My family doctor retired about two years ago, and while he was entitled to retirement more than any working person I have ever met, I have to say that his departure was tough to accept, as I knew it would potentially place my family amongst the 30 per cent of residents who do not have a family doctor.
Typically, the incoming doctor does not take over the full patient panel.
Thankfully, we were lucky and were accepted by his replacement, but the others would have to join the ranks of the unattached.
Today’s graduating doctors are, rightly, trying to achieve a work-life balance that the previous generation of family practitioners struggled with due to the construct of society during their time of practice.
This change of attitude has meant that for every doctor who is retiring, two to three doctors are needed to replace them.
Locally, looking at our doctor retirement patterns over the next five years, we will need an additional 19 doctors to cover our population and our local doctors are sounding the alarm, again, because they know that the present system of doctor recruitment is not working.
They also know that if the provincial government does not assign and fund responsibility for doctor recruitment to a designated body, the crisis of doctor shortages that is already upon us, is only going to get worse. Now the public is being asked to assist.
Divisions of Family Practice are community-based groups of family physicians working together to achieve common health care goals. Over and above the demands of their day to day clinic work, they collaborate with each other to focus attention in areas of need, such as residential care, patient attachment, the opioid crisis, mental health and addiction treatment, youth clinic, pain management and the frail elderly, so they are already doing their fair share of improving health care.
Our local Division of Family Practice recently made a presentation to Maple Ridge council and outlined the plight that we, as a community, are facing due to the doctor shortage.
In their presentation, the division referenced the new primary care model that the government is implementing that involves grouping family practices into what would be referred to as Primary Care Networks.
The model is already in place in Alberta, Quebec and Ontario and other parts of the world. The model assists a network of family practices in improving patient outcomes by having a suite of patient supports, such as a nurse practitioner specializing in frail elderly, or a diabetes specialist working directly with the network. Preliminary work in this area is already being met with positive feedback from both the doctors and patients, so it makes sense to explore supporting the move to this model.
However, it is understandable why the doctors are hesitant to embrace a new model that is void of targeted steps that will address the immediate doctor shortage crisis, which the public should also have concerns about, as the model, even though promising, will not replace the doctor-patient relationship that is non-existent for 30 per cent of the population – a number that could climb when the last of the older doctors retires over the next five years.
So far, the government has not committed to funding or assigning a recruitment program. The previous government implemented one in 2013, called A GP for Me, but it ended three years ago. And although it did not live up to its name and the promised results, it had a good measure of success throughout the province and especially for our community, so the Division of Family Practice knows that targeted work will assist with recruitment.
The Division of Family Practice is a forward thinking, focused team of doctors and staff who are pursuing solutions to primary care gaps in our community and they embrace that work.
However, the solutions for doctor recruitment to primary care is out of their realm of expertise, even though, historically, it was traditionally left up to the doctors to sell their practice to an incoming doctor when they retired.
However, due to circumstances out of their control, those days are few and far between, as there are very few doctors willing to buy a practice anymore, as they don’t want the headaches of operating a business, so any thoughts that recruitment still remains with doctors is outdated.
The division cited a number of reasons for the doctor shortage in their report to council in order to elaborate the complexity of the issue, as it goes beyond the attitude shift within the graduating doctors.
The reasons included the high cost of living in the Lower Mainland, a limited number of medical seats at UBC, a limited number of residency positions for international candidates, a highly regulatory College of Physicians that places greater barriers to international doctors than what is exists in other provinces.
The division also mentions that the college also imposed stringent licensing demands that have caused retired doctors to not renew their licenses, which has impacted locum coverage and walk-in clinic coverage, as the retired doctors were the ones that did this work.
And, finally, health authorities are scooping up doctors who are opting for the 9-5, Monday-to-Friday routine of that system.
Doctors could easily just close their doors, because they have no obligation to the government to take on the task of recruitment, but they don’t, as they care about their patients and are, instead, advocating for government to take responsibility for recruitment.
If you agree with this, then please be watchful for the public petition that the Division of Family Practice will be launching and support their message to government that it is time to fund and assign responsibility for doctor recruitment appropriately, so that we all can reap the benefits that come from the doctor-patient relationship.
Cheryl Ashlie is a former Maple Ridge school trustee, city councillor, constituency assistant and current
citizen of the year.
