South Cariboo communities experiencing a family doctor shortage aren’t alone in their struggles, and work is being done to address the issue by many organizations and levels of government.
Jill Zirnhelt, executive director of the not-for-profit Central Interior Rural Division of Family Practice (CIRD), said there have been some big changes in 100 Mile House over the past 12 months, with four doctors leaving the community or retiring, the arrival of two new physicians and a nurse practitioner and the impending departure of two more doctors.
“It’s a lot for a community that doesn’t have that many physicians to start with,” said Zirnhelt, whose organization supports family practitioners in Williams Lake, 100 Mile House and the outlying areas of the two communities.
The shortage, she said, is not unique to 100 Mile House or Williams Lake, as many communities in the province and across the country are eagerly seeking family practitioners.
“There simply aren’t enough doctors to serve the population at the moment,” she said, noting it’s a problem that has been “brewing for years.”
The issue was raised last month at the Cariboo-Chilcotin Hospital Board meeting, where vice-chair Al Richmond noted the 100 Mile House community was “losing doctors at a great rate.”
The board has requested Interior Health appear as a delegate to share details on how the authority plans on recruiting doctors to the community in light of the current shortage.
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Zirnhelt explained this week that many regions – including the Cariboo-Chilcotin – are working to shift their care model to a primary care network, or team-based care, which distributes the patient need among a larger team of health care professionals, including nurse practitioners, social workers, mental health professionals, respiratory therapists and more.
“We are implementing a primary care network here, but the impacts aren’t that dramatic or quick,” Zirnhelt explained. “It’s not a bandaid solution, it’s a system-wide change.”
One service of note implemented in the Cariboo this past year is the Bridge Care Virtual Clinic, which serves “unattached” patients – those without a family physician – who aren’t able to access walk-in clinic treatment.
Local doctors from around the region pitch in through this virtual service and appointments can be made via telephone through a patient services coordinator.
“Patients can generally get an appointment within the same week, sometimes it’s the next day,” Zirnhelt explained. “The availability depends on how many physician shifts are available that week. The local doctors are doing the best they can by helping out with the Bridge Care clinic.”
The CIRD is also one of many players heavily involved in recruitment and retention efforts in the region, along with the Ministry of Health and local health authorities.
Staff visit universities, host welcoming events, facilitate connections within the medical community, showcase the communities and work to help newcomers feel at home in their new locations once they arrive.
The CIRD also works to make the communities more attractive to locum practitioners – who fill in temporarily to fill gaps or absences – so that permanent practitioners have the opportunity to take time off when needed.
A major factor for everyone involved in recruitment, Zirnhelt said, is finding suitable accommodation. This is a topic of concern for the newly resurrected Collaborative Services Committee, which includes representation from the Cariboo Regional District, City of Williams Lake, District of 100 Mile House, the CIRD, doctors, nurse practitioners and First Nations partners.
“Accommodation is a big issue that we are all coming together and trying to find a solution on,” Zirnhelt said. “Whenever we get a new practitioner, it is always a scramble to find them nice and appropriate accommodation.”
Another aspect of recruitment is the business model of family practices, which is slowly transforming away from a fee-for-service model, Zirnhelt said, as it is not as attractive for younger doctors who seek a better work-life balance.
“The practice style has completely changed,” she said, “Work-life balance wasn’t part of the picture in the ’80s, so the health care system is trying to adjust. How do we set up a primary-care model to compensate for work-life balance?”
Despite the challenges currently facing the health care system in the region, Zirnhelt is optimistic that changes to the system and new models of practice will help ease the burden in the long term.
“There is so much being done and many clever people who spend their entire day working to help this situation.”