No easy fix for doctor shortage

Long wait for Sooke residents looking for family doctor

East Sooke resident Nick Bates can’t remember how many times he’s walked through the doors of the West Coast Family Medical Clinic on Sooke Road looking for a family doctor.

“It’s quite frustrating,” said Bates, who moved to the Island from southern Alberta with his spouse and three young daughters 2.5 years ago.

He is one of more than 3,000 people on a waiting list at the medical clinic. But that isn’t even a true number: the clinic quit taking names for the wait list more than two years ago.

Bates’ problem is complicated further due to his wife’s health issues that require medication prescribed by a doctor. To get the medicine, he must visit drop-in clinics throughout the region.

But it’s a dilemma. Doctors are reluctant to prescribe the medication because the Bates don’t have a family doctor. Sometimes Bates must travel all the way to Mill Bay to receive medical attention.

“It’s frustrating and insane, all at the same time,” said Bates, with a hesitant chuckle.

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Sooke needs at least three more family physicians just to whittle down its patient wait list at West Coast Family Medical Clinic.

The provincial government estimates 200,000 people in B.C. need a family doctor. In 2013, the province promised all residents access to a family doctor by 2015 with its $132-million A GP for Me program.

“It’s a challenge. The Island is attractive in terms of geography, climate and lifestyle, but there’s a shortage. We have many physicians retiring. We’re playing catch up,” said Brenda Warren, former manager of physician recruitment and retention for Island Health.

There are 64 vacancies for family physicians on Vancouver Island and more than 330 across B.C., according to Health Match B.C., a Health Ministry job recruitment website.

A study by University of B.C. health researchers Kim McGrail and Ruth Lavergne noted that the province has spent $1 billion to improve primary care since 2006, with more than $700 million of that going to incentives for doctors to encourage the traditional family practice model.

Those incentives include additional payments – on top of regular fees – to doctors for providing mental-health care and palliative care, and for the management of patients with chronic diseases.

Despite these incentives, family doctors already in practice are turning away new patients because their rosters are full. Many new doctors are choosing to join walk-in clinics rather than taking on the responsibility and costs of setting up a family practice.

“One of the biggest concerns many doctors have when they go into a small town is that they’re not going to be able to take vacations. In the city it’s not a big deal, you just put a note on the door telling patients to go to their local walk-in clinic, but you can’t really do that out here,” said Dr. Anton Rabien, who has practiced family medicine in Sooke since 2016.

What’s unique to Sooke is its rurality and remoteness and proximity to other desirable locations.

In the past Sooke was a designated rural community benefitting from provincial rural incentives – financial support and bonuses paid to family physicians.

With the growth of population and proximity to other services in the Western Communities, Sooke no longer holds this designation and corresponding incentives. This means it now competes against communities that still have rural incentives and communities closer to the heart of Victoria.

It’s a tough pill to swallow for Mayor Maja Tait, who, along with the Sooke Primary Health Working Service Group, has been studying ways to attract more doctors and better health services and facilities to the region.

“When we look at Sooke we see growth, aging, economic issues, increased housing costs, all contributing to the health needs of the population,” Tait said.

“All said, we see a growing need for increased access to primary care in Sooke.”

Rabien said when he arrived in Sooke as a young doctor 10 years ago, the six doctors already had a full patient load but were still taking a wait list. Today, there are eight doctors and the wait list is unending.

On average, a Sooke doctor has a 1,700 to 2,000 patient caseload. Once doctors exceed more 2,000 patients, it gets unmanageable, Rabien said.

While finding new doctors in the Sooke Region seems dim, there’s hope.

Sooke Primary Health Working Service Group is actively seeking out doctors to come to Sooke, and it’s pushing for better health-care facilities in the core, such as an upgraded X-ray facility, a full-time walk-in clinic and better support for palliative care.

“It’s competitive. Every municipality is trying to attract physicians,” Tait said.

And there’s no magic pill that will make it easier, cautioned Clay Barber, executive director of the South Island Division of Family Practice.

Barber noted Sooke has been well supported by local and provincial governments in the “complexities of family doctor recruitment and retention [that] is essential for the viability of family medicine in Sooke.

“When we talk about new family physicians coming into Sooke, we look at both retirement and growth,” he said. “Recruitment efforts need to meet the pressures on replacement and growth.”

To alleviate the problem, the province is aiming to create an integrated team of medical professionals to see patients, to help take pressure off general practitioners.

Nurse practitioners, nurses, pharmacists, counsellors – not every medical problem requires a physician, said Warren.

There are also financial and program support to help “vulnerable populations,” such as the recently funded Child and Youth Mental Health and Substance Use Collaborative, which set up primary care services at Edward Milne Community School (along with Royal Bay in Colwood and Belmont in Langford).

The Island medical program also creates learning opportunities in local Island communities, which assists in attracting and retaining family physicians.

Still, while many of these programs slowly attract doctors, patients are still desperately searching for medical care.

Cheryl Dinse has lived in Sooke for five years and she’s waiting for a family physician to call her own.

“I’d love to have a doctor here, but closest I one I could find was in Victoria. When I first moved to Sooke, the lady at the doctor’s office said I have a five to seven year wait,” Dinse said.

“It’s impossible. I don’t even bother anymore. It’s absolutely insane.”