By Deidre Taylor
The Avon Medical Clinic in Windsor was established just over a year ago, when two family physicians, a family practice nurse, a nurse practitioner and clerical staff came together to form a collaborative family practice team.
When a variety of health professionals work together as part of a collaborative family practice team, it creates capacity within the team to be able to efficiently see patients, especially when patients see the most appropriate provider for their health care needs.
“By working as a team, we are able to fit in additional appointments, such as for someone who has developed an ear infection; that way they can get in and be seen, which benefits patients who have a more pressing health need,” said Dr. Martina Babin, family physician at Avon Medical Clinic.
As well, the providers’ work together to provide quality care, relying on each other’s expertise and experience.
Dr. Babin, a family physician who had worked previously in two other family practices that included some elements of collaboration between health professionals, relied on that experience to help guide how they now work together as a team.
“It was a small speedbump at the beginning for patients to understand … you don’t necessarily need to see a doctor,” said Dr. Babin.
Joanna Cox, who is a registered nurse with additional training in primary health care to become a family practice nurse, sees the value of her collaboration as part of a team. She has the ability to provide preventative health screening and enhance chronic disease management.
“Patients might not think to mention questions [about their general health] since their focus is on the problem that they are here for today when seeing their doctor,” said Cox.
“My mandate for everyone I see is to have a discussion, asking them ‘are your immunizations up to date, when was your last Pap or colorectal screening?’ Patients like that I can spend time with them for education and well visits … and they can get their questions answered.”
Family practice nurses are part of almost every collaborative family practice team in Nova Scotia.
They help patients manage ongoing health issues such as diabetes, asthma, high blood pressure, cholesterol and heart disease. They provide well baby visits and prenatal care, perform yearly exams, review patients’ medications, give immunizations and offer wound care.
They also promote health screening and provide teaching and support for healthy living.
“Joanna [Cox] does a lot of the injections, as well as chronic care education and follow-up,” said Dr. Babin.
“When we have a patient that has a new diagnosis or doesn’t have a good grip on their health issues, we are able to ask her to step in and provide education. Patients get a much more comprehensive visit when our practice is able to provide this.”
“Sometimes as doctors we are trained to look at it from a medications standpoint first, but there are other things that we can do collectively as a team to help our patients with their care.”
Cox explains how she works with Dr. Babin and the other providers to create efficiency within the team and increase access for patients.
“When I assess their ears or throat, and then bring someone in [from the team] to diagnose or prescribe, that is a better use of their time. For most of my patient appointments I see patients independently, and then consult a primary care provider as needed.”
“Every provider that is part of our team has a different perspective and expertise. This enhances [patients’] experience in addition to increasing access. Because of my role, there are more patients who get care in the run of the day who wouldn’t otherwise be seen,” said Cox.
Dr. Babin says that the team is working to increase patients’ understanding of how to fully access the different members of their team, and to encourage patients to make an appointment with Cox.
“We are trying to promote the family practice nurse role; we tell patients to book appointments for blood pressure checks, medication refills or to answer questions about their care,” said Babin.
“I am just down the hall, so she can get me as needed. We also made a pamphlet for patients about each of our roles and backgrounds, and how we want to people to access us based on their specific health care need at the time.”
Dr. Babin also tries to promote working as part of a team to colleagues who are considering practicing as part of an interprofessional team.
“Doctors should not hesitate to work this way. I know the biggest concern is that this is going to increase workload – it’s quite the opposite,” she said.
“I would love to see more collaborative family practices for that reason. With the state of health care here, being able to increase access is important. Having multiple health professional in one clinic so that patients have access to more comprehensive care … is a great model.”