Doctor on the brink of reinventing family practice for 10,000 rural N.B. residents

The Cure is a CBC News series examining strategies provinces and territories are using to tackle the primary care crisis.

In the heart of New Brunswick's potato belt, a doctor ready and willing to reform the delivery of family medicine has been assured the province is "just on the edge" of providing the money and other supports to get collaborative care off the ground.  

That's a service model that promotes health-care professionals and non-clinical staff working together as a team in one place. All salaries and some of the business costs are paid by the province. 

Dr. Stuart Lockhart says new doctors don't want the burdens that come with running a small business. That was top of mind when he helped design the Carleton North Medical Clinic in Florenceville-Bristol and agreed to come home to New Brunswick after working in Saskatchewan.  

The 4,000-square-foot space has eight exam rooms and an artificial intelligence scribe system to capture oral examination notes, which are then stored electronically and can be accessed by any health professional who is seeing the patient on a given visit.

Ideally, Lockhart said the clinic team would consist of doctors, nurses, a diabetes educator, a medical office assistant and visiting specialists.  

"We would have 4 physicians or nurse practitioners here at all times. We would have nurses, we would have allied health rotating in and out for patients to access as their first point of contact. We would have evening classes and we would have a weekend service."

He said the clinic is designed to increase access to timely appointments by sharing patient loads, while also improving working conditions for staff, which in turn, would hopefully boost recruitment and retention. 

"This is a very new thing for New Brunswick still," said Lockhart, who is receiving support from people and businesses nearby. 

For example, the clinic was built with financial support from local service groups and the McCain Foundation, the philanthropic arm of French-fry giant McCain Foods. The municipal government, the District of Carleton North, pays the annual $85,000 rent. 

Lockhart is one of only two family physicians in a catchment area of some 10,000 people, following the retirement of his father, Dr. Bruce Lockhart, and his uncle Dr. Colin Lockhart. The family has produced four generations of local doctors dating back to 1908. 

Lockhart said a new doctor is coming soon, and the clinic will be working to take on patients from the provincial waiting list. 

It's an important development, but the overall picture is still disconcerting. In the sprawling Upper River Valley health zone, Horizon recently reported 35 physician vacancies plus 14 doctor vacancies in the local hospital. 

Family practices up and down the River Valley are due to close within a few years.