Calling all doctors: Victoria physicians on board with recruitment train

Solutions to family physician shortage begin with collaboration: stakeholders

Kathy Dabrus

A shortage of family doctors in the Capital Region has left thousands of people without consistent medical care and doctors struggling to meet demand – a problem that will soon worsen as many physicians approach retirement age.

“It’s absolutely a crisis,” said Dr. Mark Sherman, one of five family doctors at the Victoria Community Health Co-operative, where physician recruitment efforts are ongoing.

Fewer doctors are left to shoulder the burden of more complex health issues that come with Greater Victoria’s aging population.

“Patient care is appalling,” said Dr. Cara Ewert with Herald Street Health. “It’s all just a little bit overwhelming.”

There are 13 available positions for permanent, part-time and substitute, or locum, family physicians in the Capital Region listed on the Vancouver Island Health Authority’s website.

But the vacancy rate from Sooke to Sidney is likely higher, doctors say, and those numbers are expected to climb in the next five to 10 years, as many physicians look to retire. On average, family physicians in the Capital Region are in their late 50s.

“Doctors here are older than just about anywhere in B.C. It’s just reflective of the general demographics here,” said Andrew Hume, the executive director for the South Island Division of Family Practice, one of 31 community based and provincially funded groups of family physicians in the province.

And with few replacement physicians on the horizon – the reasons range from lower remuneration to new doctors preferring to specialize – many family physicians in the region are postponing retirement, some for as long as five years.

“We generally say that physicians should plan one year to recruit,” said Brenda Warren, VIHA manager of physician recruitment.

“Some of them, it takes a couple of years to fill (a position).”

But solutions may be on the horizon. Hundreds of doctors in the region are finding their collective voice through the Divisions of Family Practice, which works in co-operation with health authorities, a joint provincial physician/Ministry of Health service committee and the ministry itself. Together, physicians at the community level are taking steps to map out strategies to address issues such as recruitment and retention.

“As family doctors dealing one-on-one with individual patients, we really felt we were in a unique role to advocate on the ground, right at the grassroots level,” said Dr. Kathy Dabrus, who sits on the Victoria Division of Family Practice’s board of directors. “There hasn’t been a voice previously.”

The Victoria division, which started last November, now has 187 members.

To better understand physician demographics, divisions will survey members this summer. South Island members plan to come together in September to develop strategies, based on survey results. A recruitment working group will likely emerge from that process, Hume said.

The South Island division began in October 2010, and has 150 family physician members on the West Shore and the Saanich Peninsula.

Collaboration among physicians, the divisions, B.C.’s Ministry of Health and the health authority, among other stakeholders, is imperative to address the shortage, Hume said.

“It’s a whole community approach, so part of our strategy has to be, ‘how are we going to work with municipal governments and community based agencies, and other health providers, health authorities, the ministry, to identify resources?’”

Such municipalities as Esquimalt, which has one family practice but enough work for two or three, are looking to be part of the solution.

The township is taking steps this fall to develop a physician recruitment strategy, in co-operation with VIHA and through consulting Esquimalt-based family doctors.

“Esquimalt is an expensive place to move into (and buy a house), and also business and commercial taxes are higher,” said Mayor Barb Desjardins.

Zoning or tax policy changes, advertising and the development of an information package to introduce doctors to Esquimalt could be part of the township’s recruitment strategy, said Bill Brown, director of development services.

“Hopefully our municipality will be a leader in developing protocols in policies for physician recruitment,” he said.

In an example of teamwork, the South Island division is spearheading a working group of stakeholders on the Peninsula to develop a comprehensive multi-practice primary health-care centre.

“A municipal government can play a very active role in terms of assisting with the provision of facilities or possibly land, zoning, bylaws, to make it more attractive (for doctors) and support that kind of development in their community,” Hume said.

Collaborative, long-term solutions can’t happen soon enough for doctors facing an imminent tidal wave of patients orphaned by retiring physicians.

“We need new or practising doctors to move to Victoria to set up or join a practice,” Sherman said.

Did you know?

• An estimated 400,000 people in B.C. don’t have a family doctor or a strong attachment to one.

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