Another Guest Op-Ed in the TJ from Dr. LeBlanc, co-president CHU Dumont Medical Staff Executive

Opinion: The next chapter in Medicare

Success of today’s reforms will be measured by whether they leave New Brunswickers with a more coordinated, accessible and sustainable healthcare system

I agree with much of the destination Dr. LeBlanc describes: stronger primary-care attachment, continuity, team-based care and better integration. Where I disagree is the sequencing.

This argument assumes there is sufficient primary-care capacity behind the new system. Vitalité’s high attachment rate may make that model increasingly realistic there. It is not the reality everywhere in New Brunswick.

For an unattached patient, or even an attached patient who cannot see their provider for weeks, virtual care is not simply about convenience. It can be the only timely access to clinical care.

That is why the comparison with Medicare and the characterization of the current problems as “temporary frustrations” trouble me. Virtual Care NB replaced a service routinely providing 600 hundreds of consultations a day with one that has so far provided dramatically fewer. Government promised same-day or next-day appointments. I tested the new online prescription-renewal system this weekend and the first appointment available was 10 days away.

The Ontario study cited by Dr. LeBlanc may demonstrate the value of continuity with one’s own provider. It does not demonstrate that someone without timely access to that provider is better served by waiting days for care rather than receiving appropriate same-day virtual care.

Build the integrated, team-based system Dr. LeBlanc describes. I support that goal. But build the capacity first.

New Brunswickers should not be asked to give up access that works today because it does not fit neatly into the health-care system government hopes to have tomorrow.

Integration matters. Continuity matters. Quality matters. But so does access, and ultimately these reforms should be judged by whether New Brunswickers can actually get care when they need it. Today, they can’t and it’s only worsened.