Clinic to ensure continuity of care

The Kateri Memorial Hospital Centre (KMHC) has formalized a process to improve services for community members who do not have a family doctor or whose family doctor is absent for more than three weeks.

“We meet on a regular basis and are always looking to improve our services based on needs,” said Krissi Delaronde, KMHC’s assistant manager of outpatient care. “If we know that need has increased, then we work to try and see how we can meet that need.”

On Monday, KMHC announced formalization of the Access Clinic, a service that has been in existence since 2022, but one that is continually adapting to address the most pressing issues for clients in the community.

“We started out focusing on clients who had no family doctor who had specific chronic conditions, and we were then able to expand to clients who had a doctor, but their doctor was away for three weeks or more,” said Dr. Rachael Eniojukan, director of professional services at KMHC.

The process has been fluid, responding to patient needs as they happen.

“We went from there to try and develop a new service based on personnel that we already have,” Delaronde said.

The Access Clinic is not a dedicated team of physicians, but rather a way for KMHC family physicians, nurses, and other staff to fill in the gaps for those seeking care who do not have a physician.

“It’s based on priority, so we have a nurse going through all the motions, and the pre-assessments that lead up to the physician appointments,” Delaronde said. “If she feels that there’s priority for these five patients, they’d get the appointments first.”

The clinic for patients with non-urgent issues, but with chronic conditions or who need follow-up on medical concerns, are prioritized for efficiency. Others on the list who are not high priority are still contacted with the aim of maintaining communication, so that the hospital knows if a condition worsens or changes, Delaronde said.

“We’re really managing to keep up with the demand at the moment,” she said.

The announcement of the Access Clinic comes after news of the departure of another family doctor leaving KMHC last month – Dr. Mitra Tehranifar, who had worked at the clinic for 15 years. Tehranifar will be officially leaving at the end of November, which will bring the number of family doctors at the clinic down to 10, and leave around 900 community members on the waitlist for a new family doctor.

Medical staff at KMHC have been putting in the extra effort to make the Access Clinic work to deal with the loss of family doctors at the clinic, Delaronde said.

“Everybody’s here with their own specific job titles and this is in addition to that,” she said. “Everyone’s trying their best.”

Physicians with their own caseload of patients give any extra time to the Access Clinic, and one physician who does not work full-time in Kahnawake also supports the Access Clinic and semi-urgent care.

“We’re conscious that our doctors have their own caseloads to care for and we do try not to overpack them in regards to taking away access to their own clientele,” Eniojukan said.

Urgent and semi-urgent matters should not be tasked to the Access Clinic, and patients need to be aware of describing their concerns clearly so that the right care can be administered quickly.

“In partnership with our clients and our professionals, we’ll try to ensure our clients get the best care they can until they get a family doctor,” Eniojukan said. “It’s a partnership, it’s a shared responsibility.”

Long-term, Eniojukan sees the Access Clinic serving to better support patients in receiving quick care, for example by allowing patients who do have a family doctor to get care when their own physician doesn’t have immediate availability. Right now, however, the team is focused on dealing with the large volume of community members who do not have a family doctor - an issue that practices outside Kahnawake are also facing.

“The number of available graduating family doctors is a challenge across Quebec,” Eniojukan said.

Community members can reach the Access Clinic by calling the KMHC front desk and asking to be transferred to the Access Clinic line.

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