Walk-in clinic own­ers talk tac­tics to re­cruit and re­tain doc­tors

The Province - - NEWS - DER­RICK PEN­NER de­pen­ner@post­media.com twit­ter.com/der­rick­pen­ner

Bri­tish Columbia’s short­age of fam­ily doc­tors is crimp­ing the abil­ity of the prov­ince’s walk-in clin­ics to stay open, ac­cord­ing to an or­ga­ni­za­tion that rep­re­sents their in­ter­ests.

The non-profit group Walk-in Clin­ics of B.C., said about 50 clin­ics have closed since 2013 with the dif­fi­culty in re­cruit­ing physi­cians high on the list of rea­sons why, said found­ing di­rec­tor Mike McLough­lin.

So his group is hold­ing a con­fer­ence in Rich­mond on Fri­day to talk about ways to im­prove op­er­a­tions and per­haps of­fer bet­ter pay to re­cruit physi­cians to their busi­nesses, which are in­creas­ingly fill­ing gaps in B.C.’s pri­mary health­care sys­tem.

“Right now, the case (for walk-in clin­ics) is there’s not enough fam­ily doc­tors,” said McLough­lin, who is not a doc­tor him­self, but op­er­ates the Medi-Kel clinic in Kelowna with his wife Sue McLough­lin, who is a fam­ily physi­cian.

“There are 700,000 Bri­tish Columbians who don’t have fam­ily doc­tors, and of that 700,000, 300,000 are ac­tively seek­ing a fam­ily doc­tor,” McLough­lin said. “So who’s go­ing to look af­ter them? It’s walk-in clin­ics.”

Dr. Eric Cadesky, pres­i­dent of Doc­tors of B.C., said his or­ga­ni­za­tion is “con­cerned about any­thing that de­creases peo­ple’s ac­cess to care,” but their pref­er­ence is that pa­tients would have ac­cess to con­tin­u­ing care with a fam­ily doc­tor.

With the dilemma of not hav­ing enough doc­tors, walk-in clin­ics “pro­vide ac­cess to peo­ple for episodic care,” Cadesky said.

In the long run, how­ever, he sees the fa­cil­i­ties as a po­ten­tial av­enue to con­nect pa­tients with doc­tors in “a new era of pri­mary-care re­form.”

“They al­ready have the bricks and mor­tar, they al­ready have the staff, they al­ready have doc­tors that work for them,” Cadesky said.

He said what is needed is more sup­port in the sys­tem so that doc­tors choose to go into full-ser­vice fam­ily prac­tice.

McLough­lin said the num­ber is hard to pin down with open­ings and clos­ings, but there are about 350 walk-in clin­ics in Bri­tish Columbia, and he ar­gues they are a source of in­no­va­tion to help im­prove the sys­tem as a whole.

“If they don’t (in­no­vate) they’re go­ing to close, which is what has been hap­pen­ing,” McLough­lin said.

At the con­fer­ence, McLough­lin said they will be talk­ing about ways to use tech­nol­ogy to stream­line sys- tems and im­prove the way doc­tors do things rang­ing from mak­ing ap­point­ments to han­dling the pa­per­work for es­tab­lish­ing com­plex-care plans.

Cre­at­ing those plans can in­volve a lot of work, McLough­lin said, but also trig­ger ad­di­tional MSP pay­ments be­yond the $30 ba­sic fee for a doc­tor’s visit, which helps make fam­ily prac­tice more at­trac­tive.

“If (doc­tors) take on a ros­ter of pa­tients and bill the com­plex care, they can get (the fee) up to $60, if they’re do­ing fam­ily prac­tice,” McLough­lin said. “But it takes a lot of time to do that and that’s the chal­lenge.”

McLough­lin said walk-in clin­ics are also ad­vo­cat­ing for ways to in­crease the shar­ing of pa­tient records be­tween hos­pi­tals, spe­cial­ists and clin­ics.

“That per­sonal re­la­tion­ship (be­tween a doc­tor and a pa­tient) is the best thing,” McLough­lin said, “but if you can’t get that, the next best thing is you need to have a pa­tient record that fol­lows you around.”

And he ar­gued that walk-in clin­ics are “at the fore­front” of bring­ing those kinds of in­no­va­tion to the pri­mary-care sec­tor.

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