By The Manitoba Clinic is losing patients, shedding jobs and struggling to stay in business. But the private clinic is not going under – at least not yet, according to an insolvency monitor appointed by the court to oversee the financial operations of the Winnipeg-based clinic while it moves through creditor protection proceedings. The monitor says the clinic is working to find solutions to its current challenges.
The CBC recently reported that despite a promise to help, the federal government has not done enough for the clinic or its physicians. While the province has taken several steps to address its concerns, it’s not clear that these will be enough to save the clinic.
Health Clinic Manitoba is a community-based group that offers medical, dental and other primary care services to people who do not have a family doctor or nurse practitioner. Its goal is to connect Manitobans with a family doctor who will be their home base for all of their health needs. It is funded by the provincial and territorial governments.
While the Canadian Institute of Health Information shows that the number of Manitoba vasectomies at Men’s Health Clinic Manitoba family physicians has increased from 2005-10 and 2010-15, some regions have seen a decrease in the numbers of family doctors and other primary care providers. These trends are due to the complex interaction between supply and demand for primary health care in Canada. Most of the primary health care workforce consists of fee-for-service physicians, who tend to view themselves as independent professionals not subject to managerial sway. This makes system change challenging, as policymakers seek to promote changes that are both acceptable and measurable.
To address its challenge, Manitoba’s health authorities have a range of options to stimulate reform, including incentives and payment structures. Some of these are intended to encourage accountability (e.g., through performance indicators that link pay to process improvements). Others are intended to increase the acceptability of renewal efforts with fee-for-service physicians (e.g., through enhanced support for career planning and recruitment initiatives).
One promising development is the introduction of a premium for family medicine clinics that offer extended hours. This is designed to increase patient access to primary health care and relieve pressure on overwhelmed hospitals. The premium is available to a limited number of FFS physicians, and Manitoba Health hopes to expand it in the future. However, it is unlikely that any of these strategies will succeed without substantive behaviour change by primary health care providers themselves. That’s because these efforts are most effective when they are clearly defined, measurable and aligned with the aims of system change.
