As another clinic closes, doctors say after-hours care is set up to fail
Some doctors say after-hours medical clinics not viable under current provincial fee structure
An after-hours medical clinic in Moncton, attached to the Main Street Atlantic Superstore, now has a sign on the door announcing its permanent closure.
Doctors say that more after-hours clinics might meet the same fate — and some point to a billing system that pays physicians less for after-hours clinic care.
But Nick Spence, who was the general manager of the Main Street Primary Medical Clinic, believes it's hard to point to one reason for its closure.
As the province aims to boost access to primary care and allocates resources in that direction, Spence said the after-hours clinic is an unfortunate casualty.
"It is a shame, because there is a need for it," Spence said. "But, it's just one of those things that, you can't keep the resources in walk-in clinics full time, and also at the same time get everyone attached to a primary health-care provider.
"There's not enough resources to do both. So as you transition, you've got to pull some way from here to go over there, and this is just kind of what happens."
Spence, who is not a doctor, said his wife has been practising at the clinic for 10 years and putting in 80-hour weeks trying to keep it open.
He doesn't blame the province and sees giving everyone access to continuous primary care as a priority. But he also can see the impact that closing down will have on patients.
"It does suck, because there's a lot of patients that used our clinic, and I don't know where they're going to go."
Clinic closure not the first
A few years ago Dr. Brian Davidson also closed his after-hours clinic in the Moncton area, after he, too, was unable to find enough physicians to staff it.
"After-hours clinics are just a symptom of a bigger problem, that we can't recruit to the community," Davidson said in an interview. "People don't want to do that kind of work. It doesn't pay as well, there's more frustration with it, there's more paperwork."
He said doctors are paid significantly less for working in after-hours clinics, compared with other settings, including virtual care.
The rate of pay for after-hours care, according to Davidson and Spence, hasn't increased in at least a decade.
Because after-hours clinics also have overhead costs, Davidson said, ultimately physicians at the clinic were taking home half of what they would make if they worked elsewhere.
Dr. Lise Babin, the New Brunswick Medical Society president, was not surprised to hear about the closure of the Moncton clinic, and echoed Davidson's concerns about billing.
"Unfortunately, operating these types of services within the current fee structure is no longer viable for most physicians due to the amount of time, energy and resources required," Babin said by email. "We fully expect these closures to accelerate.
"The reality is, online non-physician services such as eVisitNB are being paid more per visit than family physicians receive for providing in-person walk-in visits. … We remain hopeful that this issue can be addressed in order to reverse the worrying trend that essentially rewards text-based medicine more than high quality in-person care."
Health Minister John Dornan declined to comment on after-hours billing, noting that negotiations are underway for a new physician compensation agreement.
Spokesperson Meghan Cumby said the province's contract with eVisit NB expires on April 1, 2026, but did not confirm whether the province plans to continue providing that virtual option.
"The Department of Health is conducting a comprehensive review of virtual care services," Cumby said by email.
"Any changes to how virtual care services are delivered after April 1, 2026 will be announced following the comprehensive review of virtual care services."
Ripple effect
Sarah Lord works as a wellness co-ordinator at the Jean Coutu Pharmacy in Riverview, which also houses the Coverdale Medical Clinic.
Lord helps patients navigate care options in the area, and she worries that the latest closure will leave patients in the region with few after-hours options.
"If our clinic was closed, we could always bet on the Superstore on Main Street clinic to offer services," she said.
"Just because they had the broadest hours that they were accommodating people, from 9 a.m. to 8 p.m. most days of the week."
Lord is aware of at least five after-hours clinics in the Moncton region that have closed, leaving four remaining options in Moncton, Riverview and Dieppe.
"We've already seen closures of multiple clinics, and we have so many people who are on a waiting list for a family doctor and our population is growing, so it really leaves limited resources for them," Lord said.
"We want people to have access to the care that they need, but it's just not available and it's getting worse all the time."
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