Overburdened emergency rooms, staff burnout and delays in patient care can all be linked to the shortage of family doctors, according to two Victoria-based physicians at a February 9 virtual town hall hosted by BC Health Care Matters (BCHCM.)

“It has this huge trickle-down effect,” said ER Doctor Fred Voon.

Over one million people province-wide lack access to a family doctor says BCHCM founder Camille Currie, and according to a report by the Kootenay Boundary Family Practice Service Committee, 18,600 of those people live in the West Kootenay.

Voon is an ER doctor and author of Your Inside Guide to Emergency – And How to Prevent Having to Go! and was joined in the session by Vanessa Young, a family practice doctor and former board chair of the South Island Division of Family Practice.

Primary care needs to be the first thing the BC government puts its money and resources into fixing, say the two doctors. Emergency room care is too costly, they say, with people often arriving too sick and too late. And Urgent Primary Care Centres are proving to be a poor substitute.

Seeing a family doctor is “the gold standard of care,” says Young, but less than half of the 6,500 licenced family physicians in British Columbia are actually practising in primary care. The compensation model and demands of family medicine mean it’s more attractive to work in other areas.

Basically, she says, family doctors make less money for doing more work.

Young hopes the new primary care payment system being rolled out in BC this month will mean more doctors are encouraged to return to family medicine. Family doctors will now be able to charge for the specific care they provide instead of a flat rate per patient.

Left without other choices, many people are forced to turn to the emergency room as the only option for healthcare. The result is overcrowding and inadequate follow-up care. The ER is there to stabilize people and find out what’s wrong, not to treat patients long-term.

“The emergency tries to be the safety net to catch people from all sorts of different services, but it’s hard for us to be everything to everyone,” Voon said.

This is hard on both patients and providers. Voon said he is seeing things like late-term cancer sufferers coming in for their first visit already terminally ill, when they may have been treatable if the sickness were caught earlier.

Emergency room cues are another problem. If Voon can’t call on a family doctor to look after a patient post-ER visit, he says they often must be kept at the hospital for monitoring. This fills up hospital rooms, and when there aren’t any beds left, the emergency room becomes the only place to lodge patients, jamming up the space and lengthening wait times.

“It’s hard to co-ordinate a safe discharge when someone doesn’t have a family doctor,” he said.

The Province attempted to solve some of these issues with the creation of Urgent Primary Care Centres, but both Voon and Young criticized them as overly expensive and inadequate.

“The government is grossly misspending our taxpayer dollars,” Young said. “British Columbians deserve to be attended to by a family doctor, they don’t deserve UPCCs.”

Young said a visit to a UPCC costs about $150 while a small clinic like hers can provide the same care for $50. Voon said most UPCCs also lack facilities to provide true emergency care.

Calling them “the worst of both worlds,” Voon said he thinks UPCCs would be far more effective if physician input had been taken into account in their design. “It just seems like such a missed opportunity,” he said.

Without a family doctor, patients also don’t have someone to track their complete medical history. Switching between UPCCs and ERs, they end up getting duplicate testing done as they are seeing a new doctor each time with no record of previous visits.

“It’s time wasted for the patient, it’s time wasted for the physician,” said Currie, who lacks a family doctor herself and has to work hard to keep track of her children’s medical records. She founded the BCHCM in 2022 after spending four years waiting for a family doctor.

Both doctors at the town hall have seen the long wait times for care and the resulting upset patients levying abuse at healthcare providers, who are already taxed by long hours working in a broken system. The message they brought to the session was for people to direct their anger at forcing the BC government to put more money into attracting family doctors to work in BC.

The BCHCM presented a petition with 50,000 signatures to the BC legislature last year demanding action, and these town hall sessions are a way for them to show people struggling to find adequate care that they can take action, and will be heard.

“They need to realize their voice counts,” Young said.

Mark Page, Local Journalism Initiative Reporter, Valley Voice