How a 'Band-Aid' urgent care strategy contributed to B.C.'s primary care crisis
The decision to focus on urgent and emergency health care to avert long waits played a key role in B.C.’s current primary care crisis, and the costlier care is compounding the problem.
That conclusion is widely agreed on by expert analysts as well as frontline physicians increasingly speaking out about their inability to continue to prop up the health-care system on an inadequate and antiquated pay system that’s seeing increasing numbers walk away from family practice.
CTV News asked one of Canada’s experts on health-care systems whether the government’s desire to avoid the negative optics and experience associated with hallway medicine and crowded hospital waiting rooms may have been a motivator in directing funding towards urgent care centres and hospitals.
“As a Band-Aid, when people are really struggling to access primary care, I guess it's understandable as a choice,” said Dalhousie associate professor of Family Medicine, Ruth Lavergne. “We've all experienced those waits in the emergency department, but as a solution this doesn’t fully address that issue and it has really deflected attention away from the real need for relationship-based primary care in the community.”
She also pointed out that hospital wait times are publicly posted and it’s easy to tabulate how many injuries or illnesses are handled, but the care that family doctors and nurse practitioners provide upstream in the medical system prevent more serious disease and worsening of symptoms, which is difficult to quantify.
“It's true it's harder to measure and it's not a quick fix to try to build a more robust primary care system and I think that's kind of what got us into this mess,” said Lavergne. “This is a problem many years in the making.”
EARLY INTERVENTION MORE EFFECTIVE, CHEAPER
Until now, focussing on tackling the more obvious, visible, signs of a strained health-care system made for good headlines, presenting the government as proactive and willing to try new things. But urgent care centers in particular have not provided the efficient emergency-department-avoiding service they government claimed they would.
“What's clear now is that despite significant investment, these centres have fallen short of meeting the population needs,” said long-time family physician, Dr. Kathleen Ross. “Without family doctors, British Columbians don't have access to that continuity of care and personal relationship that evidence repeatedly shows leads to better outcomes and, perhaps important to society, lower overall costs to achieve those better outcomes.”
She says that a hospital visit costs much more than a visit to a primary care provider, but with physicians trained in family medicine opting to practice in hospitals or other settings rather than run their own business for considerably less money -- the government has to act.
“Health-care systems are complex and certainly challenging to change overnight,” Ross acknowledged. “But there’s no question now that we're in a crisis of access to doctors in British Columbia and the government will need to work quickly to doctor to address the crisis.”
THE HEALTH MINISTER RESPONDS
The health minister, who was the subject of a rare public rebuke by a doctors’ association two weeks earlier, addressed the question of priorities when asked by CTV News on Wednesday.
"I absolutely agree with you about the central role in primary care in the health-care system, its role in prevention but also it's role of navigating people in the system," said Adrian Dix.
But he defended his government’s record in supporting the establishment of 59 primary care networks in the province, as well as 27 Urgent and Primary Care Centres, though his ministry will not provide full details on how many patients are seen on an urgent or ongoing, longitudinal basis.
“I don't think there's even the slightest bit of doubt about this, that we've given more priority to primary care than any other government in the history of British Columbia," Dix claimed.
But that pronouncement is at odds with what the premier has acknowledged is “a crisis” with some one million British Columbians without a primary care provider, and veteran frontline medical personnel who say they’ve never seen the system in such rough shape.
While Dix emphasized the impacts of the pandemic, Ross characterized it as a “last straw” situation.
“Physicians have literally been carrying the primary care system for decades, paying a personal ‘passion tax’ by continuing to subsidize the cost of running a practice and ensuring their patients receive the care that they need,” she said. “Physicians are telling us it's simply no longer possible for them to compensate.”
CTVNews.ca Top Stories
Poilievre will do 'anything to win,' must condemn Alex Jones endorsement: Trudeau
Prime Minister Justin Trudeau is ramping up his attacks on Conservative Leader Pierre Poilievre as he promotes his government's federal budget.
'My stomach dropped': Winnipeg man speaks out after being criminally harassed following single online date
A Winnipeg man said a single date gone wrong led to years of criminal harassment, false arrests, stress and depression.
'One of the single most terrifying things ever': Ontario couple among passengers on sinking tour boat in Dominican Republic
A Toronto couple are speaking out about their 'extremely dangerous' experience on board a sinking tour boat in the Dominican Republic last week.
Ottawa injects another $36M into fund for those seriously injured or killed by vaccines
The federal government has added $36.4 million to a program designed to support people who have been seriously injured or killed by vaccines since the end of 2020.
Video shows suspects waving weapons, smashing glass in Toronto jewelry store robbery
Arrests have been made after five men were captured on video rampaging through a jewelry store in Toronto, waving weapons and smashing glass display cases.
Ex-SNC executive sentenced to prison term in bridge bribery case
The RCMP says a former SNC-Lavalin executive has been sentenced to three and a half years in prison in connection with a bribery scheme for a bridge repair contract in Montreal.
What Canadians think of the latest Liberal budget
A new poll suggests the Liberals have not won over voters with their latest budget, though there is broad support for their plan to build millions of homes.
opinion Why you should protect your investments by naming a trusted contact person
Appointing a trusted person to help with financial obligations can give you peace of mind. In his personal finance column for CTVNews.ca, Christopher Liew outlines the key benefits of naming a confidant to take over your financial responsibilities, if the need ever arises.
Teacher shortages see some Ontario high school students awarded perfect grades on midterm exams
Students at a high school in York Region have been awarded perfect marks on their midterm exams in three subjects – not because of their academic performances however, but because they had no teacher.