Many Times Colonist readers have read about the problems arising from the resignations of four physicians at Health Point Care Centre. This is a Vancouver Island Health Authority primary health-care provider devoted to care for seniors, recognizing that they have more complex medical problems and require more physician time per patient than most younger people.
The issue has been an announced change in pay to the Health Point medical staff doctors, all of whom work part time. Yes, doctors have young families, too. I am with an 1,800-person group called Save Health Point, formed to try to retain our doctors. Others have well explained our needs in these pages. I am working to find what caused the problem.
There has been no suggestion of lack of performance on the part of the medical staff. On the contrary, both VIHA management and the patients have praised their work and dedication. The key, and apparently only, issue is money.
These doctors all work part time. They are paid by VIHA on a “fee for service” basis. This sounds reasonable when you first hear it, but its meaning to VIHA is that the doctor would be paid for time actually spent with patients and the nature of the work done. Then, they would be expected to pay part of the cost of the facility’s overheard.
This new arrangement is not yet in place, but its announcement led to the resignations. Senior patients need more doctor time than is usually available from a general practitioner. The current Health Point budget apparently will not enable hiring of more medical staff or even covering all the existing overhead costs.
Has any reader experienced or heard of any employer who requires their employees to pay even a share of the cost of the desk they work at? How would any of the many professional unions in B.C. react if teachers, nurses, police, firefighters or B.C. professional employees were so charged? One wonders if VIHA’s own top management pay for their overhead. It seems that the real issue here is the financial planning. Will the funds available to Health Point permit a specialized medical practice for seniors at the level realistically needed? It appears not.
VIHA management has declined to negotiate with the doctors, whose resignations are effective June 1. Would any other employer of professional staff simply announce a reduction in pay with no negotiation at all?
The lack of negotiation reminds us patients that we, too, get little communication from Health Point management. Time with the doctor is an issue for us, and any attempt to reduce it will be painful to us. We, too, would have liked some early warning and chance to talk with management about the issue and how it would affect us.
Save Health Point has brought the issue to the highest leaders of VIHA and the provincial government, but we realize that little can be done before next month’s election, unless someone in higher management will attempt to maintain the status quo for at least a few months beyond election day, until things settle down. After that, perhaps the funding issue can be resolved.
But if Health Point is not better funded, replacement doctors will receive less pay than now for the same work. What would that do to patients? The cost load to VIHA or the government would inevitably shift to emergency services, long-term care facilities or walk-in clinics. The walk-ins are very useful but not for continuity of care.
Charles T. Meadow is co-chairman of Save Health Point and is professor emeritus in the Faculty of Information, University of Toronto.
