Sixteen family doctors in Sechelt have penned an urgent letter to the B.C. government asking for financial support as they grapple with stagnant wages and increased costs.
Business expenses have “exponentially increased” while incomes have “remained neutral” for years, states the Aug. 13 letter addressed to the premier, minister of health and Doctors of BC, among others.
“Our fee structure ignores increased patient volumes and complexities amidst a steadily growing population on the Sunshine Coast,” it reads.
“We are contributing a substantial percentage of personal income to cover overhead costs and the continued increases are simply not sustainable.”
Dr. Kevin Koopman, a family physician at the Cowrie Medical Clinic and signatory to the letter, said he is aware of one local clinic on the Sunshine Coast that could close due to the unsustainable costs. The physicians from that clinic have asked to join his clinic, but with nine full-time physicians, a resident and a medical student, and only 11 exam rooms, there’s no room for them, he told Global News.
“At the end of the day, our current health care system is in a crisis,” he said.
“There’s no way of explaining it otherwise and it’s unfortunate because the crisis is only being made worse with family physicians and specialists leaving British Columbia to work in a different province.”
The letter signatories say their goal is to have a family medicine clinic with more than 25 exam rooms to accommodate patient and physician needs on the Sunshine Coast, as well as attract more medical trainees and improve doctor retention.
Buying the land in today’s market, however, is not possible without support, Koopman said.
“That extra expense has to come from somewhere, when you compound the added cost of just medical supplies and rent and all those other expenditures, it just becomes a lot more that we’re having to contribute to provide health care, a publicly-funded service,” he said.
The doctors are asking the province to either increase the billing codes to make up for the costs of inflation and running a business, or provide an overhead subsidy. As it stands, he added, overhead eats up between 20 and 30 per cent of a physician’s overall annual income.
“Our clinic relies on our medical staff for the most part and as of right now, the currently hourly wage that we offer them, they can get doing a liquor store job,” Koopman said. “We need to provide them with benefits.”
Doctors of BC was unavailable for an interview Monday, and Vancouver Coastal Health passed on a request for comment to the B.C. health minister.
In an interview, Adrian Dix said the letter’s proposed new family medical clinic “seems sound.”
“But what is, I think more immediate … is the work we’re doing really, many hours every week with the Doctors of BC to try and stabilize the challenges many doctors are facing now with the funding model, which is largely fee-for-service, that doctors and governments agreed to over a long period of time.”
Dix has previously said the province needs to make simpler contract models that give doctors options to move between fee-for-service care models and public health care.
Since 2017, he said alternative payments to doctors whose services are not delivered through fee-for-service models have increased from $500 million to about $750 million. It’s an increase of about 15 per cent every year for the past three years, he said.
Discussions with Doctors of BC are going “well,” he added on Monday, and he hopes it will have an effect in Sechelt. The province is adding more Primary Care Networks, doctors, nurses, and health professionals to combat shortages, he said, working with university medical programs and trying to attract more international physicians.
Nearly one million British Columbians are without a family doctor. According to the letter, “Primary Care Networks, contracts, and hybrid billing systems are not sufficient models to alleviate this crisis.”
“We do not want non-family doctors, non-rural doctors, administrators, and quality improvement teams telling us what will result in maximized patient care,” the physicians wrote. “We want substantially increased income and/or overhead subsidies but our asks continue to fall on deaf ears.”
— with files from Kylie Stanton
Editor’s Note: This is a corrected story. An earlier version said a Sunshine Coast clinic will be closing due to unsustainable costs. In fact, it could close due to unsustainable costs.