Sask. doctors want in to bolster urgent care, reduce wait times

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On his day off while getting a hair cut, Dr. Adam Ogieglo received a text from his colleague that the clinic was short staffed and needed additional help to handle an influx of patients.

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Ogieglo rushed to the clinic as soon as he was presentable. When he arrived, one patient was having what he described as a mini-stroke, a complex ailment that required an hour of his attention.

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He said he was willing to help on his day off, but not all doctors might feel the same way.

“For rushing away from running errands, you get paid a base rate of $40, after which you pay overhead. That sort of situation is not enticing to bring other physicians into the fold,” said Ogieglo, a family doctor and partner at Lakeside Medical Clinic in Saskatoon. “Other physicians look at situations like that and they say, ‘No, I’m going to book my patients in every 15 minutes and someone else can spend some time dealing with problems like that.’”

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That’s why, he said, if there are better incentives to work in urgent care, including stabilized compensation through a baseline rate, perhaps more doctors would be willing to take on those shifts.

He said a baseline rate could either be a salary or a per-hour payment. It would still be cheaper than seeing more patients go to emergency rooms, which cost more to operate.

“There’s just a lot of wiggle room where this system could save money by supporting urgent care,” he said. “Even though there is an upfront cost, it would save money in the long run and give people better, quicker access.”

Ogieglo, along with many other doctors in the province, have been advocating to partner with the province to improve access to urgent care, which they say would reduce wait-times.

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During the Saskatchewan Medical Association’s (SMA) annual general meeting earlier this spring, physicians passed a resolution for the organization to undertake this advocacy work and see if supports can be provided.

Dr. Carla Holinaty, who presented the resolution, told delegates at the meeting that urgent care clinics are becoming overburdened but have limited supports.

Saskatchewan’s health-care system has been stressed because of staffing shortages, surgical backlogs and heightened demand. The government, as well as various organizations, have offered their solutions to address some of the challenges.

“It’s critical for these types of locations to continue working to help keep patients out of the emergency room because we know that is already a place that is wildly overcapacity at the best of times,” Holinaty said.

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The provincial government is currently building a $15 million Urgent Care Centre in Regina to address various needs and provide mental health help. The centre, which would run 24 hours every day, is expected to open by next summer.

A second centre is being planned for Saskatoon, though no location has been decided yet.

While the province has said the centre will bolster the overall health system, some doctors at the SMA meeting were skeptical it would alleviate wait-times on its own.

They are also worried the centres won’t be integrated comprehensively with family medicine.

Therefore, they are asking the province look at current urgent care facilities run by doctors who are already doing lots of this work.

“The goal here is to try and find a way to support urgent care as part of family medicine, instead of driving it as being a standalone service and pulling people away from family medicine,” Holinaty said during the meeting.

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The province has not been able to say how much the new facility will reduce wait times, though it believes it will provide relief for emergency rooms.

Ogieglo said he had met with Health Minister Paul Merriman six months ago to discuss some of these issues, including a potential baseline rate. He said It would help stabilize income for the clinic; one complex patient per hour doesn’t cover those costs.

Such changes haven’t yet happened, Ogieglo noted, even though he says they could be implemented with a stroke of a pen. The Leader-Post did not receive a comment from the Ministry of Health by deadline.

“We see over 5,000 urgent care patients per month in our clinic alone. If we are not available to help out, that amount of volume would crush the emergency rooms in Saskatoon,” he said. “I hope the powers that be are listening when we say we need assistance.”

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