Hundreds of family doctors accepting new patients in Alberta as nearly a million British Columbians without
At the same time hundreds of thousands of British Columbians can’t find a family doctor, more than 600 physicians in Alberta are accepting new patients to their family medicine practices.
A search of the College of Physicians and Surgeons of Alberta directory turns up 618 physicians accepting patients for family medicine: 237 are fully open to new patients, 185 are accepting with criteria and 196 are taking new patients on a referral basis.
British Columbia no longer provides a directory for patients seeking a primary care provider and the BC Family Doctors association says nearly a million people in the province “do not have a family doctor and cannot get one.”
Primary care doctors in Alberta are significantly better paid than in B.C., but analysts point out there are more doctors trained in family medicine per capita in B.C., so experts and physicians alike say higher earnings haven’t drawn doctors out of the province. Instead, doctors trained in family medicine have taken up different roles within the health-care system.
Anecdotes shared by doctors on social media suggest hospitalists or doctors working at government-funded and -run urgent care centres can make double or triple what a general practitioner makes, with more predictable hours. Some work part-time providing family medicine, also working at walk-in clinics, care facilities or hospitals.
In Alberta, the average family physician billed the province $393,248 in the 2019-2020 fiscal year, compared to $308,339 in B.C., according to data from the Canadian Institute for Health Information; expenses come out of those payments and can vary by practice.
WHY THE AVAILABILITY GAP?
CTV News has spoken with a number of physicians working in various capacities in B.C.’s health-care system in recent months, all of whom have expressed frustration at the province’s model for providing longitudinal, primary care, which has been widely described as outdated and no longer serving the needs of medical providers or patients.
It’s also a subject of considerable research by analysts, who point out the focus on hospital resources and urgent care centres has drawn physicians to the better pay and working conditions, while starving family practices of trained personnel.
“There’s lots we can learn from other provinces and I think what sort of unites that is the shift to recognizing that primary care is a team sport; that we need to support family physicians with other health-care providers working alongside them,” said Ruth Lavergne, a health policy analyst who recently left a teaching position at Simon Fraser University for an assistant professorship at Dalhousie University.
“They simply brought in more nurses and allied health-care providers in the Alberta setting than in B.C. In B.C. it’s still really those family physicians that are shouldering the work of primary care system navigation,” she said, adding it costs the system more in the long run.
“When we’re bouncing around between walk-in clinics, emergency departments, and not getting our needs met — that contributes to duplication of testing, multiple referrals and is confusing from a patient perspective.”
IMPROVEMENTS COMING TOO SLOWLY
While Health Minister Adrian Dix has been touting team-based models of care in British Columbia, frontline workers say they’re often not actually working under the same roof, and the referral process is nearly the same as it’s always been, without recognition of the aging population and their growing needs.
"If I spend 15 minutes with a patient going over their medical needs and it's not a simple episodic visit, in B.C. I would be compensated about $33, whereas in Alberta with the time modifier, it’s $62, which is quite a big difference," explained Dr. Carlinn Man, who lives in B.C. where he has a slate of patients in New Westminster, but also works as a locum, filling in for sick or vacationing doctors in Alberta.
“Primary care networks in Alberta are actually designed by the local physicians that determine what the need is in their community and they get the resources they need to take care of their patients," he said. “One family practice may have more people with diabetes or elderly people having trouble taking care of their feet, so I've been to a few primary care clinics that hire a foot care nurse that comes and manages people's foot care.”
Man pointed out that many doctors trained in family medicine don’t want to be small businesspeople faced with piles of paperwork and the administrative requirements of maintaining an office and staff, when they could work in emergency departments, walk-in clinics or long-term care.
“Family medicine in B.C. is unattractive to new graduates from a compensation perspective, from a workload perspective, from a support perspective," he said. “A lot of us working in family practice in B.C. have burnt out and in places like Alberta, the compensation is quite a bit better, the support network is quite a bit better and obviously when you feel that, you're doing a better job taking care of your patients.”