Transparency Grade: F
Staffing
What's the data showing?
Budgeted vs. actual spending on staffing across different professions within each UPCC (FY2022-2023). Not shown in the charts are hiring data measured as the number of full-time equivalent (FTE's) employees instead of cost.
UPCCs are recruiting 66-70% of the number of primary care providers required.
Family Physicians: 70% of budget, 75% recruited FTEs
Nurse Practitioners: 66% of budget, 70% recruited FTEs
Nursing: 99% of budgets, 88% recruited FTEs (indicating substantial casual staff).
Large variation between different sites.
See also: UPCC Performance
See main UPCC Performance page for data sources used here.
Who do you see at a UPCC? And what are UPCC 'visits'?
Seeing a doctor or nurse practitioner at a UPCC counts as a visit.
But so does going to a UPCC and seeing a nurse (who can't diagnose, prescribe, refer, …).
Or seeing a counsellor....
And you'll more likely see a nurse.
Because many UPCCs are very understaffed. Particularly with doctors and nurse practitioners.
That's why many often close or have no doctor available.
PRIMARY CARE CENTRES — WITHOUT PRIMARY CARE.
Why? Doctors love team-based care. But not how it's done at UPCCs. Many say it's broken, inefficient, and increases risks to patients.
And if you see a nurse and then a doctor? That may count as TWO VISITS at a UPCC! The government has repeatedly refused to break down visits by profession (e.g., doctor, nurse). We need to know more about what a "visit" is — who it's with, for how long, and for what? All visits are not identical or interchangeable. If a patient visiting a UPCC can trigger multiple visits, how many patients are actually being seen?
Consider this scenario. You go to a UPCC. You first see a nurse who checks your blood pressure and asks a few other questions about your health. You then see a doctor or nurse practitioner. That's a smart use of resources, and this kind of team-based care is one of the benefits touted by UPCCs.
But does that count as ONE visit or TWO? Because if it's two, the average cost per "real" patient visit is a LOT higher than $129!
Perhaps it's not so surprising that the government has refused to release official information on who those visits are with or even how many "visits" in the data correspond with real patient visits to the UPCC. So, we're left to speculate.
But we've also heard from multiple insiders that the situation above — one patient visit resulting in multiple visits in the data — does happen. Without the data, we can't confirm this or know how often.
What difference does it make? Consider a visit where a family doctor takes a detailed medical history, performs a comprehensive examination, creates a treatment plan, reviews it with the patient, and answers their questions. Or a 50min visit with a counsellor to provide psychotherapy. I'd consider $129 to be a fair price, if not a bargain, for either of those.
But what if the visit was for a doctor to renew a simple prescription or a nurse to check your blood pressure? For either of those visits, $129 would be ridiculously high.