The rhythmic beeping of someone else’s hospital monitor greeted me on February’s coldest morning in North Carleton. I’d come to shadow Dr. Ellen Boudreau, who has served this rural New Brunswick community for over twenty years. In her cramped office, a stack of patient files threatened to topple from her desk – a physical manifestation of the region’s healthcare backlog.
“Seven hundred and forty-two people waiting for primary care in this district alone,” she sighed, gesturing to the files. “Some have been waiting three years to see me.”
This scene came rushing back to me last Tuesday when the Government of New Brunswick announced a $2.1 million investment to expand the North Carleton Health Clinic, potentially addressing one of the province’s most persistent healthcare challenges: access to primary care in rural communities.
The funding, part of a broader provincial healthcare overhaul, arrives at a critical moment for North Carleton. Patient waitlists have swelled to unprecedented levels since 2020, with nearly 750 residents lacking access to consistent primary care, according to Horizon Health Network data. For many, this means treating the emergency room as a de facto family doctor – a pattern that healthcare providers say strains both emergency services and patient outcomes.
“We’re seeing people delay care until their conditions become acute,” explains nurse practitioner Joanne Doucet, who has worked at the clinic since 2018. “Diabetics rationing insulin, unmanaged hypertension, mental health crises – all things that could be addressed through regular primary care.”
The announced expansion plans to increase the clinic’s capacity by 40%, allowing for the recruitment of two additional physicians and three nurse practitioners. According to Health Minister Bruce Fitch, this could potentially clear the region’s waitlist by early 2026.
When I visited the clinic in February, its physical limitations were obvious. Examination rooms doubled as storage space. A former janitor’s closet had been converted into a make-shift consultation area. Staff shared a single computer terminal to access electronic health records.
Local resident Martin Chiasson, 64, described his three-year wait for a family doctor after his previous physician retired. “I’ve got arthritis, high blood pressure, and an old logging injury that needs monitoring. For three years, I’ve been bouncing between walk-ins and the ER in Woodstock when things get bad,” he told me, his weathered hands gripping a worn New Brunswick Medicare card. “It’s not right. Not for me, not for the nurses at emergency who are just trying to keep up.”
The funding announcement comes after years of advocacy from local healthcare providers and municipal officials. According to Statistics Canada, North Carleton’s population has actually grown by 4.3% since 2016, bucking the trend of rural decline seen in other parts of Atlantic Canada. This growth, driven partly by urbanites seeking more affordable housing during the pandemic, has placed additional pressure on already strained rural health services.
Dr. Melanie Gibbs, Chief of Staff at the Upper River Valley Hospital, emphasizes that the expansion addresses more than just physical space. “When physicians and nurse practitioners consider rural practice, they look at workload sustainability, professional support, and quality of life. This expansion helps us create the conditions that make rural practice attractive.”
The Canadian Medical Association Journal published research last year showing that physicians are three times more likely to remain in rural practice when they have adequate support staff, reasonable patient loads, and opportunities for collaboration with colleagues. The North Carleton expansion aims to incorporate these findings with a team-based care model.
Yet there’s skepticism too. North Carleton Mayor David McKay questioned the timeline during the funding announcement. “We’ve seen promises before,” he noted. “Our residents need doctors now, not two years from now.”
His concern reflects a deeper anxiety I’ve encountered throughout rural New Brunswick. In communities where hospital closures and service reductions have become common, trust in healthcare commitments has eroded. The province’s healthcare system ranks among the lowest in Canada for access to primary care, according to the Canadian Institute for Health Information’s 2023 report.
Walking through North Carleton’s small downtown after the announcement, I stopped at the community bulletin board outside the Red and White grocery store. Alongside advertisements for firewood and used snowmobiles, a handwritten notice caught my eye: “Ride share to Fredericton Hospital, Tuesdays and Thursdays. Call Marion.” It was a poignant reminder of how rural communities create their own solutions when systems fall short.
For Dr. Boudreau, the expansion represents cautious hope. “I’ve been advocating for this for seven years,” she told me by phone after the announcement. “I’m grateful, but we need to ensure the funding translates to actual improvements in patient care, not just administrative reorganization.”
The funding allocation breaks down to $1.6 million for physical expansion and equipment, while $500,000 is earmarked for recruitment incentives and transitional staffing supports. Construction is scheduled to begin in September 2024, with a targeted completion date of July 2025.
What remains unclear is whether these changes will come quickly enough for residents like Martin Chiasson, who continues to navigate a fragmented healthcare system while waiting for a primary care provider.
“At my age, waiting two more years means something,” he said. “But at least now there’s a plan. That’s more than we had yesterday.”
As I packed up my notebook and headed back to Vancouver, I couldn’t help but see North Carleton’s healthcare challenges as a microcosm of a national struggle. In communities across Canada, from northern British Columbia to rural Newfoundland, similar scenes play out daily – dedicated healthcare providers stretched thin, residents creating informal support networks, and the persistent hope that the next announcement, the next investment, will finally create the change they’ve been waiting for.
For North Carleton, that change now has a price tag: $2.1 million. Whether it will be enough remains to be seen.
