Mackenzie, B.C. is one of the rare rural towns that has enough family doctors. But soon, it won't.
A family doctor accepting patients is hard to come by these days throughout much of B.C., in particular, in rural communities.
But Mackenzie, a small community of about 4,000 people, north of Prince George, isn't facing quite the same crisis.
The community, which has provincial funding for 6.5 family doctors, has eight. However, several work part-time hours, and all their work combined adds up to about 5.7 doctors.
Doctors in the community say that despite being slightly short of full-time family physicians, their workload is "manageable."
One of the physicians is Dr. Ian Dobson, who journeyed north from Vancouver nine years ago as part of the general practitioner locum program, which brings doctors into rural communities for a limited time.
Dobson liked Mackenzie so much, he stayed.
"I couldn't be happier," he said.
His colleague Dr. Dan Penman arrived on the scene just over 10 years ago, wanting to escape city life for a new adventure.
"It's a beautiful area," Penman said. "It's a really nice community … very welcoming people here. I find them to be quite appreciative."
Both doctors say the landscape, access to recreational activities and short commutes are big reasons they've stayed in the area.
Additionally, both have young families and are enjoying raising children in a rural setting.
But they also say that being on an alternative payment model has helped keep them and other doctors in Mackenzie.
Every single doctor in Mackenzie is on alternate payment contracts. Penman said Northern Health owns and maintains the building they work out of, meaning doctors can focus on medicine instead of running a business.
Most family doctors in B.C. are independent contractors and run their practices as businesses, paying for overhead costs such as office space and staff and medical equipment. Physicians and future physicians have long called for similar options.
A new doctor payment model began rolling out earlier this month, which compensates doctors for the number of patients they see each day, as well as the complexity of their needs; doctors will be paid for that extra time with patients.
Doctors will also be paid for the time they spend reviewing lab results, consulting with other medical professionals, updating patient lists and clinical administrative work.
Because they don't have to worry about business and administration duties, those 5.7 full-time equivalent doctors in Mackenzie are more than capable of keeping up with the town's patient needs, Penman said.
Not quite perfect
Though the family doctor situation is under control in Mackenzie, the local hospital has had to close periodically due to staffing shortages — in particular, because of the lack of nurses.
"Staffing is a major issue here," Penman said.
"There is a element of instability there and and a lot of doctors really don't want to work in a setting like that if they don't have nurses or stability in terms of emergency coverage."
Leaders have called on the province to increase resources for emergency health services, including nurses and paramedics.
Mayor Joan Atkinson said a group of about 30 mayors from across B.C. are working on a plea to the province for help dealing with health-care shortages as a whole.
"We need to staff up all of our hospitals and we need to staff up all of our paramedic units across the province."
And while the community is in good shape when it comes to family doctors now, Penman said two of its part-time physicians are planning to leave later this year.
He said that while his community and Northern Health have done a lot to recruit and retain doctors, that effort has to be ongoing.
"The moment you take your foot off the accelerator and you lose two doctors, then things destabilize," he said.
"If you lose enough doctors it becomes too onerous, people get really burnt out."