Growing shortage of family doctors a crisis

Anna Echols said when she found herself at a cocktail party politely grilling a physician about how to become a patient of another family doctor in his practice, she realized how desperate her search had become.

Echols, 44, and her husband moved to Vancouver Island from Winnipeg last May. Unable to find a family doctor, they have been reliant on the walk-in services of the Central Saanich Medical Clinic ever since.

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Statistics Canada’s Canadian Community Health Survey estimates that 11.1 per cent of Island Health’s population of 765,000 had no regular medical doctor in 2013/14. Of those, it notes 3.5 per cent of the population was actively looking for a physician. Whether the remainder didn’t want one or gave up their search, it doesn’t say. The survey is the most recent data available.

On southern Vancouver Island, the survey said 15.9 per cent were without a regular doctor, with 5.1 per cent actively looking. The provincial rate is 15.4 per cent with 4.4 per cent actively looking.

Once Echols arrived here, she learned of a new female GP who was relocating to the area.

“I kept asking every month. I kept saying to the person that said she’s coming, is she set up yet?” Echols said.

Dogged in her pursuit, Echols tracked down the Sidney clinic where the doctor would open her practice, tried to leave her name to get on a waiting list before the doctor’s arrival, and called the clinic to check in.

“I kept calling the clinic and they said she’s not taking names yet, she’s not taking names yet,” Echols said. “And I called two weeks later, and they said: ‘Oh she’s full up’ … that’s when I got really upset with the process.

“I said, I’m done with this, so we now just go to the walk-in clinic,” Echols said. “I should have been the first person on whatever list there is.”

Echols acknowledges her walk-in clinic is exceptional and her story is not unique across Canada, but said given the number of people who will move to the West Coast in coming years, it behooves the federal and B.C. governments to figure out why some areas of health care are working and apply those lessons to what’s broken and causing the family doctor-shortage crisis.

“I joined the Peninsula Newcomers Club, and there’s about 150 women in that club and most of them don’t have family doctors,” Echols said.

She questions the arbitrary way patients find doctors and the tactics patients must employ — networking or presenting themselves as healthy and low-needs — as ways to get onto a doctor’s busy roster.

“You feel like that’s what you’ve got to do, dress up and go job-hunt, doctor-hunt,” Echols said.

Desperate, Echols said she plans to call her former GP in Winnipeg and offer to find him a practice and a home if he will relocate.

But it’s not just newcomers who find themselves without a family doctor in the capital region. With an aging population, many patients are being orphaned by retiring doctors.

The average age of family doctors in B.C. was 51.2 in 2014. In the South Island, it was 53.2.

Tammy Barry, 46, of Metchosin calls the doctor shortage here a “horrible situation.”

About a month ago, her family received a retirement notice from their family doctor of more than 20 years. He is retiring as of April 30. She supports his right to do so, but had no time to plan.

“Holy smokes, I knew it would be coming but didn’t expect it to happen now,” Barry said in an email.

Since that time, she has been trying to find a doctor who will take her and her husband, 51, and two grown children, 18 and 20.

Ideally, a retiring doctor can sell or transfer his or her practice to a new doctor or other doctors within the same practice.

With funding from the A GP for Me program, the province is trying to provide incentives for new doctors to take over practices of retiring physicians.

In 2014, Saanich family physician Dr. Chris Pengilly complained he couldn’t give away, never mind sell, his Tuscany Medical Clinic practice, replete with the latest equipment and computerized records, citing a health-care system broken beyond repair.

Pengilly said he advertised all over the world and didn’t have one positive response until after a newspaper story about his woes.

He said graduates coming out of medical schools and family-practice residencies aren’t interested in pursuing full-service family practice and would rather work as hospitalists, as locums or in urgent-care clinics.

In a worst-case scenario, when a family practice closes due to a retiring physician, patients scramble on their own to find a family doctor and their files are sent to secure storage.

In June, Dr. Brian S. Pound, 77, retired after nearly five decades as a family doctor in Greater Victoria. His colleague Dr. Brad Hunter, 66, also decided to close up shop.

The pair tried to sell their McKenzie Avenue practice, advertising in medical journals, but no one at the time was willing to take on the building’s five-year, $4,200-per-month lease.

Under federal law, retiring family doctors who don’t find someone to take over their practices are required to maintain patients’ records for 16 years, so the pair moved to sign over patient medical records to DOCUdavit Solutions Inc., a document-storage company based in Ontario. The files can be transferred to patients’ new doctors — assuming they can find one — or to patients themselves for a fee.

A family doctor is not legally permitted to hand patients their original records.

Barry said she’s making calls, only to hear: “Sorry, we are not taking patients.”

“What is one to do? I guess we have two choices: Either not go to a doctor or sit in a clinic waiting room for hours.

“We pay our medical just like everyone else; we should be able to get the same level of service,” Barry said.

An administrator at Sitka Health Centre on Fairfield Road was too busy to speak Wednesday, saying she has a “huge wait list,” 18 pages of people hoping to see Dr. John Jerome, who had been accepting new patients months ago. Vacancies for doctors accepting new patients “fill up the same day,” she said.

The Victoria Medical Society website has said since December there are no family doctors currently accepting new patients. Similarly, the College of Physicians and Surgeons’ website doesn’t show any family physicians taking new patients in Victoria.

In Victoria, eight doctors have left their practices since December. The Victoria society, through its phone line and website, tries as a public service to help guide often “desperate” Greater Victoria residents “going to doctor to doctor to doctor” toward finding a family doctor, said Jo Ann Dubney, the society’s co-ordinator.

“We don’t have any family doctors taking patients currently,” Dubney said. “The last two months isn’t the worst I’ve seen it, [but] I’d say it’s the most devastating gap of doctors that we’ve had since I’ve been in this job 10 years.

“One after the other has been closing down, so the calls to our office have increased by 50 per cent.”

ceharnett@timescolonist.com

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