'Doctors are basically running a small business': B.C. Greens slam NDP for family doctor 'crisis'

The provincial Green Party says an "outdated payment model" is partially to blame for what it calls a family doctor crisis in British Columbia.

Leader Sonia Furstenau called Wednesday for immediate action from the governing NDP, saying hundreds of thousands of residents in the province are currently without a doctor.

She said estimates of doctor-less residents range from 750,000 to 900,000, and that the shortage of doctors is expected to get worse.

She blamed the shortage on how B.C. doctors are paid, and said "administrative" barriers need to be removed to keep doctors in their communities.

"The billing model is very outdated and does not provide the stability needed for good medical care," the leader and MLA said at a news conference.

"Doctors are basically running a small business instead of putting their focus into caring for their community members."

That so-called outdated billing model is essentially that most doctors receive payment for the services they provide, meaning the more patients they see in a day, the more money they make.

In cities like Vancouver – the country's priciest real estate and rental market – the fee-for-service model can encourage doctors to speed through visits.

For patients, it means they're typically only permitted to discuss one issue per visit.

The model has been in place in the province for decades, and some experts say it hasn't adapted well to changing demographics and the desires of doctors.

In addition to billing the government for their services, B.C. doctors also need to find and lease their own space, hire their own staff and source their own equipment, meaning they spend hours running their businesses instead of practicing, and instead of earning payment for services.

In an interview in the fall, president-elect of Doctors of B.C. Ramneek Dosanjh said, "This is a system that’s been overburdened, people have been overworked." 

The amount of work is so great that some doctors are walking away from family practice or leaving the province, she said. Add to that the pressures of the pandemic and the situation becomes even more stressful.

Furstenau is urging the NDP to explore other models of practice that would improve the level of care doctors are able to provide – a model that would include consistent salaries and would allow them to focus on health care instead of business operations.

She's also pushing for the province to expand the alternative payment models it does have in place to reflect the demands of B.C.'s communities.

"This would reward physicians for providing quality health care while letting them stay independent of government," she said.

"We should be working to make it desirable to be a family doctor in British Columbia. We need family doctors to want to work in this province, so that people get the care they need and lead healthier, more fulfilled lives."

Health Minister Adrian Dix was asked about it during a media availability later in the day, and said, "I think it's important that everybody get updated."

Dix noted the province's alternative payment plans that are available, and said when he took over the ministry, B.C.'s was "basically the most fee-for-service jurisdiction in the country."

He said he was told at the time that the vast majority of doctors said they wanted to work on an alternative arrangement, "or effectively on salary."

Since that time, he said, the government has been moving in the direction of those alternatives, while working with family practices to update the system.

"I appreciate and certainly will make this information available to the Opposition, because what I think the situation reflects is the desire of many younger doctors to move away from the fee-for-service model," he said.

"It's a challenge in many current fee-for-service practices in terms of recruiting new doctors… but what Ms. Furstenau was talking about this morning is something that we have been actually doing for three years in a way that's never been done before in B.C., and I appreciate her support."

With files from CTV News Vancouver's Penny Daflos