Manitoba using private health clinic as model to ease emergency room burden

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A publicly funded, privately owned, injury and illness clinic in Winnipeg is helping offload some of the burden from hospital emergency departments and urgent care sites, and the province is taking notice.

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Dr. Gerald Brennan and several other physicians along with an engineer opened the Minor Illness and Injury Clinic in Winnipeg in 2019. They’ve experienced a post-pandemic “gangbusters” uptick, treating 44,820 patients in 2023, diverting many people from emergency departments. Patient volume increased 60% from 2022 to 2023.

“We see people on a weekly basis who have been sitting on medical problems that should have been dealt with — like for weeks and months,” said Brennan, who serves as clinic CEO. “They also don’t think that it’s something important enough to justify waiting in urgent care or an emergency room.”

According to statistics compiled by the Winnipeg Regional Health Authority, there are currently around 4,836 patient visits to emergency and urgent care sites per week, not including visits for pediatric emergencies at Health Sciences Centre. The current week in 2023 saw 5,035 visits. In 2022 the number was 5,145.

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According to 2023 Shared Health data reported by media, one in three people seeking emergency care at the Health Sciences Centre leave without seeing a doctor.

While working at Children’s Hospital, Brennan once saw a child wait eight hours for suturing.

“It just dawned on me that maybe there’s a better way of doing this,” he said, noting up to 40% of people waiting in local emergency departments have non-urgent problems.

What differentiates the Minor Illness and Injury Clinic from other independent clinics in Winnipeg like walk-ins, is the level of emergency care expertise.

Brennan and his colleagues are exclusively ER doctors. X-ray imaging happens in the clinic. The clinic handles casting, splinting, heart diagnostics, abrasions, cuts and burns, as well as blood and urine tests, throat swabs, and specialist referrals.

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The clinic strives for on-time appointments and has 35 to 40 doctors on the roster. Some work a few times per months, others work more often. Slightly fewer nurses work at the clinic with 20-25 support staff.

“We’ve got the folks who are really good at getting to the bottom of things quickly,” said Brennan. “And more importantly, I think of recognizing when things are not appropriate for an outpatient clinic. We do end up sending some folks to the emergency room.”

The province took notice of Brennan’s clinic. In March, Health, Seniors and Long-Term Care Minister Uzoma Asagwara announced a minor injury and illness clinic for Brandon. More clinics are planned for Winnipeg.

There are over 80 clinics in Winnipeg offering walk-in medical care, including several offering minor injury and illness treatment, said Doctors Manitoba in a statement.

“They are making a significant contribution to improving access to care,” they wrote.

“In terms of ERs, the most effective way to reduce wait times is actually by adding more inpatient hospital beds. We don’t have nearly enough in Winnipeg, and this means patients routinely back up in emergency waiting for admission to an inpatient bed. This takes up treatment spaces for hours, sometimes days.”

The province recently announced the addition of 68 transitional beds to help address that problem.

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