HORGAN ACKNOWLEDGES FAMILY DOCTOR SHORTAGE

Premier's pledge will be tested under `a firm timeline with tangible outcomes'

After weeks of complaints about the shortage of family doctors, Premier John Horgan admitted this week that it is “a very acute” problem here in B.C.

The premier's statement followed a meeting Wednesday between himself, Health Minister Adrian Dix, and Doctors of B.C.

“The number of people without a family doctor is a real problem,” Horgan acknowledged on his Twitter account following the meeting. “It's very acute here in B.C. I've heard from physicians throughout B.C. who are overworked and understandably frustrated by pressures they're under.”

Later, Horgan discussed the substance of the meeting in a statement from his office.

“Our government and Doctors of B.C. fully agree that British Columbians should be attached to primary care and have predictable access to their physicians.

“The government has committed to working closely with Doctors of B.C. on solutions, including a clear process with firm timelines to make progress on this complex problem.”

He closed with a shot at the B.C. Liberals for neglecting the physician shortage during their time in office.

He also repeated his call for Ottawa “to address the lack of federal funding in health care.”

Horgan did not disclose how the meeting came about.

But the backdrop was provided by Dix himself, with what sounded like a backhanded shot at family doctors during debate on his ministry budget last week.

In discussing the merits of nurse practitioners, Dix said, “I'm not saying they can provide better primary care, but for many people, they do. Nurse practitioners tend to spend more time with patients.”

Dix's comment brought a rare protest from Doctors of B.C.

“Nurse practitioners cannot replace doctors, and they do not provide better care,” it read in part. “(Nurse practitioners) have more time to spend with patients due to the way they are paid.

“Patients value spending time with their health-care practitioner — something family doctors currently lack due to the multiple pressures upon them.”

Dix refused to back down. Instead, he focused on the first part of the quote — “I'm not saying they can provide better care” — to the exclusion of everything else he said.

Idle comments during debate are fair game for political opponents. The New Democrats have been known to make the most of their opportunities in that regard.

Remember the furor when the previous B.C. Liberal leader, Andrew Wilkinson, referred to renting as a “wacky, fun time of life?”

The real problem for the government was not that the Opposition made hay with Dix's gaffe. Family doctors assumed that what Dix had said represented what he and the New Democrats really thought.

This at a time when a growing number are bailing on their practices while new medical graduates avoid a calling that is seen as a paperwork-laden, underpaid, dead end.

So Horgan's meeting with Doctors of B.C. was timely.

The doctors put out their own statement afterwards.

“We had a frank, honest and robust discussion, in which both the premier and minister agreed that physicians are the foundation of primary care.”

They also disclosed some news that was not included in Horgan's statement.

“We are pleased that the premier directed deputy health minister Stephen Brown to immediately start working with Doctors of B.C. to develop new and/or enhanced payment models for longitudinal family medicine.”

Longitudinal family medicine being the preferred option for patients with ongoing and multiple conditions, whose needs do not lend themselves to visits to walk-in clinics or waiting lines at the emergency room.

“To ensure progress is made, the ministry and Doctors of B.C. will develop a firm timeline with tangible outcomes,” the statement continued. “The premier also acknowledged that significant funding will be needed, beyond monies that may be transferred from the federal government.”

When Horgan was asked during question period Wednesday about the reputed funding commitment, he deflected the question by noting that the government is currently in fee negotiations with the doctors. Both Horgan and Dix know from personal experience the need for family doctors.

“I have Type 1 diabetes, so whenever I go in to see a family doctor, I have my Type 1 diabetes and whatever problem I'm there to see them about,” said Dix said during an interview last month with Gregor Craigie on CBC's On The Island.

“Having an experience with that family doctor is unbelievably important. We sometimes call that longitudinal care.”

Horgan indicated likewise during an interview with Katie DeRosa of The Vancouver Sun this month.

“I do have a family doctor. Myself, my wife, my kids, we've had the same family doctor since the early 1990s. So we're very fortunate.”

He went on to pay tribute to his family doctor for getting him “into the stream” for the cancer care he received last winter.

Yet Horgan's experience also prompted one of the more telling comments about the shortage of family doctors.

The premier, when discussing his cancer treatment, advised people to “see your doctor and get tested” at the first sign of trouble.

But as one reader put it: “See your doctor? What if you don't have a doctor?”

Family doctors are the gatekeepers of the system in many instances. The real test of Horgan's commitments will be when they are translated into progress in providing patients with access to primary and longitudinal care.

“Actions ultimately speak louder than words,” as the doctors themselves said in their statement on the meeting with the premier.