Overworked and underpaid, this Salt Spring Island doctor says family physicians are burning out

Applewhaite practises on Salt Spring Island, B.C. — the largest of the province’s Gulf Islands — where, he says, half of the residents are without a family doctor. That figure is far higher than the estimated one in five British Columbians without a physician.

Despite the high number of people without a general practitioner, Applewhaite says he’s not the only physician reconsidering a career in the province.

Canada is facing a shortage of doctors fuelled, in part, by growing workloads and low pay.

On average, nearly 15 per cent of all Canadians 12 and over reported not having a regular health-care provider, according to a 2019 Statistics Canada report. A survey published this month by the Angus Reid Institute suggests that number is now closer to 20 per cent.

Applewhaite spoke with White Coat, Black Art host Dr. Brian Goldman at his office on Salt Spring Island about what he’s experienced in his practice — and what the system’s problems could mean for the island’s residents.

Here is part of that conversation.

So now, more than three years later, what’s the mood like for you and your colleagues?

So I think people are speaking with their feet. Practices are closing across B.C. at an alarming rate. I don’t know where the doctors are going, but they’re disappearing. I think some of them are leaving medicine altogether. They’re retiring.

I had at one time presumed that they were going to work as hospitalists. But speaking to one of my colleagues in the hospitalist program, they’re also struggling to find people. So people are just leaving practice altogether.

Including right here in this practice.

Including right here in this practice, yeah. We’ve had several departures in the last year or so. Only one of those physicians has been able to find a replacement. And for that reason, this island community has an attachment rate which is only about 50 per cent, currently. So almost the majority of people don’t have a family physician on the island now.

Applewhaite, left, pictured with registered nurse Ian Whipple, also works at Lady Minto Hospital, the island’s only hospital. (Brian Goldman/CBC)

You called this area the swamp. Why do you call it the swamp?

So this is the room where the paperwork happens and family physicians everywhere have a significant amount of paperwork to do. The burden of that has been increasing even in the time that I’ve been practising, which isn’t that long.

I don’t know why, but, you know, insurance forms and notes … et cetera, have been just multiplying at an incredible rate. And unfortunately, we are only paid for visits, which is really, you know, probably only half of our work that we do.

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