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Comment: Victoria’s doctors strive to improve patient care

When we talk about the challenges in primary care in B.C., it’s important to remember we are not alone — access to care is an issue faced by patients all across Canada.

When we talk about the challenges in primary care in B.C., it’s important to remember we are not alone — access to care is an issue faced by patients all across Canada. These issues have been years in the making, and long-term solutions will not be easy or quick to implement.

That said, significant changes are underway, many of them thanks to the hard work and leadership of local doctors working with partners at the community level. These doctors take this work on in addition to running their practices and caring for patients.

Many changes are happening through the Divisions of Family Practice, local groups of physicians funded by government and Doctors of B.C. to form all-important relationships among physicians, government, health authorities and other health care providers, without which this work could not succeed.

Here are some examples. Physicians in the South Island and Victoria Divisions of Family Practice are helping seniors in residential care, who have faced significant challenges getting medical care when and where they need it.

In Victoria, nearly half our family doctors who care for patients in residential-care facilities are participating in a program that provides regular physician visits to those facilities. Through this program, visits to care facility patients within a 90-day span have increased from 37 per cent to 97 per cent. This means that seniors receive more consistent care, there are fewer hospital transfers (reducing pressure on ERs), and physicians are planning regular, more efficient visits to care facilities, giving them more time to see patients in their practices.

We’re also working to improve patient access to continuous primary care. We recently recruited four new doctors to the Peninsula Medical Clinic in Sidney, and have connected nearly 2,000 patients with these physicians. In fact, since 2013, the South Island and Victoria Divisions of Family Practice have recruited more than 40 physicians, helped 47,600 patients find family doctors, and strengthened the doctor/patient relationship for an additional 80,000 patients.

But attracting more doctors isn’t the only way we’re working to improve access to care. We’re also working to give patients access to whole-person care through teams of care providers. Integrating teams of health care professionals into physician practices — nurses, nurse practitioners, social workers and dietitians, to name a few — is an important trend in care.

An example is the Saanich Youth Clinic, where a team of two family doctors, a psychiatrist and a mental health counsellor provide care for at-risk youth one night per week (six to 12 patients per night). These vulnerable patients would otherwise need to travel to downtown Victoria for these services, or would perhaps not receive care at all. All costs for this clinic are covered by doctors, the community and youth volunteers.

We have also worked to establish three school-based primary-care clinics staffed by teams of doctors, public health nurses, Island Sexual Health staff and Ministry of Children and Family Development counsellors. These clinics provide one-stop care for teens who might otherwise experience barriers to accessing health services.

All these projects — and countless others — are underway on the Lower Island and around the province, bringing positive change to local communities, one step at time.

We want to emphasize that physicians are doing this important work at a time when our working environment is far more complex and high-pressure than ever. In addition to diligently caring for patients, our colleagues put in many extra hours keeping up with a large administrative burden, doing additional clinical work in nursing homes, providing specialist services such as hospital care and palliative care, and more.

These demands have grown significantly over the past decade, consuming more of physicians’ time and energy. And yet, doctors continue to lead and champion change in our health-care system and to passionately advocate for our patients.

As we noted at the start, the challenges facing our health-care system today are deeply ingrained. There is much work to be done, through broader structural changes to the way the system works, and through continued investment in partnerships that allow for innovation, particularly at the community level.

We hope to see the kinds of achievements highlighted in this article enhanced and expanded throughout the Island and our province.

Dr. Robin Saunders is the chair of the South Island Division of Family Practice, and Dr. Aaron Childs is GP member of the Victoria Division of Family Practice.