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LETTERS: B.C.’s combined medical practice scheme a ‘fiasco’

Editor:
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Editor:

More than 10 years ago, BC Health decided that the best way to meet future family doctor needs was to introduce a new style of medical organization that incorporated doctors, nurses, nurse practitioners and others into a “combined” practice.

At the same time, compensation for family doctors was effectively frozen, unchanged ever since, while the new combined practices have received significant assistance.

The scheme is a fiasco. There are far too few combined practices and some are not taking as many patients as anticipated. Family doctors, still without a rate increase, are responding by retiring en masse, although some might have been willing to continue on had conditions been more acceptable.

More and more B.C. residents are now unable to find a family doctor, or even to renew existing prescriptions. Emergency rooms were never prepared or staffed to deal with the overflow from the family-doctor collapse on top of everything else, and are wearing down to the point where some are closed sometimes. Medical specialists seem abundant, but cannot be accessed without a family doctor referral and that door, too, is closing for many people. Problems are further compounded by the stress on people unable to get adequate health care.

There is no doctor shortage. B.C. has thousands of licensed doctors who are not practising. New graduates are uninterested in poorly paid general practice and instead almost exclusively develop specialties. Even if compensation was suddenly changed, many graduates would be skeptical and reluctant to depend on government policies, given past experiences.

Logic says that withdrawing basic medical services from people must harm their health, and that some people, or maybe a lot of people, dying now might still be alive if they had adequate access to health care. I fear it may be worse than COVID. But we don’t know. Unlike with COVID where we had almost constant statistics, there are none for the consequences of the family doctor collapse. Recognizing the problem and facing up to the inevitable ugly questions could be the start of very slowly turning the situation around.

We can’t go on like this.

Ronald Chisholm, Surrey