EDITOR'S NOTE: A previous version of this story stated that next year's clinic would operate two days a week. In fact, it will operate five days a week
Elliot Lake's Family Health Team representing 10 family physicians along with two nurse practitioners and a cadre of other health care providers, allied staff who work with them, is looking for $72,000 from the City to set up a virtual health clinic at their downtown facilities, next year.
The clinic, said health team Executive Director Nancy Ewen, would operate five days a week, weekdays, with Dr. Maria Celia Raquel Lopez interacting with Elliot Lake non-rostered patients on a video link.
Ewen said Lopez has previously served as a locum (a person who stands in for an absent doctor) in their clinic. Non-rostered patients are patients who do not have a family doctor.
The health team's initial ask is $300 a day, two days a week, to fund the trial project which will run from the last week in September through the end of December, this year. As well, the health team wants City Council to approve spending $72,000 in 2020 which Ewen said it would cover their operating expenses for the five-day-a-week program next year.
The virtual clinic concept was raised at Monday afternoon's meeting of the Elliot Lake Finance and Administration Committee.
The Committee voted unanimously in favour of a $3,900 trial for the rest of this year and a priority spot on the 2020 city budget roster for $72,000 for all of next year. Two members of the standing committee, Mayor Dan Marchisella and Councillor Chris Patrie, were absent from the meeting. The recommendation will go on to City Council. The City's budget process is expected to get started in October.
"They (virtual clinics) are temporary solutions to deliver care to non-rostered patients," Ewen told the committee. "Virtual clinics are popping up all over Ontario."
"A couple of cases I have heard of, New Liskeard has had a successful virtual clinic," she said.
Once a doctor was recruited there the virtual patients were absorbed into the new practice and the New Liskeard virtual clinic was disbanded, Ewen added.
"Peterborough still has a virtual clinic in place, looking after non-rostered patients and Kapuskasing has something called a locum clinic, where they actually bring in locums, so it's not virtual," she said.
"At the Family Health Team, we were established in 2007. We have 10 family physicians on site right now. Three of these are over the age of 65. Three are between 55 and 65 so they are starting to wind down, starting to look at retirement." She added that the health team has some 10,000 rostered patients who come through their doors every month.
The elephant in the room, though, was the crush to the system from the estimated 1,300 non-rostered patients who live in Elliot Lake.
Ewen provided that figure which she said was derived from the Ontario Ministry of Health and Long Term Care, "As well as conversations with our physicians."
The virtual clinic will be operated on the second floor of the health team's downtown headquarters.
Later in the meeting, during the public question period, Elliot Lake resident Mike Thomas told the committee he had been an advocate of the clinic idea for years. He said, "I think that would be great." But at the same time, he wondered if the virtual clinic would be effective.
He added that he has seen both sides of the Elliot Lake healthcare system, as a non-rostered patient and one who is rostered with a doctor. In Mr. Thomas' words, "As you know, I was in an accident in 2017. Some of the forms, prescriptions, referrals, they're pretty tough."
Thomas went on, "I don't see that changing, with the transfer to a rostered patient." Regarding the virtual clinic platform from ELFHT, Mr. Thomas said, " I wish we could bring more of their services forward. We need to know how much of their services they're going to roll over." He also said he believes the Health Ministry's estimate of 1,300 non-rostered patients in Elliot Lake is low.
"We have had a non-opioid policy as long as I've been here," Thompson said.
He wondered how family health team physicians would be able to carry out prescription requisitions for senior retirees, many of whom have been prescribed opioids elsewhere, in light of the family health team's strictures.
"So are you going to get into the details of that when it goes forward to Council?" he asked the committee.
"For any of those people, those seniors, who come to Elliot Lake, are you going to have them write their prescriptions? Because most of their prescriptions are opioids," said Thomas.
Committee Chair Councillor Norman Mann responded.
"On an operational level, it is up to the Elliot Lake Family Health Team Directors to decide how to proceed," Mann said. "So I would suggest their Board of Directors will decide on the clinic and what form of mandate it will have. That is not something I can discuss."
"But (The City) as a funder of the Elliot Lake Family Health Team, we would ask them for their consideration of your concerns."
Ewen said she needs an answer from the city on the Elliot Lake Family Health Team clinic funding proposal by November.