We, the Misericordia Urgent Care physicians, are extremely concerned about the closure of the Misericordia Urgent Care Centre and the huge impact this will have on the community we serve. As physicians we feel we need to advocate for this vulnerable population who have complex chronic health, social and mental health needs. Misericordia Urgent Care serves, in large part, a downtown core population. We care for approximately 39000 patients per annum. Of that number, approximately 11000 visits are from people who live in the downtown and the Point Douglas neighbourhoods. These communities are comprised of many of our city’s impoverished, marginalized, and disenfranchised; people who have little voice in the political decision making process and, therefore, whose needs can be and frequently are overlooked. We believe this to be the situation in the decision to close Misericordia Urgent Care. Many who live in the community around Misericordia do not own personal transportation and cannot afford to hire a taxi for the ride to seek medical care in the periphery of Winnipeg. In fact many even struggle with finding resources to purchase bus tickets and, therefore, many make their way on foot to access health care at Misericordia. With the closure of our Urgent Care Centre, the alternative will be that many will need to walk to Health Sciences Centre or St. Boniface, call for an ambulance or not seek care at all. Closing Misericordia Urgent Care, taking away access to non-emergent 24-hour care in the core of the city, will only serve to cost the system more and increase the wait times at the already struggling ERs. The conclusion cannot be denied that the closure of Misericordia will be a huge loss for some of the most needy of Winnipeg’s population and as a physician team we are concerned about the equitable access to health care for our vulnerable patients. Misericordia Urgent Care has a long history of effective and responsible health care in our community. In addition to Urgent Care medical attention, we offer triage services for the Winnipeg Ophthalmology Centre of Excellence, save many ambulance/stretcher service rides to outlying ERs for the long term residents at Misericordia Place as well as provide regular medical clearance exams for the Winnipeg Police Service prior to arrestees being transported into formal custody. Urgent Care medical teams also provide emergency care in life threatening situations to both the Personal Care Home and the Ophthalmology service housed within the Misericordia facility. It is noteworthy, that we consistently have the highest patient satisfaction ratings in our city as well as consistently operate under budget. In many ways we function as an Emergency Centre for our city, at approximately 50% of the financial outlay that a full Emergency Centre requires. Given the above facts it is difficult to understand the rationale for the decision to close Misericordia Urgent Care. In our opinion, there is certainly no patient care justification for this closure. Even from a cost savings perspective the closure of Misericordia Urgent Care is indefensible. A full 80% of Misericordia’s budget is made up of labour costs. Both the government and the WRHA are on record stating that there will not be a loss of front line care positions in the proposed restructuring process, leaving only 20% of the annual operating budget for potential savings. It is impossible to leave a well functioning facility and create new infrastructure for an urgent care centre within the 20% budget remaining to accomplish the stated goal of resource saving. We ask, where is the cost savings if indeed there will be no job losses? Again, we question the logic of closing a facility that has been fiscally responsible and upon which the two other proposed urgent care centres will be modeled. As the Misericordia physician team we advise strongly that the decision to close Misericordia Urgent Care be reconsidered and reversed. This closure decision does not in any way serve the community immediately surrounding our facility, it penalizes a centre that consistently operates at an exceedingly high level of efficiency and patient satisfaction and ultimately, if labour costs are retained as promised, it offers no cost savings to our medical system. The Misericordia Physician Team Dr. Cal Bergen Dr. George Borrett Dr. Jennifer Campbell Dr. Hermano Da Silva Dr. Paul Doucet Dr. James Edye-Rowntree Dr. Julian Joshua Dr. Paeta Lehn Dr. Leslie McIntosh Dr. Iris McKeown Dr. John Neufeld Dr. Sheila Peters Dr. Gilles Pinette Dr. Larry Rados Dr. Larry Reynolds Dr. Tim Ross Dr. Ron Scrapneck Dr. Kristian Sethi Dr. Don Simonson Dr. Grant Stefanyshen Dr. Ritchie Strachan Dr. Marcello Venditti Dr. Arlene Walker