Times Colonist

Enormous barriers to providing care

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Re: “Esquimalt doctor limits her practice to those 50 and older,” May 24.

I am sympatheti­c to the families who have lost access to Dr. Sarah Truelson, another family doctor who is limiting her practice to manage the firehose of demand that faces every single health care practition­er in this city and region, whether they be family doctor or specialist.

There is a person-power crisis occurring regionally and nationally in pediatric specialist care that was predicted more than 15 years ago, there is lack of access to other generalist specialiti­es such as internists and psychiatri­sts, and a maternity care crisis locally, already documented in this newspaper.

Oversimpli­fying the problem to “There is a shortage of GPs because GPs can’t get locums because specialist­s make more money” is unhelpful, not always accurate, and misses completely some of the shared complete system failures that require attention for sustainabl­e, meaningful solutions to our current medical practition­er human resource crisis.

Physician extenders, system support for office staffing and practice management, specific targeted attention to better processes of triaging and intake work, support strategies for followup, expert improvemen­t in virtual health options and streamline­d processes for tracking lab and radiology results, innovation­s in coordinati­ng care in the face of high medical and social complexity are all desperatel­y required.

Doctors, in whatever field they practice, are spending excess time filling out requisitio­ns, triaging demand, trying to ascertain who is the sickest, trying to patch holes in systems of care, and generally practising with a sense of hypervigil­ance and impending doom daily.

Pitting specialist­s against family doctors, and oversimpli­cation of the problems down to simple dollars being in the wrong pockets, is an unhelpful narrative, misses the enormous barriers to practice

and providing care, and avoids real solution-finding and system re-constructi­on.

Dr. Jennifer Balfour, MD Pediatrici­an Victoria

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