A new program proposed by the Ambulance Paramedics of British Columbia has received funding and approval for 80 full-time equivalent positions and $15 million in start-up costs. Aimed at filling in the gaps in community healthcare, the program is looking for up to four trial communities before rolling out across the province. Councillor Tim Rhodes and Municipal Chief Administrative Officer Kathy Lalonde met with the author of the report that explains the program while attending the recent Union of British Columbia Municipalities meeting.
“The communities that step forward will undergo an assessment, and I think acquiring one of these spots will be a competitive process,” says Rhodes. “And we wanted to put our faces, and our community’s dilemma forward right off the bat.”
The dilemma, as Rhodes describes it, is that Bowen Island is a community with extremely limited medical resources and a high number of seniors, some of whom have been known to hitchhike to get to appointments.
The solution, or part of it at least, is the implementation of a community paramedic.
“This is not a one-size fits all type of program,” says Cameron Eby, the provincial executive officer with the Paramedics of BC. “We would look at what the service gaps are in a particular community and work to try and fill them in. In a place like Bowen, for example, you might be looking at having a paramedic acting as a primary care provider, and that person might require some additional training.”
A community paramedic would be mobile and visit patients as necessary.
“Think about the old days of house calls done by general practitioners,” says Eby. “We want to bring the service to the patients, instead of the patients to the services. In a small community, you normally can’t hire full-time paramedics because there just isn’t enough work. With this model, a paramedic could continue to do emergency work as necessary but work on non-emergency medical calls at other times.”
Eby also stresses that this program is about preventative healthcare instead of emergency healthcare.
“We’re looking into regulatory changes that would give paramedics the power to say someone does not need to go to the hospital,” says Eby. “We are hoping that if someone calls the ambulance a paramedic can arrive and make the judgement call that instead of going to the hospital a community paramedic should come by later and make regular visits. It is with this kind of thing where other places in Canada are seeing major cost savings. One dollar spent on this will often result in five dollars saved.”
Gayle Little, a Bowen Islander who worked locally for six years as a paramedic but now works in Vancouver, says that this kind of program sounds like it holds a lot of promise.
“In the city, we get so many calls from people who are told to call the ambulance in cases where it is not actually necessary. I really see the importance of reducing trips to the hospital,” says Little. “I also really like the idea of giving paramedics more training. People go to the hospital for things like minor sutures, or to get IV anti-biotics. These procedures are fairly straightforward, and could be taken on by a paramedic.”
Eby says that he hopes the process of selecting trial communities will be underway by the new year, but cautions, the community with the biggest need is not necessarily the right place to start.
“Where these programs have failed elsewhere are places where they’ve tried to rush the implementation, or where they’ve tried to use it to make up for a lack of other services,” he says. “What we need to do is find very specific gaps in community healthcare, and work to provide specific solutions.”
