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Comment: Dix undermines morale of family doctors with comments

A commentary by a family physician in Saanich.
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B.C. Health Minister Adrian Dix gives a COVID-19 update at the legislature. Dix's recent comment comparing family doctors and nurse practitioners has angered members of the medical community, Dr. Jennifer Lush writes. DARREN STONE, TIMES COLONIST

A bomb went off this week in the B.C. legislature, but there was very little media coverage of the event. What took a direct hit was the morale of already beleaguered B.C. family physicians, and the casualties are the one million British Columbians without a family physician.

“With respect to … I really emphasize family doctor nurse practitioners because I think our nurse practitioners, I’m not saying they can provide better primary care, but for many people, they do,” Health Minister Adrian Dix said on Monday during debate on his ministry’s budget.

First of all, there is no such thing as a family doctor nurse practitioner. It doesn’t exist. You are either a family doctor or a nurse practitioner.

In the recent attention on the primary care crisis in B.C., physicians have been very careful to avoid any direct comparisons between nurse practitioners and family physicians.

We could highlight the years of additional education, the thousands more hours of clinical skills training and the broader scope of practice that family doctors have, but we don’t, because we absolutely value our nurse practitioner colleagues as team members, and to do so would be detrimental to ensuring a unified team approach to providing the best-quality care to British Columbians.

But it seems Dix has no such qualms. His comments encourage divisiveness among those who should be working together to ensure all people in B.C. have access to primary care.

His remarks suggesting nurse practitioners offer better care than family physicians are a slap in the face to every family doctor who has cried with their patients, missed family events to save a life, and worked hours unpaid in the early hours of the morning so they could spend the extra time in clinic that their patients needed.

Stop saying that family doctors only spend 10 minutes per patient. If you have a cancer diagnosis or a mental-health crisis, I will spend as much time with you as you need, to ensure you get the care you deserve.

Dix would have you believe otherwise. He said nurse practitioners spend more time with patients. That is because they are being paid to.

They only need to carry a panel of 500 people, and are paid to spend an hour with each patient. Family doctors will spend an hour if the situation warrants, but won’t be paid for it. Family doctors see more patients each day, which given the number of people needing care in B.C., is a good thing.

I would ask Dix: Should I fire 700 of my patients so I can carry a 500-patient panel and offer the same appointments as a nurse practitioner does?

Dix’s comments have ensured that every family physician offering longitudinal care in this province is feeling that much more demoralized, burnt out and devalued.

The time has come for Adrian Dix to step down as health minister. His words have demonstrated just how prejudiced he is against family doctors in this province, and against doing what is right for the health of all British Columbians.

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