A Family Doctor Prescription Fixing Primary Care

The rise of corporate health-care providers in British Columbia is worrying, says Jeanette Boyd, president of the BC College of Family Physicians. But she says it really needs to be recognized as a symptom of a deeper disease.

Andrew MacLeod 14 Sep 2020 | TheTyee.ca
Andrew MacLeod is The Tyee’s Legislative Bureau Chief in Victoria and the author of All Together Healthy (Douglas & McIntyre, 2018). Find him on Twitter or reach him at amacleod@thetyee.ca

“Absolutely they are filling a vacuum, but it’s a vacuum I feel is artificial and can be addressed in other ways,” she said. “If we all work together, we can potentially find solutions that don’t bring in the same inherent risk that bringing in a big corporate agency does.”

The problem is not a shortage of doctors. The province is producing more family physicians than ever, she said, but the system encourages them to move into other areas of practice.

Doctors get into family medicine because they want to make a difference and value the long-term relationships involved in providing direct patient care, she said. But they find the fee-for-service system, where each visit or treatment is assigned a dollar value, doesn’t allow them to spend as much time with patients as they may need.

“There is that need for the immediate gratification, and we know those investments in primary and preventative care, looking at dealing with the social determinants of health and access to housing, access to important food security, preventative health care, we don’t see the benefits of that until three or four or 10 election cycles,” she said.

So governments tend to focus on areas where they can have an immediate impact, like improving access to surgeries or urgent care, Boyd said.

“We’re seeing this disproportionate emphasis on things that are absolutely important, but perhaps aren’t leading to the longer term, high-quality impacts that we’re really needing to see for the broader sustainability of the health-care system overall.”

Corporations like Telus and Well Health Technologies Corp. have stepped into that fractured system.

They offer services that many patients find convenient, and it is understandable why doctors might choose to work for them, Boyd said. It’s a model where they can show up at work and earn a salary without the headaches or long-term responsibilities of running the business themselves.

Boyd said use of corporate services often leads to extra costs for the system. Patients may consult the online service and then go to their doctor for the same issues. Duplicate tests may be ordered.

The provincial government could do much to improve primary care, Boyd said.

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