'I am not prepared to commit fraud' by writing false vaccine exemptions, B.C. doctor says

VANCOUVER — After a surge in demand for medical letters for vaccine exemptions, Dr. Shane Barclay has reached his limit.

In a letter to patients this week, Barclay said no exemption letters will be written for patients unless they meet the criteria set out by health authorities. A physician who writes a false medical legal letter is committing fraud: “A doctor can be charged, fined and potentially lose their licence.”

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“I am not prepared to commit fraud, so someone can avoid a vaccine,” wrote Barclay, who treats patients in the Interior at Sun Peaks Community Health Centre.

Almost immediately after the announcement that British Columbians would need proof of vaccination to access some non-essential services, the medical exemption requests started coming in, said Barclay. “About half a dozen in the first week.”

A clinic colleague, Dr. Ivan Bantock, said patient excuses for an exemption ranged “from soup to nuts.”

The allowable medical criteria for vaccine exemption are being aged 11 or younger, having received a vaccination for something else within two weeks (so you’d have to wait two weeks to get the COVID vaccine), or having a documented history of severe allergic reaction to a COVID vaccine or one of its main ingredients. (And the chances of that, Barclay wrote, are lower than being hit by lightning.)

The letter, which has gone viral, was a way to express his dismay and put all the information in one place.

Barclay said he’s given many hours of “empathetic” counsel to patients with vaccine hesitancy, listened patiently to suggestions he is part of the “medical establishment” and “big pharma,” and tried to fight fear with good information.

“I’ve been in practice over 35 years. I was a front-line physician with the AIDS epidemic in the 1980s in Vancouver. I’ve seen what pandemics can do. We’ve got a vaccine to actually battle this, and now we have to battle people to get the vaccine,” said Barclay.

The letter also outlines the policy of asking patients that need in-person care if they are double vaccinated, so that single-vaccinated or unvaccinated patients can be seen at the end of the day.

“(W)e are not ‘mandating’ vaccinations in order to see patients in person. This is not some form of ‘punishment’. We are simply trying to safeguard the unvaccinated, our staff and other patients,” said Barclay in the letter.

So far no patients have specifically asked for medical exemptions because they want to avoid employer-mandated vaccines, said the Centre’s executive director, Dr. Laura Bantock.

Bantock said the clinic has a responsibility to protect immunocompromised patients, its staff and all patients safe, and to keep the clinic, which serves 4,000 patients (and more during ski season), open. A COVID exposure that would require staff to self-isolate would mean curtailing services to the community.

“If you need to come into a clinic for an in-person appointment, and you haven’t had a vaccine, we will not deny you care but we would have to gown up in full PPE, and make an appointment at the end of the day, so the room can be thoroughly deep-cleaned before another patient comes in,” she said.

The Health Centre does provides emergency care, and exceptions would be made in those cases, said Bantock.

Dr. Matthew Chow, president of Doctors of B.C., an organization that represents some 15,000 physicians, said the situation is being echoed in clinics and doctor’s offices across the province.

“This is a good example of the practical challenges doctors face when balancing the needs of unvaccinated patients while protecting other patients, including unvaccinated children and the immunocompromised,” said Chow, who called the measures Sun Peaks Health Centre has put in place “entirely appropriate.”

“We are all trying to balance doing what is ethically and professionally right, but also protecting one another,” said Chow.

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