Physician Neighborhood Model:
Frequently Asked Questions


Describe the 3 phases of the implementation of the Physician Neighborhood Model and the estimated timeline. What can families expect?
Physician Neighborhood Model is a multi-year project. Within the next 2 years, the goal is that physicians will be on their neighborhoods and specific nursing wings. For current families, there will be no movements or changes unless physicians will leave or retire.

1st PHASE: Family Physicians (FP) are cohorted based on the most number of residents that they have in a nursing unit regardless if the residents are on the North wing or South wing.
2nd PHASE: New admissions will be assigned to physicians based on the physician assignments future state plan. This will be a slow transition as this is based on residents attrition.
3rd PHASE: Future state – Physicians will have a manageable resident panel ranging from 25-25 residents each. This is anticipated to be accomplished by 2022.

How many residents per FP/NP?
On Average: 25-35 residents per FP.

Is it the same throughout LBHH or does SCU and the Hospital have fewer residents per FP/NP?
Generally, yes. Some of the providers who work in the Hospital wings have more residents as they expressed interest in caring for a greater number of the residents. For example, FP and NP in the hospital wings have 35-40 residents and FP have 25-30 residents.

How long can we expect to wait to meet our FP/NP?
You can reach out to the RN/LPN on the unit or CNL if you want to meet with the FP/NP on their rounding days, which makes it easier to schedule a meeting. This could be set up on an individual basis. We also have admission and annual care conferences as opportunities to meet with the respective provider. If there is a pressing issue, families can request a family meeting.

What is the difference between a NP and FP and how does their care of residents differ?
Family Physicians (FP) s are medical doctors who obtain a medical degree and complete a family practice residency. Nurse Practitioners (NP) are Registered Nurse who complete additional and advanced education and training above their basic nursing education. The scope of practice of NP in Long Term Care (LTC) is very similar to that of FPs. The approach to care may be influenced by respective medical and nursing practice model. NPs are employees of Vancouver Coastal Health Authority (VCH), and may not have or be involved in private practice. FPs often have their own community family practices (doctor’s offices) and complement/supplement their work by having a resident panel in a LTC facility, such as LBHH.

What are each of the FPs/NPs names and what area of the home and hospital do they cover?
Dr. Dan Ezekiel and Dr. Tamara Krivakopic: Home Center
Dr. Larry Barzelai: Home West
Dr. Sohan Mansingh: Home East
Dr. Jeffrey Silver and Dr. Merrick Tosefsky: Special Care Unit
Dr. Eric Cadesky and Dr. Merrick Tosefsky: Hospital West
Dr. Eric Cadesky and Leanne Park: Hospital East

**You will also find more information about the physicians in the Snider Schmooze Newsletter April edition. You will get to know them a little bit more – through their short bio and a picture.**

How can families send a message to their FP/NP when it’s not the day that the doctor typically arrives (through the nurse? By E-Mail? By voice mail?)
This may be best determined through a discussion with the FP that is assigned to the unit where your loved one is located. Every FP/NP have their preferred way of being contacted by families. Before reaching the physicians, please talk to the RN/LPN and/or CNL in charge of the nursing unit to facilitate the communication.

Is there are plan, long term, to have more FPs/NPs practicing at Louis Brier?
Yes. Our goal is to recruit an additional 1-2 physicians to allow for a more seamless coverage and keep resident panels manageable. Our goal is to keep the number of physicians who provide services to our residents, limited, to ensure better management and enhanced quality of care. However, before we proceed with additional recruitment of physicians, we are hoping to evaluate the new model and make relevant adjustments to avoid any potential interruptions and dissatisfaction.

If so, what is the recruitment process?
Care Providers need to be a member of the Long Term Care Initiative of the Vancouver Division of Family Practice. LB also has a credentialing and privileging process.

What happens if a resident has been assigned a FP/NP who they have already determined is an impossible fit? What kind of exceptions can be made here?
We will work to resolve the concern with the nursing leadership. If issue with medical care cannot be resolved, we involve Medical Coordinator and the Executive Director for Resident Services. Exceptions will be considered on a case-to-case basis.

Nicole Encarnacion
Nurse Manager
Louis Brier Home & Hospital and Weinberg Residence