‘In crisis’: Award-winning B.C. family doctor mulls giving up bursting practice

Another British Columbia family doctor is warning she may give up her practice — amid a caseload bursting at the seams.

Dr. Tahmeena Ali, a 20-year veteran who serves the South Surrey-White Rock community was named B.C.’s Family Physician of the Year in 2020 by the College of Family Physicians of Canada.

She reached her breaking point after contracting COVID-19 a few weeks ago.

“I don’t have any paid sick time, and if I don’t work I don’t generate income to pay my staff and pay my rent. And so on the week of isolation, I wasn’t able to rest like my body needed to,” she said.

“Instead I turned all my in-person work to virtual…I stayed at home and I continued to care for my patients even though I too was sick.”

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Upon returning to work she faced a massive backlog of administrative work and in-person patients. Those pressures were above and beyond her daily workload, which often includes taking care of paperwork before and after seeing patients. And she says, she is constantly inundated with new patient requests.

Ali is not alone. In recent months, three clinics in the Greater Victoria area closed shop, some citing a massive patient load and lack of available physicians.

According to a 2019 report, more than 800,000 British Columbians were without a regular health-care provider.

“I absolutely adore it. I chose it because I enjoy the relationships I’ve developed with my patients over the years. The thought of leaving them stranded without a family physician breaks my heart,” Ali said.

“So if I ever get to that point, and every day I get closer and closer to it, it would be with very heavy heart. Because I know in doing that, not only am I putting a burden on them, I’m putting a burden on my colleagues, because there’s simply no other family physicians who are going to be able to take up my place.”

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B.C. Health Minister Adrian Dix agreed that changes are necessary and said the province has been steadily grinding away at the problem.

“Family practice doctors who are the backbone of our system are certainly struggling,” he acknowledged, adding he planned to reach out to Ali.

Dix said B.C. is working to take pressure off family physicians through the rollout of primary care networks, urgent and primary care centres and community health centres. Through these innovations the province has already added 950 health-care workers to support doctors.

Those types of models, proposed and led by doctors, are a part of B.C.’s efforts to move away from a fee-for-service model, in which doctors operate their own private practices and are paid per patient.

B.C., Dix said, still has two times as many doctors working in a fee-for-service model as Ontario.

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“New doctors say it is not for them. They don’t want to be business people and doctors. They want to practice medicine. So we have to address that while ensuring our existing folks who have been dealing with the old system, remain stable,” Dix said.

“So, it’s a big challenge.”

Ali acknowledged that the sitting government has made some improvements to the system since coming to power, but she said it hasn’t been enough.

She said young doctors and graduates are being turned off family medicine because of the growing financial costs and workload. More team-based solutions are necessary, she said, and that the province needs to go beyond just adding doctors or nurse practitioners. She points to other jurisdictions that employ physician assistants who can help doctors with smaller tasks and administrative work.

“British Columbia has been a leader in health care and we showed it through the pandemic … but we’re going to have to do more, because unfortunately what we’ve done so far hasn’t been enough.”