British Columbia

Trudeau pitched family doctors for everyone. But B.C. already tried that and failed

A campaign promise by federal Liberal leader Justin Trudeau about making sure all Canadians have access to a family doctor might feel a little bit like déjà vu in British Columbia.

Medical expert says a change to the business model is needed to attract new graduates

Trudeau said a re-elected Liberal government would make sure every Canadian had access to a family doctor. (Getty Images)

A campaign promise by federal Liberal leader Justin Trudeau about making sure all Canadians have access to a family doctor might feel a little bit like déjà vu in British Columbia.

A key platform for the B.C. Liberals in 2010 — which they doubled down on in 2013 — was that everyone who wanted a family doctor would be able to have one by 2015; a program remembered as A GP for Me.

Former health minister Margaret MacDiarmid in 2013 reiterating the government's commitment to A GP for Me 

Health Minister Margaret MacDiarmid says everyone will have access to a GP by 2015. 0:13

Well, 2015 arrived. And while there was progress including the training of more family physicians, hundreds of thousands of British Columbians still had no family doctor.

Now, many in the healthcare industry, like family physician Dr. Rita McCracken, are wondering how such a complex problem could work on a federal level when it failed provincially.

Across the province, around 780,000 people are without a primary care doctor or nurse practitioner, according to the government of B.C.

One of them is Alyssa Koehn.

When she moved back to Vancouver two years ago, she struggled to find a family doctor. After six months of searching, she found a doctor and only because "she knew someone who knew someone" that had a new physician start at their clinic.

But due to her new doctor's busy schedule — she continuously cancelled appointments on her — Koehn is now once again on the hunt for a primary-care physician.

"It's not been great," she said, reflecting on the process.

Koehn has hypothyroidism, which requires regular blood tests every six months. Instead of seeing a regular doctor who knows her medical history and has all the results of her past blood tests, she has to visit a walk-in clinic "on the outskirts of town." 

Every time she visits a new clinic, she has to fill the doctor-of-the-day in on her case and get another blood test.

"If I could just have someone I could regularly trust to see, I would be less of an impact on the medical system," said Koehn.

Why A GP for Me didn't work

Dr. Rita McCracken has no doubt that better access to family doctors will mean healthier British Columbians. But, putting that dream into practice is a whole different problem, one the medical industry in B.C. has been working on for 15 years.

"Unfortunately, we haven't really moved the yardstick forward," said McCracken, who is also an assistant professor at UBC.

Dr. Rita McCracken, left, with a patient at a nursing home where she works. McCracken wants the province to provide more team-based care for patients. (Providence Health Care)

She said there are a few reasons why A GP for Me was unsuccessful.

A primary focus of the program was to offer physicians a financial incentive to take on more patients with complex needs, which McCracken says completely ignored the fact patient lists were already at capacity and doctors were working as hard as possible.

"Simply providing an incentive fee...was inadequate," she said.

What was — and still is — needed, she says, is structural change.

Right now, the family physician model revolves around owning a business and includes all the overhead costs that accompany a brick and mortar shop — but there's a change to how the next generation of doctors wants to work, said McCracken.

"New graduates are choosing work patterns that allow them to be human beings and parents and not just family doctors," she said.

Finally, for a sustainable primary care system to succeed, McCracken says B.C. needs to move away from the traditional fee-for-service pay structure for family physicians and, instead, adopt a salary model.

B.C. changes underway

B.C.'s NDP government has promised changes to primary care, including more than a dozen team-based primary care networks, which are meant to streamline referrals between family doctors, nurse practitioners and other health care providers.

The province has also promised money for up to 200 new general practioners to work in the team-based care model, and 10 new urgent primary care centres that will help those without a family doctor or nurse practitioner.

With files from Laurie Tritschler