Family Care Clinics

March 22 2014

Open Letter regarding Family Care Clinics

In April 2012 the first three Family Care Clinics opened in Edmonton, Calgary and Slave Lake. The aim of these clinics is to reduce non-urgent visits to the emergency department and to deliver greater and timelier access to care through an interdisciplinary team.  Alberta Health Services has announced these clinics are a success and plans to open dozens more across the province.

Let us share our Slave Lake story.  We hope it opens your eyes to the problems an FCC could create for your community.  Before the Slave Lake wildfires, we had 13 doctors practicing in two clinics. Today our 11,000 people have one option- the Family Care Clinic, staffed with 4 doctors and 7 nurse practitioners. 4 longtime doctors resigned and although they still live here, they practice elsewhere.  AHS has been unable to recruit new physicians.  Wait times at the clinic, where walk-ins are encouraged, can be up to five hours and it is not unheard of to have twenty people ahead of you in line. Now many residents drive from 100 to 500 km roundtrip for basic health care. All first time and high risk moms travel 200 km or more to deliver their babies. Seniors no longer have a family doctor. Referrals for specialists are becoming more difficult to schedule. Since patients are directed to the most “relevant” or next available primary health practitioner (a nurse practitioner, doctor or chronic care nurse), the same patient may see several different people in the course of a week or two, leading to lapses in continuity of care with potentially life-threatening consequences.

Ask your municipal government, Alberta Health Services Clinical Director, MLA and local Health Advisory Council the following questions:

·       Are your local doctors on board with the FCC concept? If they are unable to work with the FCC model, you will lose them- and there are very few doctors available to replace them.

·       Will you have a choice in your medical care or will the FCC be your only option?

·       Will you continue to have your own family doctor or will you be assigned to the first available practitioner?

·       Who will determine who the “most appropriate” person is to address your needs? (In our case, it appears to be a receptionist.)

·       Who is ultimately responsible for continuity of care?

·       Who will advocate for your needs if a specialist is required?

·       Who is responsible for follow-up care?

·       Who will sit on your local advisory committee and what is its mandate?

If your community is about to establish an FCC, please ask questions and demand answers. Our community was not given the opportunity to look into this model and today we are suffering the consequences. If you are concerned about healthcare in your community, please get more information and advocate for quality of care.  

Premier Redford: Please Accept My Application

March 10 2014

Office of the Premier
Room 307
Legislature Building 10800-97 Avenue
Edmonton, Alberta
T5K 2B6

RE: Application for the position of Official Letter Writer to Her Majesty Queen Alison Redford

Dear Ms Redford:

It is wonderful to see that the province of Alberta has seen fit to provide an additional budget for the Premier’s office to hire a letter writer.  A royal personage such as yourself must be absolutely inundated with mail! With all those important international royal duties and obligations, one must certainly not have the time to reply to one's loyal subjects! I know I have not received a reply to any letters I have sent your way and I am sure that must prey on your mind.

Therefore I am happy to offer my services for the stated amount of $300,000.00. For $300,000.00 I will compose replies to each and every item of correspondence you receive. For $300,000.00 I will craft a 100% made in Alberta product, written in longhand with the finest Alberta red ink, produced with petroleum by-products from the Alberta Oil Sands on clean, bright, high quality Peace River White Spruce softwood Kraft paper. For $300,000.00 I will employ as calligraphers the legion of skilled Slave Lake labourers who sit patiently every day in the highly successful Family Care Clinic piloted by Alberta Health Services, waiting to see one of the three doctors who serve the community’s 11,000 citizens.  For $300,00.00 your loyal subjects will be more than happy to assist you #BuildingAlberta with the diligence, care and compassion we have come to expect from your office.

Thank you for your consideration.

Your most humble servant
Nicola Ramsey
Stand Up Slave Lake

Dear Mr. Horne

Nicola Ramsey
Slave Lake Alberta

March 6 2014

The Honourable Fred Horne
Minster of Health
Edmonton, Alberta

Dear Mr. Horne:

As you are aware, the people of Slave Lake are very concerned about the lack of doctors and other health services in our community. We are confused as to why you, as Minister of Health, have denied that our community is in a state of crisis regarding local healthcare.  We are not sure if you are misinformed or are deliberately misleading the public- but either way, you are not easing the tensions for our residents and healthcare workers. 

The people of Slave Lake are not alarmists, Mr. Horne. We do not panic over nothing.  Our 11,000 people calmly exited our area in May of 2011 as our homes burned down around us, assisting friends, neighbours and total strangers as we did so.  Our 11,000 people lived in hotels, tents, trailers, evacuation centres and the homes of others as we waited to know our fate. Our 11,000 people returned to the devastation of our community and rebuilt our homes and our lives without protest, letters to the editor, or complaints to national news about a lack of government support.  So if we say today that there is a crisis, please listen. We know what a disaster is.

