctors primarily see patients on a one-time basis and have extended hours in order to provide healthcare services when patients can’t access their own doctor.
“It’s a concept more than a language,” says Burnett. “Just because you get through the door [at Open Health] doesn’t mean you’re going to have an appointment. It depends if there is availability… Yes, we have appointments, and yes, the timing from those is very loose, but there is a finite resource each day and I would say most of that is booked up very quickly.”
What Niverville Open Health does want to be is a family medical home where routine follow-ups occur and longer consultation times are the norm—a place where doctors can get to know the entire family, not just the individual, providing them the opportunity to see the bigger picture of how the family dynamic plays out in a person’s life and health situations.
“It is one of the riches of family medicine, that you get to see people in the context of the community,” Burnett says.
The Future of Urgent Care
Another of Burnett’s goals is to transition Niverville Open Health from a primary care clinic to include urgent care. Once the clinic is approved for an X-ray machine and additional staff has been acquired, they will be able to extend their services to include non-life-and-limb-threatening issues such as bone fractures and cuts.
With the construction of the Community Resource and Recreation Centre, and with it the sorts of competitions that will occur there, Burnett says urgent care in town would be an asset.
“Quite honestly, emergency rooms don’t really want those,” says Burnett. “Those are the people that wait for six hours. When you [consider that] the majority of people have [physical] trauma or infectious diseases [such as] coughs or colds… I think we can design a rural urgent care that can cope with those people and keep them out of the emergency room.”
Extended Hours
In order to do that, Niverville Open Health has been slowly extending their hours. Three days per week the clinic now opens at 7:00 a.m. Another three days of the week, hours have been extended to 8:30 p.m.
The hope for the future, as more doctors come on staff, is to provide care for Niverville and area residents between five to seven days per week, from 6:00 a.m. to 10:00 p.m.
Even so, residents may feel a need for a doctor consultation beyond those time slots. Burnett says if the clinic is closed and you can’t wait until they open again, your situation is probably an emergency and would be better addressed by an emergency room.
“I think we can educate the public on [which healthcare level is right for their situation],” says Burnett.
To a large degree, that is what Health Links phone line is for. Burnett adds that the provincial government recently developed a flat fee for ambulance use as opposed to the “per kilometre” fee they were charging before, which has improved access for rural residents who need emergency services.
In the end, he anticipates that being able to provide full primary care services for extended hours and days will keep more people from requiring the services of ERs. Already the Niverville Open Health clinic offers something pretty unique to the community and surrounding area.
“We need to grow with the town and the town has been very, very supportive,” says Burnett. “I have not come across a town that is so engaged and cooperative as this one… Every town has its foibles, but this town understands that healthcare is like [good infrastructure]. You will not get sustained growth if you don’t have the ability to look after families.”
