Primary care clinic for Community Outreach Centre clients showing positive outcomes

A doctor on P.E.I. is providing a primary care clinic at the Community Outreach Centre in Charlottetown.

Dr. Reuven Stott works as a hospitalist, but he's also been helping with the health-care needs of clients at the centre for the last six months. Stott now holds a clinic at the centre at least once a week to address the needs of people experiencing homelessness or addiction — and in many cases, both.

Stott's hope is to alleviate strains on P.E.I.'s health-care system by providing services to vulnerable populations.

"Reducing ER visits by clients or patients that may visit the ER multiple times, now they can visit our clinic," he said.

"We've been able to prevent hospitalizations and open up rooms in the hospital, and we've been able to even facilitate early discharges [from] the hospital, which gives ... individuals who are waiting in the ER more access to a hospital bed."

Work at shelters and facilities like the outreach centre is something Stott has done previously in larger centres.

"I trained in New York City and I did a lot of outreach work there." he said. "I've ... done a lot of inner-city work inside the States and Toronto, where I am originally from."

He helped develop shelter clinics at Toronto's Maxwell Meighen Centre.

"It was just literally myself, I don't want to say a broom closet but something similar, and a computer and we started seeing clients and we were able to do fabulous work, really helping the individuals there," he said. "So, when I came here I saw some need for that, especially with some of the clients I see coming through the hospital."

'Set up an exam table and started to see people'

So six months ago, Stott walked down to the Community Outreach Centre at its former location on Euston Street with a backpack full of medical equipment and spoke with representatives from The Adventure Group, which runs the centre.

"Set up an exam table and we just started to see people," he said. "Things kind of expanded from there [and] we were able to get funding for a nurse to come on."

Now there is regular nursing care at the outreach centre's new location, off of Park Street. Stott runs a clinic there once a week, but will deal with more serious issues outside of those hours if he's alerted to them by nursing staff.

Stott said he was drawn to the work because he's lost friends to overdose and family members to exposure. Right now, he said, the clinic is providing a lot of foot care.

The outreach centre moved from Euston Street to Park Street at the end of March. (Stephen Brun/CBC)

"If people are are sleeping outside or sleeping rough, even if it's in temperatures above zero, if it's prolonged enough they'll get injury to their hands and their feet. They may develop ulcers or infections that can get quite severe quickly," he said.

"A small wound that isn't cared for properly ... can become quite severe and turn into a limb-threatening cellulitis, but if they come into our clinic and they're seen quickly and we start them on antibiotics, give them a clean pair of shoes and socks … then we can stop that disease process from running out of control."

The clinic also provides access to addictions treatment and mental health supports. Those who are using drugs get information about harm-reduction supplies, such as clean needles, to prevent the spread of blood-borne illnesses.

'We all have to play a role'

Stott understands there are many people on P.E.I who don't have access to a family doctor, but he hopes that treating vulnerable populations will help free up the health-care system for others.

"There's many good people working in many areas to try to relieve that stress," he said.

"We all have to play a role. We all have to chip away at this and do our part. My part is to take care of these vulnerable individuals."

'I think we are preventing ER visits and maybe escalation of health-care issues,' says P.E.I. Health Minister Mark McLane. (Shane Hennessey/CBC)

P.E.I. Health Minister Mark McLane believes Stott's work may help ease wait times in the emergency department at Charlottetown's Queen Elizabeth Hospital.

"A client had almost 500 ER visits over the course of two years that they are now treating at the centre. It does help our health-care system," McLane said.

"I think they are being treated where it may be most appropriate. I think we are preventing ER visits and maybe escalation of health-care issues by treating them at the [outreach centre]."

The clinic is also helping to reduce the number of mental health calls to police.

According to Stott, one client was responsible for 50 mental health calls per month to Charlottetown Police Services. He said that's now down to one call a month now that the person has been given the correct medication.

Some other initiatives are up and running at the outreach centre such as a classroom and a program to teaching clients how to file their taxes, says Roxanne Carter-Thompson, executive director of The Adventure Group. (Kevin Yarr/CBC)

Roxanne Carter-Thompson, the executive director of The Adventure Group, said there have been some positive outcomes since Stott's clinic started.

"People who were escalating on a daily basis, we saw them become more compliant," she said. "There was a client with untreated mental health issues who was able to access care at the clinic.… He was on the streets and now he is living with his family.

"Not only did he receive support that improved his overall quality of life, but a family ... was reunited with their son."

Some other new initiatives are also up and running at the outreach centre such as a classroom and a program that helps clients with filing their income tax returns, Carter-Thompson said.

Officials with P.E.I.'s Department of Housing, Land and Communities said in an email that a community open house is being planned at the outreach centre for mid-June.