On the day you announced in the legislature that there are six doctors working in Slave Lake, there were in fact three doctors and three nurse practitioners serving our 11,000 people. Two doctors were fully booked. On that same day, Slave Lake's AHS Clinical Director shared the new Q&A webpage that acknowledges that we need more physicians, and stated that four doctors are working in Slave Lake. Four doctors, Mr. Horne. Four doctors for 11,000 people. Four doctors cannot possibly cope with our healthcare needs. People wait for weeks for a doctor’s appointment or sit for hours as a walk-ins patient or drive for hours for routine treatment. Your office has received many of accounts of people whose needs are not met.

Further, your statement to the media that there was one doctor practicing in Slave Lake when you became Minister of Health on October 12 2011 is incorrect. In fact there were twelve doctors practicing medicine in Slave Lake on that date.  The people of Slave Lake have nothing but admiration for the doctors, nurses, and other healthcare professionals who returned to our community to serve our people after the fire in the face of great personal loss.  We ask that you respect their contributions.

Our 11,000 people have fought tooth and nail to restore our community to what it was before the fire. Our citizens including our local AHS administrators, front-line healthcare workers, municipal leaders and every day people are struggling to restore our medical services. 

If we say there is a crisis, please acknowledge that reality. Please do not belittle our situation. Please do not disrespect our community. We have suffered enough.  

Standing Up

The first time I saw an MLA on the run was prior to the 1982 provincial election.  The Social Studies teacher at the small Sexsmith Secondary School where I was librarian had arranged to host the first all-candidates forum. Diploma exams had just come in and two of our high school boys began questioning the PC Candidate about their validity. These were two smart kids, both on my Reach for the Top team (one is now an assistant superintendent of schools and the other is an international tax accountant) who had good, well researched questions. The MLA, a soft-spoken agricultural researcher, did not have answers. He did not attend another forum before the election.

The second time was shortly after Ralph Klein imposed his cuts in 2003. Our PC MLA was holding some kind of love-in at our local mall.  The teachers from our local primary school showed up wearing bandannas over their mouths to symbolize the gag order that had been placed on many provincial government workers.  They started asking questions. A grade two teacher, a well loved, grandmotherly little lady, started scolding "our girl Pearl," reprimanding her for saying teachers only worked 200 days a year. "The legislature only sat for 38 days last year, Pearl," the teacher said. "Did you only work for 38 days? Shame on you!"  It was a classic moment. The MLA was literally and figuratively backed into a corner. Rumour has it she asked her riding president to call the RCMP.

Last week some tensions regarding healthcare in Slave Lake came to a bit of head at a protest outside the offices of MD 124. Services had been dwindling for years, exacerbated by the 2011 wildfires that saw several doctors lose their homes and leave the community and a new provincially implemented model of delivery that led to more doctors resigning. 

I'm a Social Studies teacher.  I try to practice what I teach. When I first realized what was happening, I did my own research into the issue. I sent many letters to my MLA, Alberta Health Services and the Minister of Health. So did others. No answer. Time to call in the fourth estate. I sent a letter to the Edmonton Journal, the local Lakeside Leader, and the Grande Prairie Herald Tribune. I contacted CBC, CTV and they, along with our local newspapers and Global News attended a town hall meeting hosted by Friends of Medicare and a local advocacy group where our Mayor and the NDP and Wildrose healthcare critics spoke. Our own MLA had a "prior commitment." The Edmonton Journal covered it the next day. 

The next day the media interviewed Health Minister Fred Horne and he said "Slave Lake has more than enough resources to meet its needs." This absurd statement, combined with the lack of communication from AHS, led to outrage. People were talking roadblocks to make the government sit up and listen. Saturday I sat in a hotel room in the city and set up a Facebook group with a couple of other ladies. In 20 minutes we had 80 members. We planned a "silent protest." Suddenly people were making signs, sharing information, talking strategy. It felt good to be doing something.  

The night before the rally we got wind of the fact that at the MLA's request, the location was going to change. Or maybe it wasn't. Or maybe it was. Around 6 pm MD 124 posted that the meeting was being moved from main street to their office on the highway out of town.  That just seemed to rile people up more and even though it was -25 that morning, by 9:45  there were 125 people there. Moms with kids in strollers, retired teachers and other seniors, guys from the oilpatch, business people, professionals, newcomers and oldtimers- a real community event.  Not exactly a silent protest and our MLA was once again put on notice. After the meeting started people stood outside the window of the board room peering in and holding up their signs. The meeting lasted seven and a half hours. That evening our story was on the CTV news and the next morning Edmonton AM. We have been told via our Mayor's blog that significant progress has been made.  On March 5 a rally was held at the provincial legislature and later that day I was interviewed by CBC's As it Happens about the Slave Lake situation.

Social Studies teachers encourage their students to use critical thinking skills to form and support a position on an issue and to practice appropriate forms of dissent as citizens in a democracy. We know it doesn't always work.  Maybe it won't this time. But as a teacher I will continue to stand up. Among many other things, that is my job.