Gaining access to primary care has become an increasingly daunting task for Canadians. This has led to a sense of hopelessness as many have given up on the prospect of securing a family doctor. (Canadians giving up on finding a family doctor: CMA Report.) Alarming projections from the Ontario Medical Association indicate that by 2026, one in four individuals in the province will be without a “cradle to grave” family doctor (Meet some of the 6 million Canadians who don’t have a family doctor | CBC News 2024). During what has been called “rostering days”, a Kingston clinic recently advertised being able to take on new patients and effectively clogged their front office with hundreds of patients waiting in a line outside their front door. Some people waited for as long as eight hours; in the rain no less! (Hundreds line up outside Kingston Clinic in a desperate bid for family doctor | CBC News 2024). This concerning reality extends nationwide and since 2020 Lumeca Health has actively been working on a better way to connect people with a family doctor.
In response to the urgent clinical needs in the early days of the COVID-19 Pandemic, Lumeca promptly evolved into a virtual same-day access clinic for Saskatchewan residents. With a daily capacity exceeding 190 patients, it became apparent that nearly half of the patients using our service did not have their own family physician. Recognizing this gap and our limitations as a virtual same-day access clinic, Lumeca initiated a search for physicians willing to accept new patients. The goal was to refer them from the virtual clinic and attach them to physical practices. This search consisted of calling family practice clinics, one by one, and asking if they had the capacity to accept new patients.
When questioned about accepting patients from the virtual access clinic, most clinics emphatically responded with, “No.” However, when asked about accommodating ten to twenty patients, many were open to the idea. This was a remarkable insight. Clinics would accept a small batch of patients or a referral, but they were not officially accepting new patients.
Essentially, many clinics that appear closed to new patients from the public’s perspective were in fact open to taking on a limited number. Unfortunately advertising the ability to accept new patients led to overwhelmed front office staff. Conversations with physicians revealed a lack of any process for smoothly bringing in a small batch of new patients without inundating office staff. We learned it had become common practice for family physicians to accept new patients through word of mouth; often taking on family members or friends of existing patients. This left us to wonder, “How many clinics had some small capacity that was being unused for fear of advertising?”
In 2020, in Saskatchewan, the only method of notifying the public of family doctors accepting new patients was a provincial webpage featuring a list of clinics. Even when operational, clinics updating this list faced delays of several days to weeks in getting listings posted and removed. Recognizing the limitations of this system, and the needs of the many orphan patients using our services, Lumeca introduced an online self-serve feature called Find-A-Doc. This feature was aimed at connecting a small, limited number of patients to family physicians, facilitating a more flexible and efficient process.
Find-A-Doc incorporated a “metered intake” concept which ensured that the listing would be taken down as soon as a clinic reached its new patient goal. This streamlined approach significantly reduced phone line congestion for providers and allowed patients to view clinics near them accepting new patients on a map, making the selection process more convenient.
During our proof of concept trial in 2021 Lumeca successfully linked 267 previously unattached patients with three new family physicians; ensuring enhanced continuity of care. While this test was small-scale, the results were very encouraging:
• Over 18 days, one doctor was able to intake a small batch of six patients through the app without overwhelming front office staff.
• A recent Saskatchewan family medicine graduate was able to empanel an additional 225 patients over the course of a month, growing their practice by roughly 5% without overwhelming front-end staff.
• Another SK family physician, Dr. Ronan J. Conlon, empanelled a batch of 20 nearby patients over 13 days.
As the world adapted to the pandemic, Lumeca closed its virtual same-day access clinic in 2022 to exclusively become a software provider. The Find-A-Doc feature was temporarily paused, but its potential remains untapped.
There is capacity within the system if we are creative. The question is, “How do we make it easier for all family medicine clinics to use a metered intake system?”
What do you think? Lumeca would love to hear from you. Comment below or write us at ideas@lumeca.com
