About the Author:
This blog was written by BCACHC volunteer, Patricia Balmes, who brings the perspective of a UBC undergraduate student who has a keen interest in CHCs. She is hoping to attend medical school and I hope she will end up working at a CHC!
The Search for Reliable Care
1 in 5 British Columbians are unattached. This means 1 in 5 British Columbians do not have reliable access to primary care, with devastating implications for their health and our healthcare system.
My family struggled with this very problem when we first moved here. In fact, it took us 8 years to get a family doctor. My mother constantly struggled to get appointments at drop-in clinics for regular prescription refills for her blood pressure medication. My parents constantly debated what to do when one of us got sick, not wanting to burden the already packed emergency rooms but not wanting to risk our health by waiting until we can finally book an appointment as unattached patients to nearby clinics.
“My family struggled with this very problem when we first moved here. In fact, it took us 8 years to get a family doctor.”
Unfortunately, since the release of this troubling statistic in early 2022, there has been little change in the situation. The main approach of provincial health bodies is the establishment of urgent and primary care centres (UPCCs), but these centres are chronically understaffed and are not always the right choice. While UPCCs may be a good strategy for some urban populations, the UPCC model is not well-suited to rural populations, where one catchment area could account for communities with very different needs, or for marginalized and underserved communities that also require integrated health and social services. Those in rural areas often already have trouble accessing care, and further centralizing care in large UPCCs can make the situation worse.
Putting Community First
My family’s experience with this has been a guiding force for me and one of the main reasons why I want to go into healthcare. And it was when I continued to explore the primary care challenge in BC and the ways we have been approaching it that I was first introduced to the CHC model. For many of these underserved populations, the Community Health Centre (CHC) model is the solution. CHCs provide multidisciplinary and team-based care in addition to services that address the unique challenges and situations in their community.
Everyone in BC deserves access to personalized and community-driven health and social services. CHCs are designed to provide services and address wellness gaps.
Another highlight of the CHC model is that they are centred around community engagement in decision-making and promotes patient-centred care. This patient-centred approach to care moves away from paternalistic care and acknowledges that community members know their health and social needs the best. The result is a partnership between healthcare providers and the community with stronger patient-provider relationships, greater patient engagement with their own health, and personalized care. CHCs also employ specialized professionals to address the unique needs of each community.
This includes mental health services and cultural brokers, who give voice to the most vulnerable and help patients navigate the healthcare system and ensure that they receive culturally appropriate care. My family was fortunate to have had an amazing support system and family members who lived here already. For the many newcomers and underserved groups who do not, CHCs can help them navigate this often scary and frustrating process.
Scale Up Solutions
CHCs already exist in BC and are already making great strides in improving patient care. However, they are often resource-limited due to a lack of support and commitment from the government. In Ontario and some areas in the United States, we have seen how better support from both the local and federal governments have allowed CHCs to serve their communities better. Communities with CHCs benefit from:
- Greater access to primary health care services for those from lower socio-economic backgrounds 1
- Higher rates of chronic disease management and control 2
- Improved access to mental health resources for youth and vulnerable populations 3
All of these also help decrease the burden of high-cost healthcare services such as hospitalizations and specialist care and address the needs of populations that are normally high users of health services by addressing issues before they are exacerbated. After the initial investment in the CHC model in Ontario, data suggests that CHCs may be more cost-effective and could reduce healthcare spending in the long run by focusing on easy access to primary care and preventative care that addresses the socioeconomic factors that affect the health of individuals and communities.
Given the significant benefits CHCs have brought to communities, we hope that the CHCs will play a larger role in the upcoming primary care reform that is planned for BC. At the moment, lack of awareness among the public and health policymakers is an obstacle to making this a reality. But as communities continue to voice their needs to health authorities, BC CHCs can be a game changer in patient care and be the solution to the primary care crisis here in BC.
Learn more about the types of services and resources CHC’s offer here.
Learn more about the CHC model here.
References
- Glazier et al. Comparison of primary care models in Ontario by demographics, Case Mix and Emergency Department Use
- Nocon et al. Health care use and spending for Medicaid Enrollees in Federally Qualified Health Centers Versus other Primary Care Settings. AJPH. November 2016. 106(11): 1981-1989.
- Streeter et al. The effect of community health centers on healthcare spending and utilization. National Association of Community Health Centers. September 2009.