British Columbia

These med students want to become family doctors. B.C.'s compensation model is making them think twice

Some medical students in B.C. are rethinking their career paths as they near graduation amid a critical shortage of long-term care physicians in the province. 

The thought of running a business while caring for patients is 'incredibly daunting,' one student says

Nearly one million British Columbians don't have a family doctor, and medical school graduates are hesitant to fill those roles. (Shutterstock)

Some medical students in B.C. are rethinking their career paths as they near graduation amid a critical shortage of family doctors in the province. 

Nearly one million British Columbians don't have a family doctor.

Although the University of British Columbia has the largest family practice program in the country, with about 170 spots that are consistently filled by future physicians, that isn't translating into more family doctors in B.C. Some medical students say they are concerned about having to run a business on top of caring for patients, and say the financial viability of the current fee-for-service model doesn't make sense.

Jordyn Heal, 23, is about to enter her third year in medicine at UBC, and says although she's passionate about family medicine, her mentors are advising her to rethink it.

She said the fee-for-service model isn't "feasible" when it comes to making ends meet. 

"I need to think about myself in the practical aspects of being able to finance my own future," she said. 

"I feel a little bit guilty about that because I didn't go into medicine for the money. I went into it … to care about patients."

Every year hundreds of medical students choose a family practice residency in B.C., but most of them never make it into an actual family practice. We hear from two students about the tough decisions they feel forced to make.

Most family doctors in B.C. are paid anywhere from $30 to $50 per patient visit, depending on age, whether they're treating a common cold or a complex chronic health problem.

They do receive higher payments for consultations, complete medical exams and minor procedures, according to the Ministry of Health. They also get annual per-patient payments of $125 for treating patients with chronic illnesses.

Physicians run their practice as a business, paying out overhead costs like staff and office space at an average rate of about $60 per hour or more.

Ivy Deavy, 34, went into medical school at age 32, with the intention of becoming a family physician. While she still intends to go that route, she says she's not as excited about it as she once was. 

Ivy Deavy, 34, says the workload and financial aspects of running a family practice are "discouraging." (Ivy Deavy)

"New grads and students like myself are thinking, why would I go into longitudinal care when it's not financially sustainable, when there's so much burnout, when the workload is overwhelming?" she told The Early Edition host Stephen Quinn.

She often hears of family physicians leaving their practices to work in telehealth, retire early or just pack it in altogether because the workload is too much and they can't afford to stay afloat.

"It's incredibly discouraging."

Deavy says the thought of having to run a business as well as provide care to patients is "incredibly daunting."

"We get no training in that," she said. 

"I get tons of training in identifying different diseases, training in medication, training in communication. I get no training in business. That is not what I am specializing in. It is not what I want to do." 

Deavy says people who are looking to practice family medicine have other options: they can work in hospitals, specialise in palliative care or find salaried positions in youth or sexual health clinics. 

If the current business model for longitudinal care — family physicians providing long-term care — doesn't change, Deavy says she'll consider those other options.

The shortage of family doctors in B.C., came to a head last week at a rally in Victoria. We speak to B.C.'s Minister of Health Adrian Dix.

Health Minister Adrian Dix has said he recognizes that young doctors don't like the current business model for family physicians. 

"We have to do a better job recruiting new family practice doctors," Dix said. 

When he spoke with CBC last week, Dix said he'd be meeting with Doctors of B.C., an association that advocates for physicians, to discuss short-term and long-term measures to ensure British Columbians have access to family physicians.

For now, he points to urgent primary care centres and primary care networks, although critics say those models are not fixing the problem as they too remain under-staffed and overused

ABOUT THE AUTHOR

Courtney Dickson

Broadcast and Digital Journalist

Courtney Dickson is a journalist working in Vancouver, B.C. Email her at courtney.dickson@cbc.ca with story tips.

With files from The Early Edition

Comments

To encourage thoughtful and respectful conversations, first and last names will appear with each submission to CBC/Radio-Canada's online communities (except in children and youth-oriented communities). Pseudonyms will no longer be permitted.

By submitting a comment, you accept that CBC has the right to reproduce and publish that comment in whole or in part, in any manner CBC chooses. Please note that CBC does not endorse the opinions expressed in comments. Comments on this story are moderated according to our Submission Guidelines. Comments are welcome while open. We reserve the right to close comments at any time.

Become a CBC Member

Join the conversation  Create account

Already have an account?

now