Time is money: B.C. doctors' group proposes 'overnight' fix for primary care crisis
A new advocacy group of B.C. family doctors is coming forward to say the primary care crisis in the province isn’t the result of too few physicians, but a matter of priorities and compensation that could be solved virtually overnight.
Family Doctors for Better Patient Care in B.C. is proposing a five-point plan to improve primary care, with the first and quickest action with the biggest impact being to pay general practitioners for the time they actually spend with patients – a move that would not require a dramatic overhaul of the system.
B.C currently pays them per visit, no matter how much time they spend with a patient, which often leads to either rushed appointments or doctors making significantly less than their hospitalist counterparts. In Alberta, family doctors are paid under the fee-for-service model, but with “time modifiers” that allow them to bill the province when they need to spend more time with a patient.
There, family practices are thriving, with hundreds of doctors currently accepting new patients.
“It's a very common sense solution to a problem that can be addressed relatively quickly,” said Dr. Carllin Man, a family doctor in New Westminster who also works in Alberta as a locum. “I know many (B.C.) doctors who spent countless hours seeing their patients and caring for them and they’re not being valued for it by our government in our current fee-for-services system.”
The document his group presented to MLAs in Victoria last week points out that B.C. has a high doctor-to-patient ratio compared to other provinces and would only require 8.8 per cent of doctors trained in family medicine to return to primary care practices to resolve the access issue; many currently work in hospitals where they make significantly more income without the burden of running a business.
“(Health Minister) Adrian Dix could do this overnight, almost,” said family doctor Erin Carlson. “It would get more doctors working as family doctors here instead of doing other work and that would help solve the crisis."
She points out that when the pandemic shuttered doctors’ offices and patients could largely only access care virtually, the provincial government was swift to adapt the system so that general practitioners could bill for telehealth on par with in-person visits.
“Solutions we could put into place right now to turn this crisis around on a dime,” insisted Carlson.
PREMIER NOW DIRECTLY INVOLVED IN ‘RESET’ WITH DOCTORS
After an eyebrow-raising misstep by the health minister that further damaged the already-deteriorating relationship with physicians when he suggested nurse practitioners provide better care, the premier is now directly involved with the situation.
“It is a crisis,” acknowledged John Horgan last week, as doctors and patients gathered on the legislature grounds to demand solutions.
He also revealed to reporters that when he met with the Doctors of B.C. earlier in the week, he considered it a “reset” of their relationship and a chance to move forward, but cautioned that true progress could only happen if the federal government accepted the demands of Canada’s premiers for more health-care funding.
“Over the decades, the federal component of delivering health care has gone from about 50 per cent to less than 25 per cent – that's had a huge impact on the government’s ability to provide services, which is our jurisdictional responsibility,” Horgan said, insisting that several payment models and funding options are on the table.
“We can't do that without an infusion of cash. the federal government is starting to come around to that and I'm hopeful we can have a new vision for healthcare in the 21st century that includes a federal government that's fully participating in the delivery of these services by funding them adequately.”
PATIENTS INCREASINGLY IMPATIENT FOR SOLUTIONS
With an estimated one million British Columbians without a family doctor, the stakes are high for those seeking a long-term relationship with a health-care provider who can see to their problems before they become serious enough to need urgent or emergency care.
But even those with family doctors are typically waiting several weeks to see them, and a few are going to considerable lengths to keep the one they have.
"I go back to Vancouver," said Victoria resident Steffani Cameron, who relies on friends to find accommodation on the mainland. "I don't feel it's an option. What other choice do I have?"
She spent more than four years travelling the world and working abroad and her experience with multiple health-care systems has her particularly frustrated at policymakers’ lack of innovation and agility to adapt to changing challenges and issues in B.C.’s system.
“I think it’s a lack of intelligence, a lack of perspective, a lack of worldliness, a lack of experience, a lack of creativity,” said Cameron. “There’s a whole lot of lacks right now with the attitude the provincial government has about medical.”
As patients struggle, so do the physicians putting in long hours of paperwork and administrative effort to keep their doors open – and finding it increasingly not worth it.
“We really need to change the system now to stop the bleeding of family doctors leaving practice,” said Man.
CTVNews.ca Top Stories
What is whooping cough and should Canadians be concerned as Europe declares outbreak?
There is currently a whooping cough epidemic in Europe, with 10 times as many cases compared to the previous two years. While an outbreak has not been declared nationwide in Canada, whooping cough is regularly detected in the country.
Ontario Provincial Police arrest 64 suspects in child sexual exploitation investigation
Ontario Provincial Police say 64 suspects are facing a combined 348 charges in connection with a series of child sexual exploitation investigations that spanned the province.
'Summer of discontent': Federal unions vow to fight new 3-day a week office mandate
Federal unions are launching legal challenges and encouraging public sector workers to file "tens of thousands" of grievances over the new mandate requiring federal workers to return to the office at least three days a week in the fall.
Watch fighter jet pilots pummel fake enemy ship off coast of Philippines
The United States and Philippines held annual joint-training drills just off the Southeast Asian nation’s western coast on Wednesday. Military forces sunk a 'mock' enemy warship – the BRP Lake Caliraya, which was a decommissioned tanker made in China.
'Ozempic babies': Reports of surprise pregnancies raise new questions about weight loss drugs
Numerous women have shared stories of 'Ozempic babies' on social media. But the joy some experience in discovering pregnancies may come with anxiety about the unknowns.
OPINION What King Charles' schedule being too 'full' to accommodate son suggests
Prince Harry, the Duke of Sussex, has made headlines with his recent arrival in the U.K., this time to celebrate all things Invictus. But upon the prince landing in the U.K., we have already had confirmation that King Charles III won't have time to see his youngest son during his brief visit.
'I killed four people': Trial hears video evidence of Jeremy Skibicki at Winnipeg trial
“I killed four people,” alleged serial killer Jeremy Skibicki told two homicide detectives during a recorded interview played as evidence in his trial Wednesday.
AstraZeneca says it will withdraw COVID-19 vaccine globally as demand dips
AstraZeneca said on Tuesday it had initiated the worldwide withdrawal of its COVID-19 vaccine due to a 'surplus of available updated vaccines' since the pandemic.
Seafood, eat food: Calgary Stampede releases Midway menu
The Calgary Stampede has released its menu of sweet, salty and spicy treats available on the Midway for the Greatest Outdoor Show on Earth.