GP shortage major crisis

Dear editor: David Bond’s opinion piece suggesting that the pay model for physicians is hurting health care is hopefully an important initial salvo for our new political leaders to consider (Courier, Page 1 column, March 6).

And he is right that the trends in primary care do not bode well for the future, although, regrettably, this ominous message has been repeated so many times in recent decades, that no one is really listening anymore.

Consider Roy Romanow’s words back in 2002, when, as head of the Commission on the Future of Health Care in Canada, when he stated, “I cannot say often enough: that the status quo is not an option.” And yet, what has really changed for the better since?

Trends to improve access to primary care in B.C. have failed to date. In June 2010, Health Minister Kevin Falcon’s news release assured the province that B.C. was committing to “a family doctor for everyone by 2015,” with a $137-million investment to strengthen service delivery.

This initiative was further supported with a further $132million in 2013, and, as a joint initiative of government and the BC Medical Association, was christened the “A GP for Me” program.

By 2016, Health Minister Terry Lake had to admit that this goal not only was not achievable, but the trends have grown worse in the years that the “A GP for Me” initiative had begun: more doctors needed than ever, and more patients without a doctor than ever.

Here in the Okanagan, access to primary care has long become restrictive: walk-in clinics have been closing, and fewer physicians available to work in the ones still open; existing general practices have remained full, with aging patient populations within them requiring more time than ever; and too few new doctors arriving to replace the aging cadre of family physicians (average age of GPs in the Central Okanagan is about 55) or deal with the rapidly growing population. Long gone are the lists of doctors accepting patients provided by either the hospital or the College of Physicians and Surgeons of BC.

As Bond suggests, we are all getting older--the baby boom is retiring, and in increasing need of primary care support--so more challenges are on the horizon without an effective plan to increase access to primary care. Solutions are wanting:

You can’t just manufacture 400 new physicians out of thin air, much less convince them that they should do primary care, or go to underserved areas. Being a GP is harder than ever — there is so much to know and to keep up with — so why not allow them the ability to delegate, to share responsibilities with qualified allied professionals, and reward them for building the comprehensive medical homes that all of us patients would love to one day actually utilize? Regrettably, most governments have remained reluctant to embrace the philosophical changes required to fix our health care system, so we need the many voices of the population to jump into this fray, as David Bond has.

After all, whose health-care system is it anyways?

Mark Fromberg, MD (retired)

Kelowna