Dr. Steven MacDougall has transformed his clinical practice and is improving patient care with same-day appointments and house calls. A family doctor in Sydney, Nova Scotia, Dr. MacDougall has made visits to the doctor more convenient for roughly 3,000 patients in his practice.

The decision to reform his practice stemmed from the chronic backlog in the emergency room of Cape Breton Regional Hospital – a condition common in many centres across the province. “Many people go to the emergency room when they can’t see a doctor when they need to,” said Dr. MacDougall. “I believe my patients should be seen when and where they want.”

This patient-centred approach allows patients to call the clinic and book appointments when they want, even for later the same day. The clinic also makes house calls to patients who have difficulty making trips to the office. “Prior to this system my patients had to wait three weeks to see me. Now it’s virtually same day so I deal with health issues as they arise,” said Dr. MacDougall.

Previously, if a patient had to be seen on short notice they would get squeezed in similar to a triage model. This new structure has reduced the number of cancellations and no-shows from 25 per cent to only four per cent. What’s even more remarkable is the number of the clinic’s patients visiting the emergency room fell by nearly 30 per cent.
But it’s the improvement in the quality of care that Dr. MacDougall is most proud of. Close to seventy per cent of what primary care physicians do is manage chronic disease like diabetes, heart disease and lung disease. When patients have a consistent caregiver they are better able to manage these ailments.

A patient with diabetes may go to a walk-in clinic to receive one refill and then have to make an appointment with their family doctor for a follow-up appointment. That’s two visits instead of one, if the patient is able to see their own doctor from the get-go. It’s more efficient for my patients and it’s simply better care.