The Vancouver Island doctor shortage, explained
Thousands of Islanders have virtually no prospect of finding a primary physician, but the solution may not be more doctors
By Sol Dolor October 23, 2020
[Excerpts] There is a doctor shortage, but it’s not unique to the Island
It’s no secret that for newcomers to Vancouver Island, it is basically impossible to find a family doctor. And for thousands of others, the retirement of a family physician can often leave them with no place to turn. In a BC Medical Journal editorial published just before the onset of COVID-19, recently retired Parksville doctor Jonathan Winner wrote that the local doctor shortage has reached crisis proportions.
Physicians have a right to decide where they want to practice, which means supply will not be equal among places. As Winner pointed out in his March editorial, it’s been apparent for decades that BC doctors are increasingly staying away from family practice. As early as the 1980s, he wrote, “the family practice model we were all working in was becoming less attractive to the next generation of doctors, who were able to work in walk-in clinics.”
In a study of 11 developed countries in 2016, The Commonwealth Fund found that a fifth of Canadians waited more than seven days to see a family doctor. Seeing a specialist, meanwhile, can take four or more weeks.
The problem, as experts told Capital Daily, is not necessarily a shortage of qualified professionals graduating from med school; Ross noted that BC has already upped its intakes of med students and residency spots. Rather, as family doctors age out, a more realistic solution may be to reform the province’s decades-old model of family doctors as the primary gatekeepers to healthcare. Instead, Ross argues, BC could do well to pursue coordinated teams of nurse practitioners, midwives and other professionals taking on the role of primary care; lightening the load on the Island’s physicians.
Contandriopoulos says Canada has been sedate in making the shift to these “intraprofessional teams,” despite vast scientific evidence showing their success in other countries. A key change, he said, is shifting the “fee for service” model, in which physicians are paid by the visit. Whether a doctor visit is for a sore throat or for the first stages of leukemia, they’re all paid the same. As one doctor told Capital Daily, it’s akin to a dentist charging the same for a tooth polish as for complex dental diagnostics.
To access the full article, click on https://www.capitaldaily.ca/news/doctor-shortage-vancouver-island-victoria-healthcare
Patients searching for family doctor at new Langford urgent care centre disappointed
CTV Vancouver Island Published Monday, November 5, 2018
[Excerpt] There was confusion on opening day of a new urgent primary care facility on the West Shore Monday morning.
More than a dozen people waited in line before the Westshore Urgent Primary Care Centre opened its doors for the first time at 8 a.m.
But some of those people were frustrated to learn that they would not be able to find a new family doctor at the centre – at least for now.
“It’s just purely an urgent care walk-in clinic,” said Wendy Wilson. “I asked if there was a waiting list, no they don’t have a waiting list. I asked if they knew when the prospective pod is going to open for doctors, the answer was no, they don’t know that but it won’t be until the new year for sure.”
Times Colonist Sept 28, 2017
Chris Pengilly, formerly of Tuscany Medical Clinic, is a part-time family physician.
[Excerpt] I read with interest the op-ed from Joanne Hamilton concerning her parents who are now “orphan patients.” The responses from Vanessa Hammond and Dr. Robin Saunders suggest solutions that offer a realistic and optimistic future. (“Physician shortage is now a crisis situation,” comment, Aug. 31; “Physician shortage doesn’t have to be a crisis,” comment, Sept. 5; “Victoria’s doctors strive to improve patient care,” comment, Sept. 19.)
I am particularly sensitive to the subject of orphan patients at the moment because I retired from family practice early in 2015. After great difficulty, I found a physician to continue the care of my patients, but because of a serious medical condition she was unable to continue.
She and I spent a long time trying to find physicians in the community to undertake the care of her sickest patients.
Unfortunately, family practice and/or Victoria were insufficient to retain one young female physician who had adopted several of my orphans, so they are re-orphaned.
What we need to do now is to make the current physicians more productive, and less burdened by unnecessary paperwork and bureaucracy — until the community health centres are up and going.
These suggestions could begin to be effective by the end of this year:
• Provide each physician with a typist service, as has long been provided to hospital physicians.
• Compensate family physicians a quarter of an office-visit fee for the responsibility and time involved in repeating prescriptions of their own patients; these are more safely prescribed by the family physician who has access to the medical record, and not infrequently the patient might not need to come to the office.
• Encourage physicians to form groups of four or more doctors (which are proven to be more effective and more efficient) by offering a one-time grant to cover the cost of amalgamating and moving offices.
• Integrate and co-ordinate public-health nurses to work in close liaison within group practices.
• Eliminate, or at least simplify, the form-filling needed for a patient to access “special authority drugs.”
To read the full article, click on: Let’s declare a family-practice emergency