Green Party calls on B.C. government to take urgent action on family doctor shortage

Hundreds of thousands of British Columbians do not have a family doctor and the provincial government needs to rectify the situation immediately, says the leader of the B.C. Green Party.

Sonia Furstenau, the leader of the B.C. Greens and MLA for Cowichan Valley, made the statement during a Wednesday morning news conference.

She said up to 900,000 provincial residents need a physician and called on the B.C. NDP to overhaul the province's current fee-for-service model — saying the restructuring is critically needed to attract and retain doctors because the shortage is predicted to keep growing.

Under the model, doctors and hospitals are paid by the province for each office visit, test or operation. To stay afloat, she says, they need to continuously work through a high volume of patients and run a business at the same time.

This model, said Furstenau, is turning prospective doctors away from B.C. and also leaves those fortunate enough to have a doctor right now afraid of what will happen when their physician retires.

"People have been without access to consistent quality health care for quite some time and it's reaching a breaking point," said Furstenau. "We need an all-hands-on-deck approach."

In a statement released after the news event, the Green Party laid out specifics of its request, including modernizing the fee-for-service model and expanding alternative payment models.

"This government needs to explore models of practice that maintain or improve the current level of in-person, in-community care that doctors are providing," said Furstenau in the statement.

Speaking to reporters, she noted the impact of the pandemic on the mental health of British Columbians has yet to be fully realized and said, in combination with growing wealth inequality and an aging population, that will put further strain on an already stressed system.

"Now, more than ever, people need access to quality primary care," she said.

Beyond the call of duty

Dr. Dan Cutfeet is a senior physician with the Namgis First Nation in Alert Bay, B.C. He told CBC's The Early Edition mental health services have really taken a hit during the pandemic.

He said it usually took about two weeks for a patient to access a mental health counsellor before anyone had heard of COVID-19. Now, he says, it's a wait of at least two months.

"It always has, in many ways, fallen to a family physician where, you know, I might be seeing somebody weekly and sort of counselling them in sessions, but that's sort of taken on more importance now, just because we can't access the mental health that we need."

Alert Bay is a village on Cormorant Island, located about a 40-minute ferry ride from Port McNeill on Vancouver Island, the closest urban centre. Along with two other Indigenous physicians, Cutfeet treats patients for three remote First Nations in the region. 

"You're not just a family physician. You're not just working on their hypertension, but, you know, covering emergencies in hospital ... delivering babies, fixing fractures and assessing traumas and witnessing deaths and palliating and, you know, helping people accessing housing and deal with financing issues. The list goes on."

Help wanted

Cutfeet said it is a wonderful place to live and work with incredible community ties, but that his job would be much easier if there were more medical professionals available in the area so patients could consistently get X-rays and lab tests completed in a timely manner.

"We definitely need more bodies on the ground in terms of paraprofessionals and doctors and nurses. We kind of need everybody."

Doctors of B.C. — which represents physicians and medical students in the province — has said burnout is partly to blame for the lack of available doctors.

Dr. Ramneek Dosanjh, the president of the organization, told CBC in January the province should focus on making family practice more attractive to more doctors while enhancing patient care.

Retention is key, she said, and efforts should be made to offset things like business cost premiums for physicians in existing offices.

Dosanjh said doctors are keen to explore different ways to be compensated for their work and Doctors of B.C. is working with the province to find alternatives to a fee-for-service model.

"Our goal is to provide a range of ways for doctors to receive their compensation so they can choose which one works best for them," Dosanjh said.

In November, a report published in the Canadian Family Physician Journal found up-and-coming family doctors are choosing more hospital-based work and specialized practice rather than family medicine — in part because they're worried about the consequences of B.C.'s fee-for-service model.

The report — which interviewed 63 young doctors across three provinces, including B.C. — found many respondents would prefer alternative funding models.

In an emailed statement to CBC News, the Ministry of Health said it has recruited 950 new full-time-equivalent family physicians and other allied health workers since 2018, and more than 1,000 are "on the way."

"Measuring how many people have a primary care provider and how many need a primary care provider is difficult," the statement reads. "The measures that are presently available, such as the Canadian Community Health Survey, are estimates and do not necessarily accurately describe the true number of people who are without a primary care provider at any given time in our communities. The ministry is working on several strategies to address this issue so we can get a better understanding of attachment."

The province says it has expanded postgraduate medical training at UBC, and has added nursing seats at post-secondary institutions province-wide. 

The ministry also says it will be announcing details of its plan to address capacity issues throughout the health-care system "soon."