Thousands of Islanders have virtually no prospect of finding a primary physician, but the solution may not be more doctors

By Sol Dolor October 23, 2020 

[Excerpts] There is a doctor shortage, but it’s not unique to the Island 

It’s no secret that for newcomers to Vancouver Island, it is basically impossible to find a family doctor. And for thousands of others, the retirement of a family physician can often leave them with no place to turn. In a BC Medical Journal editorial published just before the onset of COVID-19, recently retired Parksville doctor Jonathan Winner wrote that the local doctor shortage has reached crisis proportions

Physicians have a right to decide where they want to practice, which means supply will not be equal among places. As Winner pointed out in his March editorial, it’s been apparent for decades that BC doctors are increasingly staying away from family practice. As early as the 1980s, he wrote, “the family practice model we were all working in was becoming less attractive to the next generation of doctors, who were able to work in walk-in clinics.”
In a study of 11 developed countries in 2016, The Commonwealth Fund found that a fifth of Canadians waited more than seven days to see a family doctor. Seeing a specialist, meanwhile, can take four or more weeks. 

The problem, as experts told Capital Daily, is not necessarily a shortage of qualified professionals graduating from med school; Ross noted that BC has already upped its intakes of med students and residency spots. Rather, as family doctors age out, a more realistic solution may be to reform the province’s decades-old model of family doctors as the primary gatekeepers to healthcare. Instead, Ross argues, BC could do well to pursue coordinated teams of nurse practitioners, midwives and other professionals taking on the role of primary care; lightening the load on the Island’s physicians.

Contandriopoulos says Canada has been sedate in making the shift to these “intraprofessional teams,” despite vast scientific evidence showing their success in other countries. A key change, he said, is shifting the “fee for service” model, in which physicians are paid by the visit. Whether a doctor visit is for a sore throat or for the first stages of leukemia, they’re all paid the same. As one doctor told Capital Daily, it’s akin to a dentist charging the same for a tooth polish as for complex dental diagnostics. 

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