Small Communites Need Doctors

The Shuswap, like many areas in the province, is facing a growing crisis in doctor availability. Enderby used to have 6 GPs to service the community and is now down to 1. Sorrento used to have 1 but no longer has access to any doctors. There are many reasons for this and therefore no single solution.  Our healthcare system is under considerable stress and we must reverse this trend. It will only become harder the longer we wait to address it.

Two issues are:

1)      Doctors that are trained in BC are moving to other provinces where they can do better than they can here.

2)      Doctors that stay in BC, don’t want to move to the smaller communities in spite of the incentives that are offered to do so.

The first thing I see is that we are competing for health care professionals between the provinces and we need an inter-provincial policy to level the playing field. This will be difficult to achieve and will require a premier that is willing to sit down with the other provinces and not leave the table for a photo-op.

As we work toward this long term strategy, there are some steps that can be taken immediately. BC Doctors are paid based on a huge set of fee schedules. These are complex and due to the speed of advances, they become outdated quickly and hard to keep updated. The result is that doctors are paid far too much for some procedures that have been simplified and far too little for others where more expensive procedures have now become available. To manage these, we need to start doing comparative reviews between all the provinces to see what is being paid for similar procedures in each province.   This would identify large differences and set the priorities for review.

The second issue, of doctors not wanting to live in the small communities, is related.  Since they are not paid a salary as such, but get paid based on these fee schedules, they do not have the same opportunity for wages in a small community. More than that, they also do not have the same variety of work since people will go into the major centers for complex health issue and therefore the smaller communities do not offer the same challenges as the larger centers.  No one wants to get trapped on a dead end career path so understandably they are concerned.  The incentives currently offered do not address their concerns adequately.

Most politicians are not health care professionals and so we need to work with the doctors to address these issues.  A few ideas I am starting to discuss with the medical community are:

1)      Tie the fee schedules to an adjustment so that in the smaller communities the fees are adjusted up.

2)      Look at salaries for doctors in small or remote communities rather than fees.

3)      Work with the smaller communities and the doctor's to find ways to make them attractive as a step in a career plan. This could include help with business set up or other benifits.

I am dedicated to working with our communities and our doctors to find solutions that meet everyone’s needs.  I have some starting points but what is needed is the hard work to craft a solution. I am dedicated to do just that.

I have begun discussing these ideas with our local doctors and will be solidifying an approach in the months ahead to help bring doctors back into our communities.

I would ask that any health care professionals that would like to join this conversation please contact me with your input. Together we will meet the needs of the Shuswap and create a framework that can be used througout the province.