The disenfranchised and those without family doctors have always landed in emergency departments but that’s “exploded” in the last few years, Victoria ER physician Dr. Simon Hoogewerf told the B.C. Health Care Matters rally at the legislature on Thursday.
“So it’s gone from a little trickle to a tsunami of patients who just don’t have a family doctor to look after them and it has an impact in so many ways,” Hoogewerf said in an interview.
The rally drew about 1,000 people the the legislature, many carrying signs reading “Everyone Deserves a Family Doctor.” Many in the crowd were family doctors and nurses from the Island and Lower Mainland.
Camille Currie, the founder of B.C. Health Care Matters, which is now morphing into Canada Pacific Health Care Matters Society, started the organization in February after learning she would lose her physician at Eagle Creek Medical Clinic in View Royal in April.
She has since whipped up support from doctors, nurses and people both without a family doctor and those in fear of losing one, and the organization’s main petition, presented in the legislature by health critic Shirley Bond, has more than 42,000 signatures.
About 900,000 British Columbians are without a family doctor, including about 100,000 on the south Island. A recent report by Medimap said Victoria had the longest waits in Canada for walk-in clinics.
Hoogewerf told the crowd that patients come into the emergency department with illnesses that could have been prevented, managed or treated in early stages under a family physician. Instead, they end up in the emergency department as complex, critical or terminal cases — issues that can’t be dealt with in one urgent visit.
“It’s really complex medicine and only family doctors can do it,” Hoogewerf said. Often, patients are discharged with no one to follow up with. “It breaks our hearts.”
Victoria cardiologist Dr. Peter Gladstone said one third of heart attack patients are discharged with no family doctor to navigate them through critical follow-up care, “nobody to renew their medications — or adjust them — or see the complications that may develop.”
“Even more frightening,” he said, “is how many would have avoided the heart attack, or stroke or advanced cancer in the first place with adequate primary prevention from a skilled, caring family doctor.”
The NDP government was criticized for both its inaction and some of its solutions, including the province’s network of urgent and primary care centres.
“The government has spent $100 million on UPCCs across the province and today none of them are fully staffed and few provide any longitudinal care,” Gladstone said. “They basically provide walk-in care at two to three times the cost of a family doctor.
“You could put a UPCC on every street corner but they’ll be of less use than a Tim Hortons unless they’ve got doctors in them — qualified doctors providing long-term, comprehensive care.”
B.C. has about 6,800 trained family doctors — yet only about 3,500 are practising in that role, according to Family Doctors for Better Patient Care in B.C.
Premier John Horgan and Health Minister Adrian Dix tried to head off some of the discontent this week by meeting with the Doctors of B.C. and issuing a statement promising a clear process and timelines to take action.
“I’m very pleased this is underway and I have to say we have a collaborative working relationship but this crisis — and it is a crisis — didn’t arrive yesterday, and it didn’t arrive five years ago or 1o years ago," Horgan said. "It’s been building over time."
In question period, B.C. Green Leader Sonia Furstenau said millions of British Columbians are at risk of losing their family doctor and asked how the government would protect those relationships.
Dix said the premier is committed to a system of team-based primary care and to ensuring people have access to a family practice doctor, which “is why so much priority is given to this area now, has been throughout the pandemic, and will be over the coming days and weeks as we work with family practice doctors on the real challenges that they face.”
Doctors, who are typically paid using a fee-for-service model in B.C., have been asking the province for more options when it comes to how they’re paid, such as salary or contracts or enhanced fee codes, along with financial assistance with overhead costs, provision of more allied health professionals, more training spaces for physicians, and an improved accreditation process for foreign-trained doctors.