The New Brunswick Medical Society (NBMS) says Horizon Health Network has decided to eliminate incentives at two rural hospitals for in-person physicians for the emergency departments.
It says for the past two quarters, the incentives played a critical role in keeping rural emergency departments open in these communities.
NBMS says the incentives are expected to stop effective Feb. 15.
“The impact of this decision is already being felt,” said NBMS president Dr. Lise Babin in a statement. “The Sussex Emergency Department is anticipating its first closure on the evening of February 17, 2025, forcing patients to seek care in larger urban centres—adding strain to already overburdened hospitals and increasing risks for patients.”
Babin said in the statement that while virtual care has its place, it is not a substitute for in-person emergency services.
“Without immediate action to maintain these incentives, further closures are inevitable,” she said in the statement.
The NBMS said it is engaged with the impacted physicians, Horizon Health, and the Department of Health to advocate for patients in the community to continue to receive timely emergency care in their communities.
Teladoc Health Canada, which is providing virtual health care, was introduced at both the Sussex ER and Charlotte County Hospital earlier this month for a one-year pilot project.
It was aimed at reducing wait times and enhancing access to care by supporting operations in the smaller more rural hospitals.
Recently called for cancellation of virtual care ER pilot
Earlier this week, the society called for the end of the Teladoc Health Canada’s contract.
“We do not understand why our public authorities are contracting out these services to a United States-based private sector human resource agency, at a premium to the taxpayer, when there was a range of less costly and more effective solutions to increase access to care available to them,” Babin said in a statement.
It said it was concerned about the precedent being set by these contracts.
“It is obvious that, left unchecked, this approach will lead to more closures of small emergency rooms across the province as clinicians choose the less onerous option. This risk is reinforced by adding a third-party with a profit motive to accelerate such a change,” she said in the statement.
The NBMS alleged that the pilot project, costing nearly $1 million, would be better spent in collaborative care clinics in the underserved areas.
“The use of highly specialized emergency department physicians and nurses to provide what is essentially a virtual primary care service seems like a misutilization of resources at a time when our system is in crisis,” she said.
The NBMS said this removal of incentives raises bigger concerns about the intentions toward rural hospitals.
“This decision is deeply concerning and reinforces our longstanding fears of a deliberate shift away from rural emergency services,” she said in the statement. “It appears that a successful, proven measure is being removed—potentially to justify the introduction of a virtual care pilot project that cannot replace in-person emergency care.”
Babin said the decision to fundamentally change access to care in rural communities is happening behind closed doors.
During the election campaign last year, and in mandate letters, the Holt government promised several things to improve access to primary and emergency care in rural areas, including a collaborative care clinic in St. Stephen within the first 18 months of the Liberals mandate.
“Our health system already faces significant challenges. We cannot afford to create new ones,” Babin said in the statement.
Horizon Health Network said in an email it does not negotiate physician compensation, according to a statement from Dr. Susan Brien.
“Physician compensation is negotiated between Medicare, the Department of Health, and the New Brunswick Medical Society on behalf of physicians,” she said in an email.
The Courier has asked both the Department of Health and Horizon Health Network for confirmation these incentives have been taken away, but neither answered the question. Instead, the two just directed The Courier back to other.
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