Dix denies doctor comment amid growing backlash for 'misleading,' 'insulting,' 'clueless' remark

B.C.'s health minister is facing growing backlash and anger from the province's doctors over a comment he tried to deny making, even though it was recorded and publicly available.

On Tuesday, Adrian Dix faced detailed budget questions from the official Opposition leader in a special committee meeting, and in response to a question about team-based primary care, he suggested since nurses spend more time with patients, they may do a better job.

"I really emphasize family doctor-nurse practitioner because I think nurse practitioners – I'm not saying they can provide better primary care, but for many people they do," he said.

B.C. doctors immediately shared the recording, which went viral on social media and within Canada’s medical community, prompting a statement from the Doctors of B.C. expressing disappointment and asserting that “(Nurse Practitioners) cannot replace doctors.” That response was followed by a more-strongly-worded statement from the BC Family Doctors association, calling the comments divisive. 

“It's not going to fix health-care playing Peter against Paul,” said Dr. Toye Oyelese, in an interview speaking for family doctors.

“It’s very well established that (general practitioners) are the specialists in primary care by nature of our training, by nature of our role. There definitely is a lot of room for everybody and the future of primary care is working as a team.”

When CTV News asked Dix to clarify whether he believed nurse practitioners do a better job with patients, Dix brushed off the controversy.

“I actually said quite the opposite,” he insisted. “My first line was I’m not saying that and of course family doctors, family practice doctors are foundational in our health-care system.”

RANK-AND-FILE OUTRAGED AND SPEAKING UP

The Opposition Liberals hounded Dix in question period on Thursday, insisting he explain his comments and presenting him with angry social media comments from the B.C. doctors. 

"I didn't say it, I don't believe it," Dix shot back, peppering his response with statistics comparing Liberal and NDP government management of health care.

"We should be perfectly clear about who heard the comments and what was said,” responded visibly frustrated opposition leader Shirley Bond.

“Doctors were watching across British Columbia and their comments were based on what they heard, not what I heard."

Usually diplomatic and reserved on social media, many of the province’s doctors launched an unprecedented avalanche of criticism and frustration aimed at Dix.

Retired doctor Art Hister was baffled that Dix would insult doctors in the midst of a massive shortage, and some practicing physicians speculated their peers would be even more likely to leave in the face of what they call disrespect, misleading information, and divisive politics.

“I’m not saying that Adrian Dix is totally clueless,” wrote Dr. Gareth Eeson in a cheeky tweet.

“But sometimes Adrian Dix is totally clueless.”

In an interview with Vancouver Island’s “Victoria Rumble Room,” Dr. Jennifer Lush called the minister’s comments “a profound slap in the face to every family physician” who’s continuing to do their job despite the long hours and many obstacles they face. 

“It’s time for an apology,” tweeted Dr. Erin Carlson.

A FUNDAMENTAL MISUNDERSTANDING?

The province and family doctors have been butting heads on how to modernize the primary care system, which pays general practitioners based on patient visits, not how long they spend with them. The province doesn’t account for complex patients or rising overhead costs, unlike Alberta where doctors make much more and family practices are thriving, despite fewer trained physicians per capita.

Oyelese wonders whether Dix has a firm understanding of how primary care actually works for patients and medical staff on the ground.

“To be honest with you, when I heard his comment, I wasn’t surprised at all, because the minister has always confused nurse practitioners for family physicians and I’ve always felt he wasn’t clear on their training and roles,” Oyelese said, pointing out doctors typically take twice as long for schooling and training.

“It seems to me the health minister needs to spend more time with family physicians. I would be very happy to educate him on what it is we’re doing and what our roles are.”

For more than a year, CTV News has been speaking regularly with health-care workers in various roles and communities. They increasingly see Dix as playing a major role in poor management and bad morale in the system; the deteriorating relationship with doctors and his handling of this latest controversy has made things even worse. 

