Critics say BC’s understaffed urgent primary care centers are failing, but health minister insists hiring is taking place

The government has put a bureaucracy in charge instead of doctors, critics charge

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Protests are growing over the British Columbia government’s chronically understaffed primary and urgent care clinics, which critics say are plagued by inefficient and costly bureaucracy and a system that does nothing to attract family doctors.

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This week, the BC Liberals called for an audit to address the “worsening dysfunction” of urgent primary care clinics, while the BC Greens recommended keeping the clinic infrastructure but returning control to doctors.

A Chilliwack doctor joined the chorus of criticism on Wednesday, calling on the government to provide funding directly to doctors to set up team-based primary care clinics instead of the current system of clinics run by health authorities, which he says it’s costing taxpayers a fortune.

Since the BC NDP began implementing them in 2018, primary care and urgent care centers have been touted as a way to ease the strain on hospital emergency rooms by providing people with urgent but not urgent medical care. same day emergency

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Health Minister Adrian Dix also said the clinics, staffed by teams of family doctors, nurses and nurse practitioners, could provide ongoing, long-term care by “connecting” patients without a family doctor.

Instead, many of BC’s 27 primary and urgent care centers are understaffed, leaving frustrated patients unable to see a nurse or doctor.

Dr. Darren Joneson, who opened the Spectrum Medical clinic in Chilliwack in 2020, said the ministry must recognize that doctors, not employees of health authorities, are primary care specialists.

The Ministry of Health has “excluded family doctors” from the process of establishing team-based care and that is why the clinics are failing, Joneson said. Health authorities also require doctors to sign a full-time contract, which Joneson says is not attractive enough.

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In June, Dix said the province would offer new family doctors a $25,000 signing bonus plus a “new-to-practice” contract valued at $295,457 for the first year.

“They expect a lot more 24-hour coverage and weekend work and after-hours work and they don’t really value family doctors for what they’re worth,” Joneson said.

Primary and urgent care center in Northeast Vancouver.
Primary and urgent care center in Northeast Vancouver. PNG

When Joneson opened his clinic in the fall of 2020, the cost to get it fully operational again was about $27 per square foot. He compares that to the Chilliwack and Fraser Health rural primary care center that opened in May with $5 million in capital costs paid for by the province. With a 13,000-square-foot building, that works out to $384 per square foot, he said.

“Here’s the government really spending a lot of money (on primary care clinics), but why couldn’t they have given those funds to family doctors” to establish team care, Joneson asked.

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He points to one such system in Alberta, where the Ministry of Health provides funds directly to family physicians to pay for salaries and space used by allied health professionals, such as physical therapists, dieticians and medical laboratory technicians.

However, there is no sign that BC is pausing its expansion of urgent primary care clinics and primary care networks.

The province has earmarked $57 million over the next three years to expand the number of its clinics in BC

Dix told Postmedia News on Wednesday that the primary and urgent care centers have 351 full-time equivalent employees and efforts are underway to recruit more.

“I think in a general sense, hiring has been very good overall, in line with other parts of the system. I understand the Opposition’s approach… but there are 27 of them. And there are challenges in staffing and health care,” Dix said.

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“I think during the pandemic they were invaluable, but we have to do more to build (patient) attachment with every dollar we spend. And we need more doctors.”

Of the 27 primary urgent care centers, 21 required total capital funding of $28.4 million, Dix said.

BC Liberal finance critic Peter Milobar said the clinics “have been touted by the minister as the be all and end all. And now when we see them struggle, the prime minister recently said that they are a stopgap. So it’s hard to have faith that they’re really delivering what they intended.”

The shortage of nurses and doctors has affected all aspects of the health care system, forcing the temporary closure of emergency rooms across the province. On July 11, a woman died after lying on a stretcher for two days in the overcrowded and understaffed Lions Gate emergency waiting room.

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Milobar said the government has been unable to find evidence that primary and urgent care clinics are easing the burden on emergency rooms or filling the void for an estimated one million British Columbians without a family doctor.

So far, only about 20,000 people have been assigned to the 27 primary care clinics in the province.

BC Green Leader Sonia Furstenau said a low number is one of the indicators that the system is not working for patients or family doctors.

She compares that to Shoreline Medical, a thriving medical clinic on Vancouver Island’s Saanich Peninsula with a team of 25 doctors and 18,000 patients.

Karen Morgan, interim executive director of the Shoreline Medical Society, said family doctors like that they have the flexibility to split their work between the clinic and Saanich Peninsula Hospital.

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While the doctors pay overhead, about 30 to 35 percent of their profits, the Saanich Peninsula Hospital and Healthcare Foundation also puts in additional funds while the society’s board of directors manages the business side of the business. clinic, Morgan said.

“That allows doctors to focus on taking care of their patients,” he said.

The government, Furstenau said, must provide the most modern clinical infrastructure and medical equipment, but allow clinics to be operated by teams of doctors, nurse practitioners and health professionals who provide community health care.

“The government should focus on (asking health professionals), ‘How do we support you to create these high-functioning community health centers that serve many people and also don’t burn out doctors and nurses?'” Furstenau said. .

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