Despite the decision of the Nechako Medical Clinic group of doctors to dissolve the corporation that staffs the Prince George Acute and Primary Care Centre at Parkwood Mall, Adrian Dix, who was health minister for the NDP government, and the Northern Health Authority have provided reassurances the clinic will stay open.
They also say the clinic will be able to attract doctors under a different payment model than the current Medical Services Plan system, which bases pay on the number of patients seen.
In a statement issued Wednesday Northern Health said it is “currently reviewing alternate compensation models to ensure continuity of services” at the clinic once the doctors end their ownership agreement on Dec. 7.
The problem stems from the fact the Nechako group has been unable to convince enough family doctors to work in clinic since the province introduced the Longitudinal Family Physician payment model in February 2023. The LFP system better compensates doctors for their time while providing in-patient, maternity, palliative and long-term care and recognizes the complex needs of patients who require more physician care.
But according to longtime BC Liberal/United MLA Coralee Oakes, currently running as an independent in Prince George-North Cariboo, the one-size-fits-all approach of the LFP model is not working in northern BC hospitals that are suffering with doctor shortages that have forced the overnight closures of emergency wards.
Oakes says family doctors at G.R. Baker Hospital in her hometown of Quesnel are bearing the brunt of not having enough staff to cover shifts.
In addition to running their own practices, they are being asked to handle shifts in ER, maternity, geriatric and other hospital departments, as well as taking on duties in the acute/primary care clinic based at the hospital.
As a result, she said, doctors are leaving for the Lower Mainland, where there are enough physicians to cover most shifts in hospital and clinical positions.
“The Longitudinal Family Physician payment model, while it works in the Lower Mainland, from what I’ve heard from doctors, it’s not working in rural northern communities and we need to look at it before we lose any more doctors,” said Oakes.
“I think it’s critical we allow doctors to speak freely about what’s happening in health care. They are getting bullied in Northern Health. Because they’re losing the doctors at urgent and primary care clinics, they are forcing the doctors they have left in the community to cover shifts, and that’s why we are hemorrhaging the doctors that we are. The model didn’t take into consideration that when you’re up in our communities in the North, you’re covering all these other scopes of practice.”
Seven doctors have left Quesnel just in the past year and their contracts do not allow them to state publicly about why they were leaving. Oakes says doctors she has spoken to fear if they do speak up there will be repercussions such as lawsuits.
Patients of doctors who have left were sent letters advising them to go to Northern Health’s hospital clinic in Quesnel, where they are required to book virtual appointments with a doctor in the Lower Mainland. But there are more patients than there are available appointment times and doctors in the hospital are expected to fill in those gaps to meet the demand.
“They have to cover ER, they have to cover regular rounds at the hospital and then they’re also required to cover urgent and primary care and they just can’t do it anymore,” Oakes said.
“When you can go down to the Lower Mainland and make more money and not have to work the scope of practice that you have to in Northern Health, and that means covering the ER, covering your practice, you’re basically on call 24/7 with very few days off, it makes moving to the Lower Mainland far more attractive.
“We have so few doctors left, we’re literally on life support because they cannot take on any additional shifts.”
Oakes says that while truck drivers and pilots are restricted on the number of consecutive hours they work at their jobs there are no such restrictions for doctors who have to make vital decisions that affect the health of their patients.
“They’re worried about how they can take care of their patients,” she said. “If your doctor has been working 72 hours, where is your level of competence? And why would you work 24/7 and see the system collapsing around you if you’re going to make less money.”
Doctors with young children who in the past were able to hire live-in nannies to look after their kids while they were at work are finding it more difficult to hire them due to changes in immigration laws.
“If 24-hour child care secured two more doctors, that’s 2,400 more people that will have a doctor,” said Oakes.
Oakes said the Quesnel situation can be rectified, provided the health ministry and Northern Health sit down with the doctors to figure out a more equitable payment plan that will encourage them to staff clinics. Key in that strategy is to finding a way to entice more locums from regions that are better served with doctors and bringing them to northern communities.
“It’s not too late to fix, but if we continue to allow it to operate the way it is we’re not going to have any health care professionals left,” Oakes said.