Within that context, the minister’s final comment to journalists was particularly noteworthy for its dissonance. 

“I don’t think there’s been a government in history that’s been as supportive of family practice doctors,” claimed Dix. “We have a lot of work to do together.”  

NPs and FPs are partners.

We work together and we all see the detrimental effects of this crisis on our patients - your constituents.
We will not be divided. @adriandix it’s time for an apology. @FDs4PCinBC https://t.co/RU03PGqZMm

— Erin Carlson (@DrErinCCFP) May 11, 2022

I’m not saying that @adriandix is totally clueless, but sometimes @adriandix is totally clueless. https://t.co/6ijAHHTuZI

— Gareth Eeson (@GarethEeson) May 12, 2022

I'm feeling despair that Doctors of BC would even need to put out this statement https://t.co/MU7VosI3GY

— Rebekah Eatmon (@RebekahEmd) May 11, 2022

There is so much need in our system- plenty of work for Family Doctors, Nurse Practitioners, Physician Assistants. Why not support all of us to do our work in an equitable way, so we can look after our patients? We will not be divided. @DoctorsOfBC @BCFamilyDoctors https://t.co/8WvPhvSMNb

— Trina Larsen Soles (@DrLarsenSoles) May 12, 2022

@adriandix fallout from your "NPs are better at primary care" will be severe. It's clear there is no respect for what we do as family doc.

Many family docs now planning to leave because of this comment. @DoctorsOfBC @BCCFP @BCFamilyDoctors @FDs4PCinBC @ResidentDocsBC

— Carllin Man MD CCFP (@CMan_CCFP) May 11, 2022

BC Minister of Health triggering a mass exodus of FPs will be the last nail in the coffin of Family medicine as health care is collapsing. Unless BC govt puts resources to save Family Practice now on life support, many lives will be lost. https://t.co/Jxvh1SlGH1

— Dr Caroline Wang (@CarolineWangMD) May 12, 2022

What universe does this happen in? Minister of Health is faced with huge doctor shortage in his province, so he insults the doctors already working there; this is real? In BC, yes

— arthister (@arthister) May 11, 2022

I am dismayed and disappointed in the manner that @adriandix is treating and addressing family doctors. He continues to undervalue hard-working family doctors. We provide expert longitudinal healthcare and save the govt tons of money @DoctorsOfBC @dr_rdosanjh @BirinderNarang https://t.co/RJd0DwFGUh

— Dr Jawanda (@MadhuJawanda) May 12, 2022

Positioning family docs and NPs as an either/or solution to the primary care crisis is not helpful. Fosters turf wars when it should be all hands on deck and a culture of team work. @adriandix @jjhorgan @MitziDeanBC

— Jennifer Ross (@JRossfamilymed) May 11, 2022

Such generalizations by Mr. Dix are not ok.

It is divisive and not good for the public in general. @BCFamilyDoctors @dr_rdosanjh @DoctorsOfBC https://t.co/EpDmvjlP1t

— Geriatrician Nishi 🇨🇦 (@GeriMedMD) May 11, 2022

Thanks for this show of unity. We all have our place and work better united. Divisive comments help no one. https://t.co/TD4cEvjOS5

— Adam Thompson MBBS (Hons) MRCGP CCFP (@cv_familydoc) May 11, 2022

Another misleading statement - Dix doesn't really understand that in order to provide primary care you need to have GPs on your side .... He is not going to get many GPs on his side with these comments. We really should get a MD as Health Minister to help with competent choices https://t.co/ghQlHt0hrx

— Dr. Emanuela Tura (@TuraEmanuela) May 11, 2022

Here’s a good example of what life is like for a family doctor in BC. It’s obvious why there’s a shortage. The lack of support and locums burns doctors out. We sacrifice so much & to hear @adriandix’s words is frustrating & demoralizing. https://t.co/TGDzDQJw6k

— Dr. Yvette Lu (@yvettelu) May 12, 2022