Back in 2017, when Lisa Gallant saw that thousands of people in her own community of Crapaud and the surrounding areas suddenly were without a family doctor, she knew she had to take action.
That year, longtime family doctor Dr. Hendrik Visser retired after 32 years of practice in Crapaud. A new physician took over, but the practice proved untenable for one person, and he left the same year.
“We had no primary health care, and we knew that something had to be done,” Gallant told Island Morning host Mitch Cormier during the CBC radio show’s remote broadcast from her community Thursday.
Gallant, who is a pharmacist and owner of South Shore Pharmacy, joined forces with other local leaders to form the non-profit South Shore Health and Wellness Inc. They raised about $10,000 to establish a walk-in clinic, at the time located in what had been the pharmacy’s kitchen, in January 2018.
Today, that small walk-in has grown into the South Shore Health and Wellness Centre, which has undergone two expansions and is now in the middle of a third. Once the work is complete, the centre will span more than 5,000 sqare feet.
“There were times where I thought ‘This is never going to happen,'” she said.
The centre now has a comprehensive care team, including a full-time physician, two full-time nurse practitioners, three licensed practical nurses, two part-time nurses specializing in chronic disease management, and a part-time physiotherapist. The latest expansion will allow for even more staff in the future.
This is exactly the kind of collaborative, multidisciplinary primary-care model that Gallant and her group envisioned from the start, one that could meet the health-care needs of a growing rural population.
But Gallant said the journey hasn’t been easy; it took years of persistent advocacy with the provincial government. Now, they hope the success in Crapaud can be replicated in other rural communities across Prince Edward Island.
The concept of collaborative, team-based health care is now being embraced across P.E.I.
There are currently 17 of what the government calls medical homes in the province. These clinics offer a wide range of services, with doctors collaborating with other health-care workers. They have been touted by the province as a way to alleviate pressure on the health-care system.
But it’s not a new idea.
Visser, the retired doctor who has since returned to Crapaud, said he pitched the concept to the province years ago, inspired by his early career in Africa.
“That is the way forward. We saw that effectively implemented in resource-poor countries in Africa, where six of us as physicians were able to manage a hospital the size of the Queen Elizabeth Hospital, all with allied health professionals, midwives, primary health-care workers and nurses and lab and rehabilitation services — all under one roof, all interdisciplinary,” Visser said.
“We were able to serve a population of about two million people with rural health centres that we equipped to be in the communities, and we would then be the referral centre from those small clinics out in the community.”
Even in his own practice in Crapaud, Visser collaborated with a nurse for years. Together, they managed care for more than 2,000 patients.
Before retiring, Visser said he proposed a collaborative model for rural health care to the provincial government, but he said there wasn’t much reception around the idea at the time.
In the years after Visser’s retirement, Gallant and her group continued pushing the idea, bringing proposals and presentations to meetings with Health P.E.I. and government officials.
“We just heard ‘no’ so many times,” she said. “We just felt that if we kept being consistent and never gave up, we would eventually reach our goals.”
In 2020, they met with then-premier Dennis King.
“We came in armed with all of our documents and our proposals and all of our facts, ready to do battle,” she said. “The premier looked at us and said, ‘Yes, I agree with you. You should have a doctor. You should have primary health care in Crapaud.'”
King later visited the clinic and committed to making it a collaborative practice with a physician involved.
In July 2023, Dr. Meghan Cameron joined the clinic — the community’s first family doctor in five years. In total, Gallant’s group has invested more than $30,000 in clinic improvements and equipment over the years.
Gallant said the community has gone from desperately needing practitioners to receiving inquiries from physicians and nurse practitioners interested in working at the Crapaud clinic.
She credits not only the facility but also the team atmosphere.
“Health-care professionals talk to each other, and the team here is so great. They’re so collaborative and wonderful, dedicated professionals, and there’s a really good morale at the clinic,” Gallant said. “Other health-care practitioners hear that, and they want to be here.”
Her group also works hard to support the team with things like thank-you cards, baking, and small gifts to express appreciation, Gallant said.
“Everyone is so thankful to have that care here. So it’s important that the health-care providers feel that,” she said.
They also help with recruitment by touring candidates around the facility and community, as well as presenting baskets filled with local products.
What’s been built in Crapaud should serve as a model for other rural areas, Health Minister Mark McLane told CBC News at the remote broadcast.
“Back to rural health care in the past, we used to have a single physician in an office,” he said. “Now, with the collaborative-care model, there’s more supports around those physicians and nurse practitioners to provide service, so we’re not as reliant on one position in one area.”
McLane said lessons can be learned from the model in Crapaud. While a nice setup helps to attract physicians, he said community support for these health providers is also essential, and Crapaud has both.
When asked whether Health P.E.I. has made hires to staff the clinic’s expansion, McLane did not say yes.
“We keep hiring, and again, we have so many positions within our system… You know, the provider chooses where they go,” the minister said.
McLane also noted that the federal government’s loan forgiveness program, introduced last year for doctors and nurses, serves as another tool to attract health-care professionals to rural and remote areas.
Meanwhile, some communities on P.E.I. are taking similar action. A volunteer group raised $200,000 to help create additional clinic space in Montague.
Green MLA Matt MacFarlane, who was part of the Crapaud clinic’s board, said the burden of getting a clinic open shouldn’t fall on communities.
“It’s government’s job to deliver health care, to provide health care, and to get the 37,000 Islanders on the wait list for a doctor off that wait list,” he said.
“It shouldn’t fall to volunteers who have full-time jobs — farmers, fishers, whatever — to have to come in on the little bit of time they have and spend six years advocating for health care and building a clinic up from scratch and then having the government just take the key and then say, ‘OK, now we have a clinic.’ That’s government’s job.”
Albany resident Darlene Smith, a retired teacher, has been on the P.E.I. patient registry for six years.
While she has relied on the virtual platform Maple for minor issues, Smith said she often hesitates to seek in-person care for fear of burdening the system.
“It’s a little stressful because you just don’t know what to do.”
But with the expansion, and Gallant saying the clinic is accepting new patients weekly, Smith hopes she and her husband will soon get the call.
“It will be joyous,” she said. “It’s not that we’re unwell and that we need to go see a doctor, but just to have that peace of mind, to be able to call someone that’s going to take care of you.”
Gallant said her group isn’t done.
“We’re going to keep working at it until there isn’t one person left on the registry for this South Shore area, so whatever that takes,” she said. “With this last addition, I think that should be able to clean up the registry for this area over time.”
