The B.C. government pledged five years ago that every British Columbian would have access to a family doctor by 2015. Since then, the number of people in the province without a family doctor has grown.
The government should not abandon its pledge, but should consider a complete remake for the family-practice system, the front line of health care.
Health Minister Terry Lake acknowledged last month the government won鈥檛 likely be able to deliver on its promise, but said 鈥済reat progress鈥� has been made.
When the government made its family-doctor promise in 2010, about 176,000 British Columbians did not have a family doctor. In 2013, the government negotiated funding of $132.4 million with the Doctors of B.C. and named it the GP for Me program as part of its re-election platform. By the end of 2013, the number of British Columbians without a family doctor had risen to 200,000.
It would be unfair to blame the shortage of general practitioners on failed government policy 鈥� the problem is nothing new and is not unique to B.C. Changes in the field of medicine, as well as changes in culture, are major factors.
Retiring Saanich family physician Chris Pengilly wrote in a 2014 Times 91原创 commentary that he could find no buyers for his practice, no medical-school graduates interested in a full-service family practice. He eventually found someone to take over.
One cause, Pengilly suggested, was that in the 1980s, health-care planners decided Canada had too many physicians and cut medical-school places. When it was realized this was shortsighted, medical schools were expanded, but not enough to match the number of retiring physicians or fill new medical specialities.
Pengilly also said the younger generation has a different perspective.
鈥淭hey simply are not willing to work the brutal hours that I can remember working in the 1970s and 1980s,鈥� he said. 鈥淚 think this generation is wiser than mine.鈥�
Doctors working fewer hours means more physicians are needed to care for the same number of patients.
An 鈥渦nbearable鈥� amount of paperwork required of family doctors is also a major detriment, Pengilly said. On most days, he had to spend two hours after the office closed to handle the paperwork.
It鈥檚 no wonder that more medical-school graduates decide against family practice, choosing more lucrative specialties that don鈥檛 require the sacrifice of a balanced lifestyle.
Pengilly says the current system is broken beyond repair.
鈥淎n analogy is a 1950s car in which engine, transmissions and tires have been replaced and it still runs, but not efficiently or even safely,鈥� he wrote. 鈥淭here comes a point where the car has to be dumped and replaced by a new one.鈥�
E-News, a newsletter of the B.C. College of Family Physicians, says: 鈥淔amily physicians are 鈥� crucial in avoiding unnecessary hospitalization. People who don鈥檛 have access to a family doctor tend to visit the hospital and emergency room for minor health concerns, putting a strain on the medical system and tying up life-saving resources.鈥�
A study conducted in 2007-08 by Victoria-based Hollander Analytical Services Ltd. found that the more patients go to the same family practice, the lower the overall annual cost to the health-care system.
According to the Lancet, among the top medical journals in the world, 鈥減rimary-care orientation 鈥� is associated with lower costs of care, higher satisfaction of the population with its health services, better health levels and lower medication use.鈥�
The government needs to revisit its family-doctor pledge, but with the aim of building a different approach. Tinkering and tweaking won鈥檛 be enough.
