Cortes has been fortunate for many years to have a stable rota of physicians staffing our clinic but we are now in a time of feeling the crunch that all rural areas of BC have been feeling for a while. The model here is that we have a group of physicians who contract with Island Health to staff our clinic- our community was one of the first in the province to benefit from this model.
For those who watch the news the inability to recruit full time medical staff has long been the case in rural and remote communities. It is also now common in urban setting for a retiring physician to be unable to find anyone to take on a solo practice.
The reasons for this are complex - e.g.fewer graduating physicians are choosing General Practice, less interest in solo practice and more in a team based approach to patient care, financial disincentives for rural practice.
We are hoping that we will have 4 physicians providing rotating coverage for our clinic. Our physicians also have practices and lives elsewhere. In the terms of their contract they are entitled to approximately 42 days of replacement by locum physicians. These replacement physicians are a pool of doctors who contract with the Rural Locum GP Program to provide services in places such as Cortes. Ideally under this system, all days that the clinic is open are covered by a physician. Three things have been happening-
1. Our physician group has not been able to fill some weeks that they require locums due to a shortage of locum physicians available through the RGPLP at the times needed here.
2. The physician group of only 3 last year was just not able to cover all the days they were contracted for due to having lives and practices elsewhere. Ideally they would find another physician to subcontract these days to, but they are often not able to find that physician willing to come here and subcontract those days.
3. The familiar group of locums who were relied on to cover those locum days and were familiar faces at the clinic, has dwindled, mostly due to retirement
Thus in 2022 we have had a few times when there is not a physician at our clinic and we also saw new locum physicians at our clinic. Hopefully some of these newer locums will want to return here and get to know the community better.
This is all to say that there may well be more weeks in the future that there is no physician at the clinic and there will be several less familiar faces as new locums try out the Cortes Clinic.
In addition, our clinic has been seeing increased patient volume and complexity- you probably have noticed longer wait times for an physician appointment or lab work.What we are doing to maintain stability for our patients:
1. If there is no physician at the clinic it does remain open and an RN is on site for lab work, triaging phone calls, seeing patients and treatments within their scope of practice. As well, the office staff remain staffing the phones, scheduling future appointments and labwork, answering questions and filling out travel forms and all the myriad other tasks they do.
2. All physicians rotating through the clinic leave a handover note to the next physician detailing patients who have forseeable concerns in the next week that would need to be addressed (although they don’t have crystal balls)
3. There is regular communication between the clinic nurses and physicians about patients of concern.
4. The physician, the RN, the Mental Health clinician, the Community Paramedic have regular multidisciplinary rounds to discuss clients of concernWhat you can do
- Bring an up to date medication list to your appointment
- Have a concise list/history of your medical concerns, conditions
- Realize that if your needs are complex, you may require more than one physician visit. Ideally with the same physician but realistically it may with with a different physician. - Know that they do make good notes and suggestions for treatment plan so you don’t necessarily have to start at the beginning again.
- Take your own notes, maybe have someone with you as a second pair of earsWe encourage you to look at these resources re BC health care situation.https://bchealthcarematters.com/https://bchealthcarematters.com/family-physician-shortage
If you would like to make your voice hear about the physician shortage here are some suggestions:https://bcfamilydocs.ca/wp-content/uploads/2022/04/BCFD_Toolkit_FINAL.pdfhttps://bcruralhealth.org/