Doctor shortage a serious concern

Elected officials question Interior Health about step to recruit family physicians to the East Kootenay

Local elected officials are worried about people in the community who aren’t able to find a family doctor.

The Kootenay East Regional Hospital District board of directors met with a representative of Interior Health Authority earlier this month to talk about what is being done to recruit family doctors to East Kootenay communities.

During her presentation to the board on Friday, November 1, Dr. Peggy Yakimov began by going over physician vacancies around the region.

Cranbrook is short two family doctors, while two more vacancies have recently be filled. A position in internal medicine has also been filled. However, there is an upcoming vacancy in general surgery, and the regional hospital is short one anesthetist, despite a $100,000 incentive.

There is one vacancy for a family doctor in Kimberley. In Fernie, there is a shortage of a general surgeon. There are no vacancies in Invermere. Like Cranbrook, Creston is short two family doctors.

According to the College of Physicians and Surgeons of British Columbia, there are four doctors accepting new patients in Kimberley, but only one in Cranbrook.

Dr. Yakimov explained the various incentives offered by the B.C. Medical Association and the Ministry of Health, including increased fees, an annual flat lump sum payment, locum support so physicians can take time off, continuing medical education support and relocation expenses.

But, Dr. Yakimov said, enticing a doctor to move to a rural community is not usually about money.

“Those incentives – they are fun, but that’s not what gets them here. It’s not dollars and that has been very clearly shown,” she said.

Physicians, like many other professionals, seek a work-life balance, she went on.

“The most important factors for recruiting to rural (areas) are that there is a job for their spouse, that there are good schools and recreation activities for the kids,” said Dr. Yakimov.

Some communities with a physician shortage, such as Nelson, are turning to a walk-in clinic as a solution so that people who are not able to get a family doctor can still receive medical attention without having to go to the hospital.

Doctors who work at a walk-in clinic enjoy benefits that regular family physicians do not, Dr. Yakimov said.

“The physicians that work there have a very cushy life. They don’t have to be on call, they don’t have to follow their patients into hospital, they don’t have to be available for their patients. They go and they work whatever their hours are for the day, then they go home and that’s the end of their work day.”

But walk-in clinics “siphon off easy stuff”, Dr. Yakimov said, leaving time-consuming, less lucrative medical problems for the full service family doctors.

“This leads to burn-out of the full service family physicians and an inability for them to sustain their income at a level that makes them happy.”

In rural communities, family physicians take turns manning the hospital’s emergency department. Physicians at a walk-in clinic are not required to work at the hospital.

“These guys come in and they don’t work there, and they sit in the community and they take off the easy stuff and they don’t contribute. That causes a loss of morale amongst the physicians working in the community and a lack of cohesion amongst the medical staff,” said Dr. Yakimov.

What’s more, patients who visit a walk-in clinic do not receive the same long-term care that they do from a family doctor.

“That doctor may never have seen you before, may not know anything about you, doesn’t have that sense about you that your family practitioner has about you, who looks at you and knows you’re not well just by looking at you. You don’t get that in a walk-in clinic,” she said.

But John Kettle, chair of the hospital district board, said that’s a non-issue because people who can’t get a family doctor don’t have that level of care when they have to go to the emergency department instead.

“The reality is, when you go to emergency, you don’t see the same doctor either. He doesn’t have your history. And yet when you need a medical, you can’t get one because you don’t have a doctor,” said Kettle.

He cautioned Interior Health not to refer to financial pros and cons when talking about health care for people who can’t get a family doctor.

“Because to me, what we are supposed to be providing is the best service we can for our patients,” said Kettle.

“I can tell you that of the 1,100 or 1,200 people who don’t have doctors, they would go anywhere to get a doctor, whether it’s a walk-in clinic or a doctor who takes patients. To leave those people unattended is just not going to work.”

He encouraged elected officials representing every community in the East Kootenay to look into walk-in clinics.

“The reality is, we have to look at other options if the doctors that are currently serving us don’t provide the answers to those problems,” said Kettle.

“We’re talking about the welfare of people who can’t get a doctor and who need one. So I would urge anyone here who has an opportunity to look at options in your community that you do so expeditiously. These people are not being served, and we are not serving them well if we sit back and watch this happen.”