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
Doctors say capital gains tax changes will jeopardize their retirement. Is that true?
The Canadian Medical Association asserts the Liberals' proposed changes to capital gains taxation will put doctors' retirement savings in jeopardy, but some financial experts insist incorporated professionals are not as doomed as they say they are.
Something in the water? Canadian family latest to spot elusive 'Loch Ness Monster'
For centuries, people have wondered what, if anything, might be lurking beneath the surface of Loch Ness in Scotland. When Canadian couple Parry Malm and Shannon Wiseman visited the Scottish highlands earlier this month with their two children, they didn’t expect to become part of the mystery.
Fair in Ontario, flurries in Labrador: Weather systems make for an erratic spring
It's no secret that spring can be a tumultuous time for Canadian weather, and as an unseasonably mild El Nino winter gives way to summer, there's bound to be a few swings in temperature that seem out of the ordinary. From Ontario to the Atlantic, though, this week is about to feel a little erratic.
What a urologist wants you to know about male infertility
When opposite sex couples are trying and failing to get pregnant, the attention often focuses on the woman. That’s not always the case.
'It was instant karma': Viral video captures failed theft attempt in Nanaimo, B.C.
Mounties in Nanaimo, B.C., say two late-night revellers are lucky their allegedly drunken antics weren't reported to police after security cameras captured the men trying to steal a heavy sign from a downtown business.
Bank of Canada officials split on when to start cutting interest rates
Members of the Bank of Canada's governing council were split on how long the central bank should wait before it starts cutting interest rates when they met earlier this month.
Quebec nurse had to clean up after husband's death in Montreal hospital
On a night she should have been mourning, a nurse from Quebec's Laurentians region says she was forced to clean up her husband after he died at a hospital in Montreal.
Northern Ont. lawyer who abandoned clients in child protection cases disbarred
A North Bay, Ont., lawyer who abandoned 15 clients – many of them child protection cases – has lost his licence to practise law.
An Ontario senior thought he called Geek Squad for help with his printer. Instead, he got scammed out of $25,000
An Ontario senior’s attempt to get technical help online led him into a spoofing scam where he lost $25,000. Now, he’s sharing his story to warn others.