In the summer of 2023, the Department of Health announced a series of new and enhanced incentives available to all physicians practising under the Family Medicine New Brunswick (FMNB) model.
One of these new incentives is the Allied Health Professional (AHP) fund, which supports physicians in expanding the range of services offered to their rostered patients. The fund is designed to enhance patient access to diverse health professionals, while providing each physician with the flexibility to determine which services will best address their patients’ health-care needs. Eligible services include Physiotherapist, Registered Dietician, Occupational Therapist, Pharmacist, Social Worker, Psychologist, and Licensed Counseling Therapist.
A group of physicians may combine their allocated funding to jointly engage the services of one or more allied health professionals. Allied health services can be delivered within the practice setting or provided offsite at an external location, and AHPs may work directly for the physician or be employed by an external services provider (e.g., privately operated business).
This flexibility has been key to implementing the funding most effectively, according to Dr. Naomi White, who is part of the Oromocto Comprehensive Family Physicians team. Dr. White concedes that although adding AHPs can be very advantageous, “space can be an issue. I think this is a common challenge for team-based care. Most of us are still housed in an office space that was designed for the solo practitioner. So, the ability to include virtual options has definitely made managing that easier.”
Dr. Kristen Brown, another member of the Oromocto team, points to the ability, and also sometimes the need to be creative in the implementation of AHPs as well. While she has a social worker that sees patients in the clinic due to a lack of other available office space, this option is not feasible for her physiotherapist. “My physio does not come to my office, I send patients to his office because he has all his equipment there”, she says.
The annual AHP annual funding allocated to each physician is based on their number of rostered patients as of March 31st each year.
In terms of choosing which AHPs to incorporate in your practice, it is important to consider both the needs of a physician’s specific roster, as well the potential advantages for the physician themself. Both Drs. Brown and White note the volume of patients requiring mental health services combined with the demanding nature of these visits as factors in their decisions to add social workers to their team, and the results have been positive.
Dr. Brown has noticed that her patients are appreciative of the quicker service and tend to come back happier, because “they can see a social worker or counselor within two weeks compared to going through a public service, where there is still a wait of a month or two if you are fortunate.”
Dr. White’s experience has been similar, and she points out that “social workers are trained counselors, and we are not. We treat these patients to the best of our abilities, but with a social worker they are seeing a person with a skill set that is better suited to their issues.”
Other considerations include the additional time freed up for physicians to focus on other patients, and reduced burnout. Dr. White admits, “the mental health visits are a hard mental load, so just being able to offload some of that burden means you feel less exhausted at the end of the day.”
Dr. Brown also chose to add a physiotherapist to her practice after seeing many of her patients struggle with insufficient health benefit coverage and extended wait times. “There’s a lot of people who don’t have a physio plan. They just have basic coverage that doesn’t include any physio, and getting into the hospital can be a six or nine month wait. And the longer somebody has a problem, the more likely it is going to be chronic”, she explains. She has also noticed that once a patient has been referred to her physio, they rarely need to come back to see her because the physio is able to fully manage the issue, significantly reducing follow-up visits.
In terms of advice for other physicians, Dr. White urges clinics to get creative. “Be open to creative solutions. If space is an issue, there may be options for virtual delivery. Or is contracting out right for them? If they are not comfortable hiring another employee and taking on that responsibility, then explore the option to just contract the services out instead.”
Reflecting on her overall experience with AHPs in the FMNB model, Dr. Brown says, “I definitely advise other physicians to do it. We went into family medicine because we want to help patients, so to be able to give them that faster service and to help them recover, it makes you feel like you did something today that makes a difference.”
To learn more about adding allied health professionals to your practice, or for any questions relating to Family Medicine New Brunswick, please visit www.fmnb.ca or contact hello@fmnb.ca.
Jim Johnson, Communications Specialist
