A Saanich family physician says his inability to give away, nevermind sell, his family practice is an indication of a system broken beyond repair.
Dr. Chris Pengilly, 68, says his futile attempt to find someone to take over his practice exemplifies the shortage of physicians and the challenges posed by a generation of doctors who don’t want the responsibility of owning a family practice.
“I have advertised literally all over the world,” Pengilly said. “I have had not one positive response.
“Not one of this year’s graduates coming out of medical schools and family practice residencies is interested in pursuing full-service family practice.”
The Saanich doctor said his Tuscany Medical Clinic has the latest equipment and computerized records. He works with a group of doctors so there’s shared resources and back up. Still, he says, there have been no takers.
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New doctors are interested in primary care but would rather work as hospitalists, locums or in urgent-care clinics, Pengilly said.
Retiring family doctors don’t blame new doctors for wanting to avoid what some say are the headaches of family practice: having sole responsibility for hundreds of patients, overhead, human resources issues, overtime, little vacation relief, keeping up to date on drugs and science, and an abundance of paperwork.
B.C. needs about 450 new doctors a year to keep pace with current demand, said Dr. Bill Cavers, president of Doctors of B.C. The province’s medical schools graduate 288 a year. “The figures are a bit alarming,” said Cavers, who has been practising medicine in Victoria for 34 years. “I don’t think there is a community in B.C. that is not looking for more family physicians.”
And because new doctors expect a healthier work-life balance, meaning many won’t commit to longer work days, he said it’s thought there will need to be 1.5 doctors to replace the average older retiring doctor.
In recent weeks, Dr. Dave Williams, 53, has found a doctor to replace him at his Feltham Medical Clinic, off Shelbourne Street in Saanich.
Williams is one of three doctors in Victoria currently advertising a business in the B.C. Medical Journal’s online classified ads. About 83 listings placed by B.C. doctors appeared over the past year, according to Doctors of B.C.
Williams is delighted he found someone to look after his patients.
“I know how hard it is, it’s kind of like selling the house on the block that no one wants to buy. It’s been difficult,” Williams said.
Retiring family doctors who don’t find replacements are required under federal law to maintain patients’ records for 16 years.
Williams leaves Dec. 1. After 26 years, the toll of the work overtook the personal and professional rewards of the job, including a handsome income, he said.
The future of family practices in B.C. is at risk, despite some favourable efforts to save it, he said. Of about 24 doctors trained in Victoria each year, few choose family practice.
“New doctors come from a different mindset,” Williams said. “The future of family practice is at risk. We haven’t been successful in Victoria at taking new grads into family medicine.”
There have been improvements in recent years, Cavers said, citing the creation of the General Practice Services Committee as a catalyst. The committee, formed in 2002 to increase the number of graduates going into family medicine, provides incentives and support to physicians.
Since then, the number of new graduates going into family practice has risen to 34 per cent from 23 per cent — a “pretty good turnaround,” Cavers said.
Pengilly disagrees, saying the committee has been a help but certainly not a cure. For example, he said, the financial incentives have come with extra paperwork, adding to the workload of family physicians. Instead, he said, the solution includes fixed hours, staff and facilities provided by a health authority and an improved fee-for-service schedule.
Cavers said part of the solution includes co-operatives of family physicians working with non-physicians (nurses and pharmacists, for example) who will essentially extend the reach and work of family doctors.
For Williams, the answers lie with new graduates themselves.
“We have to talk to residents and talk to them about their barriers to family practice and do whatever we can to create a clinic they want to work in.”