A provincewide dearth of dermatologists is set to hit Prince George in the coming months as the city's lone specialist shuts down his practice.
Dr. Michael Martindale has informed Northern Health that as of Dec. 31 he will close his practice, leaving no Medical Services Plan dermatologists between Prince George and Kelowna.
With 24 vacancies across the province, B.C. section of dermatology president Dr. Evert Tuyp said the chronic shortage of physicians in his specialty could make it difficult for Northern Health to recruit a replacement.
"This isn't a problem just in the north, this is a problem across the entire province," he said. "If Victoria can't find someone, do you think anyone else will be able to?"
Northern Health spokesman Steve Raper said the health authority has a plan it puts in place when it's notified a specialist is leaving a community due to retirement, a new job, family reasons or other causes. Although he didn't address the dermatologist situation in Prince George specifically, he said Northern Health is confident it can fill specialist vacancies as they arise.
"As we find out when these things happen we prepare and we initiate the recruitment process," he said. "We activate the various resources we have to look for a permanent replacement for a particular position."
If a specialist does leave and no immediate replacement is recruited, Raper said Northern Health will look at the possibility of bringing in locum coverage to fill the void.
Raper said Prince George can be an attractive market for specialists because of the opportunities outside of the clinic.
"I think in partnership with the Northern Medical Problem, the teaching opportunities, as well as the lifestyle and standard of living here makes Northern Health pretty competitive when we go out and look for particular specialists to come to our communities and work," he said.
Prince George is hardly the only city feeling a dermatology crunch. Two physicians in Kamloops recently de-enrolled from the Medical Services Plan to protest the low fees paid to dermatologists in B.C. One is now commuting to Newfoundland to practice, while the other is splitting time between Newfoundland and a private fee-for-service practice in Kamloops.
The one dermatologist in Kelowna would then be the closest option for Prince George patients,but she currently has a six-month waiting list.
Tuyp said the problem in dermatology is systemic. The low fees paid to dermatologists in B.C. compared with other provinces make it difficult to recruit physicians from other jurisdictions and UBC only graduates three dermatologists each year. Many of the made-in-B.C. specialists also leave the province for better-paying jobs.
"We have a situation at UBC where they're training too many of certain types of specialties," Tuyp said. "Maybe people are applying to dermatology and are told, 'no, no, no, we don't have a spot for you, but you can become an orthopedic surgeon and guess what when you're done, there won't be a job for you.' "
Skin conditions are a common reason why patients visit their family doctors and general practitioners can handle many of those cases, but dermatologists are needed when serious or unusual cases come up.
In the coming months when Prince George will be without a full-time dermatologist, Tuyp said the impact on patients could be disastrous. He said people could be forced to travel hundreds of kilometres and have their name put on lengthy wait lists.
"That's awful if your two-year-old child has eczema and wakes up every night and wakes you and you have to go to work the next day," he said. "That's awful if you have a painful condition like shingles; that's awful if you have something and you're not sure it's a skin cancer; that's awful if you've had a skin cancer and you're worried about getting another and you need followup care."
