Off a quiet road next to the local Lion’s Club and skate park, the clinic offers a helicopter landing pad, part-time nurse practitioner, massage therapist and chiropractor, among other services.
But in the end, said Kendall Kyle, chair of the Galiano Health Care Society, “The whole idea of the health care centre was to have a place that would encourage a doctor to come.”
Built three decades ago, for the last eight years, Dr. Erin Carlson has cared for the community, even as its population spiked by more than a third in the last national census.
“It was a great time for health care on Galiano,” said Linda Reudrich, who manages the clinic as executive director.
The model worked, at least for a while.
Now, Galiano’s only doctor is scheduled to depart in August, throwing health care for the island’s 1,400 residents into uncertainty — a primary care gap echoed in rural areas across the province.
But unlike other small communities in B.C., on Galiano, to seek medical assistance further afield means getting on a ferry, water taxi, or in the worst case, a medevac helicopter.
At the same time, Kyle says the island’s ambulance service can no longer guarantee 24/7 coverage, meaning at some hours during the week, the community must rely on its volunteer firefighters in an emergency medical situation.
Despite thousands of dollars in recruitment incentives and relocation bonuses, the clinic still can’t find a doctor to fill a void. According to Reudrich, there are over 150 open positions for primary care doctors in the Island Health authority alone.
“It’s a tough crowd that we’re working against. And I know it’s that way in many parts of the province, in many parts of Canada,” said the clinic’s manager. “It’s a big crisis.”
Nearly a million British Columbians without family doctors
B.C.’s family doctor shortage is not limited to rural communities like Galiano Island.
Roughly 900,000 British Columbians don’t have a family doctor. Of those, two-thirds say it’s because they “can’t find one,” and 19 per cent said they have lost their family doctor to closed practices, according to a recent poll from the BC College of Family Physicians.
More worrying, says the college, 40 per cent of patients who now have a family doctor said they are concerned their doctor will close their practice or retire in the future.
Retiring family doctors is a problem, but so is the job itself. For some, it has become unbearable.
Government solution ‘compounding the problem’
As part of a solution to the doctor shortage, the current B.C. government has moved to open nearly 30 UPCCs meant as an alternative to visiting an emergency department for non-emergency issues.
At their best, both Lovett and the management at the Galiano Island clinic say the well-funded clinics are a temporary fix; at their worst, they say UPCCs are compounding the doctor shortage by offering better pay and job opportunities for family doctors that could otherwise move into community-based clinics.
Like a “well-structured and well-funded walk-in clinic,” UPCCs provide episodic care for single problems, says Lovett.
“They’re not equivalent to a family doctor,” she said.
As funding goes elsewhere, Lovett says the rise of UPCCs has also made her and other family doctors feel even more “devalued” and “unsupported” by the health-care system.
“That doesn’t feel great from the position of a family doctor on the ground,” she said.
No silver bullet
In the search for solutions to B.C.’s family doctor crisis, many have called for an overhaul of the province’s fee-for-service model.
BC Family Doctors, which advocates on physicians’ behalf, describes the scheme as “outdated and inequitable.”
“Every hour that I see patients, there’s an additional 15 to 30 minutes of work for charting — unpaid,” said Dr. Rita McCracken, an East Vancouver family physician with 15 years of experience.
McCracken, who also works as an associate professor in the University of British Columbia’s Faculty of Medicine, says family practices require a funding scheme that recognizes everyone it takes to run a family clinic — from administrative staff to nurses to physiotherapists and family counsellors.
Pay them directly, says McCracken, and the provincial government will take a lot of pressure off doctors who would rather focus on practicing medicine than “running a business.”
Read more at: ‘A big crisis’: How B.C.’s family doctor shortage is spreading
