Retiring family doctor worries about the future of his patients without changes to the job

Everyone should have access to a family doctor. That is the message from a longtime family physician in Kamloops, B.C., who shared his thoughts in a recent letter to a local newspaper. 

Dr. Grant Del Begio has added his voice to a chorus of concerns over the fact that almost a million British Columbians are without a family doctor.

As he nears retirement, his office regularly gets calls from people searching for a family physician, he says. 

Daybreak Kamloops host Shelley Joyce spoke with Del Begio about his concern for the future of family medicine in B.C., and what can be done to support current family doctors.

The following transcript has been edited for clarity and length.

Why did you write the letter? 

I wanted to share a little of my experience of having been a physician here for nearly 30 years in Kamloops and having really enjoyed it. I felt it was a great privilege to be a family doctor and do that full scope of family medicine, from delivering babies to end-of-life care, but also my sense of concern that this privilege of doing this well has been eroded over time.

What do you think needs to be done to bring in more family doctors? 

The stress of running an office has really increased and very much, I would say, the cost and the time commitment to do that have not been met with support. The government has tried in ways and I think increasingly in recent years has started to move in that direction to be of some support in this area, but really it's not happening to the extent that it needs to. 

Even the family doctor residents that we train, you see it — they vote with their feet.

I try to certainly help them see and embrace this role as a family doctor but there's a resistance to take on the responsibility of running an office, of even taking on that longitudinal care of patients, because it seems like something they don't want to be encumbered with over a long time. 

We need to keep training family physicians, but we also need to support them in the overhead of running their office, in office supports and in just decreasing the amount of bureaucracy and paperwork that they can get bogged [down] in so their evenings are not spent doing that sort of stuff. 

What kind of support do doctors need from the government? 

I think part of it is some more creativity in terms of even the way family doctors are remunerated. So these are some of these alternative payment systems that we've been trying to work out with the government.

I think just understanding that the time that they put in after hours, for the government to acknowledge that, because most people sort of think, OK, well, they see their family doctor, maybe it's a 15-minute visit as far as that goes. They get paid just over $30 for that.

But they don't appreciate that all the care of following up lab tests, of writing up the chart afterwards, of making referrals as needed, reading those referrals when they come back or those consult notes — all that is extra time that goes beyond that visit. 

What comes next for you? 

I am getting to that point where I'm kind of winding down my practice somewhat and reducing my hours. I've been fortunate enough to have some younger family physicians working with me and willing to take over the patients in my practice. 

But most doctors who've retired in recent years certainly haven't had that and there's others that are maybe close to that. But I want to keep working in terms of teaching the next generation of physicians to have a passion about doing family medicine.