Model clinics connect teams of MDs with Island patients

When Dr. Gordon Henderson opened a walk-in clinic on Bevan Avenue in Sidney in 1992, he was told the area was “overdoctored” and “you probably won’t make a living.”

The opposite turned out to be true.

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For two decades, Henderson operated the walk-in clinic seven days a week, 12 hours a day and did hospital work. He took on partners within the first few years. Eventually, exhausted, he semi-retired.

These days, Henderson, 60, works part-time at the same clinic, now called Shoreline Medical in Sidney, because of an “emotional tie to wanting to see them do well.”

On Friday, four people were lined up more than an hour before the clinic’s 8:30 a.m. opening. Two had brought chairs to sit on while they waited.

On the Saanich Peninsula, where an estimated 15,000 people are without a family doctor, the community is struggling with a population that’s both growing and aging.

The non-profit Shoreline Medical Society, governed by a group of volunteer board members and funded primarily by the Saanich Peninsula Hospital and Healthcare Foundation, was formed after years of discussion in September 2015 to address the shortage.

At the time, Saanich Peninsula Hospital was facing doctor retirements with no new recruits to replace them.

One physician in the Bevan Avenue clinic got involved in the society, and eventually all of the doctors agreed to dissolve their personal ownership in the practice and sign on to pilot a new model of care under the society.

Three of the original family doctors retained their patient loads and stayed on full time to work in the new clinic, while others agreed to work on a part-time basis to support its walk-in clinic component.

The clinic was renovated in phases to accommodate 10 clinical rooms with a large collaboration room for doctors and a staff room with showers.

The society, whose major funding partner is the hospital foundation, paid for the renovations and medical equipment.

In summer 2016, Shoreline Medical officially opened with the goal of offering the community both a team-based family practice and a walk-in clinic. The Sidney clinic, staffed by seven doctors, was followed by a Brentwood location, also called Shoreline Medical, that brought together nine doctors with their own practices to work as a team.

Since opening, the two clinics, with a total of 16 physicians, have connected an additional 3,800 patients to family doctors, said Shawna Walker, executive director of Shoreline Medical Society.

The difference between this model and independently owned family practices is that the latter are not attracting physicians, said Walker.

“We have doctors calling us to work here. That’s a very differ ent scenario from other clinics.”

Walker said Shoreline has developed a primary-care network that has proven to be the model the government is now implementing around the province.

The clinics are the result of “years and years of collaboration” with the Health Ministry, Island Health, physicians, community members and Saanich Peninsula Hospital and Healthcare Foundation members, she said.

Shoreline Medical in Sidney is set to expand again this fall with five more doctors committed to opening practices as well as serving the walk-in clinic, Walker said. To accommodate the additional doctors, other health-care workers and administrative support staff, the current 10-room clinic will expand in phases to a 23-room, 7,500-square-foot clinic with two labs and a pharmacy and extended staff areas with more showers.

Once renovated, Shoreline Medical in Sidney will be accepting new patients in October, said Walker.

The two clinics will have a complement of 21 family physicians, not including allied health-care workers and support staff. When those family doctors work in Saanich Peninsula Hospital, there’s a pool of 15 locums who fill in for them.

Henderson said the new generation of family doctors is right to seek “boundaries between life and medicine.” This generation will last longer, he said.

“The Shoreline Medical model, where the onus on family doctors to be a small-businessperson is removed and they can just walk into the clinic and be physicians, is a good one,” Henderson said.

Out of their fees paid through the Medical Services Plan, doctors pay a fixed percentage toward the overhead, which includes the lease, staffing costs and supplies.

One of the problems for family doctors in traditional solo practices is that those fees don’t compensate them for overhead and paperwork, or the extra time caring for chronic and complex-care patients, Henderson said.

Shoreline Medical clinic, by contrast, offers team-based care where doctors have reasonable control of their responsibilities and hours and can take vacations, he said. They also rotate hospital shifts to sustain the hospital.

Shoreline Medical Society, through the Sidney clinic, also provides a Thursday night clinic for those ages 12 to 24, offering the services of a family doctor and Ministry of Children and Family Development counsellor to address physical, mental and sexual issues.

A third Shoreline Medical clinic near Saanich Peninsula Hospital is in the planning stage.

Walker said there are no plans to stop until that third centre is built.

Currently, the clinic in Sidney is supported by a nurse and pharmacist, but the society is working with the Health Ministry to expand its roster of health professionals and have them paid a salary through the health authority by the province.

The goal is to bring in additional nurses, a dietitian and social workers, Walker said.

“It would be fantastic if the ministry would say we are doing what they want and come to the table with the funding we need.”

ceharnett@timescolonist.com

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