New Patient Advocacy Group formed for PEI

The Island Health and Patient Advocacy Association has launched its new website.

"The Island Health and Patient Advocacy Association (IHPAA) is dedicated to positive change in the PEI health care system through reasonable, responsible and respectful philosophies and methods."

We are delighted to see a Patient Advocacy Group formed on PEI.  This is a huge step towards improving health care for patients on the island.  The Island Health and Patient Advocacy Group will give patients a voice.  It empowers patients.  It allows patients to engage with government and ask important questions about how health care is being provided.

Visit the Island Health and Patient Advocacy Association if you would like to get involved.

Cost comparison

This is a cost comparison of the Health PEI units at Four Neighbourhoods Community Health Center (4NCHC) and Hunter River compared with the Phoenix Medical Practice.

4NCHC and Central Queens are Health PEI-run Community Health Centres.  Like Phoenix Medical Practice, they were set up to run as modern collaborative medical practice providing family health services through a team of health care professionals.

The 4NCHC and Central Queens figures are our estimates, but we'd be happy for Health PEI to provide corrections from their own figures.

	Health PEI Four Neighbourhoods (Charlottetown)	Health PEI Central Queens Community Health Centre (Hunter River)	Phoenix Medical Practice
Year Opened	around 2002	around 2002	2009
# Patients	1,750	1900	4,500
# Doctors	2.2 full time equivalents	2 full time equivalents	1 full time equivalent
Status	Never functional. Nursing services never developed. All the doctors left 4NCHC in 2010 but staff remain in post.	Limited success via Nurse Practitioner	Fully functional Collaborative service Extended opening hours. Wide range of services.
Funding / year	$1 million estimate	$765,000 estimate	$600,000
Cost/yr/patient	$535 (in 2010)	$403	$133

One of the figures is the 'cost per patient per year'.  That's one of the two key things you need to look at to work out if you are getting value for money in health care: the cost.  Phoenix Medical Practice was $133 per patient per year.  I estimate Health PEI's centres were around 3 to 4 times that amount: up to $535 per patient per year.

The second key thing you need to look at to see if you are getting value for your health care dollars is quality.   Health PEI's 4NCHC was never really functional.  After around 10 years of trying to get the collaborative system working properly, the last doctor left 4NCHC in 2010.   The Phoenix Medical Practice, on the other hand, was fully functional.  This functionality included quality systems to keep people healthy longer (great for patients, but also keeps the hospital bill down for taxpayers), and systems to measure that quality.

This enabled the Phoenix Medical Practice were able to provide evidence of quality care and low cost per patient.

Phoenix Medical Practice to close

We have recently learned that Health PEI will not be providing the additional funding we requested in order to stay open. We are therefore very sad to announce that the Phoenix Medical Practice is closing with immediate effect. 

Download the full press release.

Information on services still available.

How to obtain a copy of your records


What happened?
It was always going to be difficult providing high-quality modern health care under the old 'fee-for-service' model.   We were only receiving half the funding per-patient per-year of a salaried doctor, so we never made a profit from fee-for-service.    Initially we used the 'Patient Access' pilot which is open to all PEI doctors - this paid us a fee for taking on new patients.  However, this was still not enough funding to attract a second doctor.  

But we knew we were doing a lot of the right things.  We cost less money than traditional practice per patient per year.  We were keeping people out of hospital with our prevention services.   And Health PEI had described us when they described their vision for the future.  So we put together an offer of a pilot.  The Medical Society were supporting us, and Health PEI seemed very interested.   It was quality care, a doctor for every islander,  it was going to cost less per patient per year,  and it was going to save them money elsewhere as well.  We were asking for $7 per patient per month extra funding to keep us open over the next six month until we could get the pilot set up.

It seemed like a great offer.   Quality car for more patients for less money.  So we were very disappointed when they said 'no'.


Could I have stayed on as a 'regular' doctor?
Yes, but it's not an attractive option.  I'd still have to lose all my staff (except say one receptionist and a half-time nurse).  I'd have to let go about 80% of my patients.  I'd have to reduced the quality of the care we were able to provide.  I'd might have to give up my license as a doctor in the UK because the General Medical Council which regulates doctors in the UK would not accept my work in the PEI health care system towards my revalidation.  I'd need to work around two months each year back in Scotland to retain my license.

Download the full press release. 

Phoenix Medical Practice Budget Spreadsheet
Download a copy of our practice budget spreadsheet.   This complex spreadsheet contains the costs and projected income for various different possible set ups.  It is saved as our current budget for 1 doctor with the province covering 50% of the nurse billing values, showing a loss of $55,000 per year.  Changing the number of doctors to 3 and the percentage of the nurse billing covered by the province to 100% will give our original business model which is what we based our pilot proposal on.  Health PEI had one of their financial officers go through this spreadsheet and they met with us to discuss it.  They agreed the figures were reasonably accurate.

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