Last Doctor Standing
Commentary by Dr. Lorne Verhulst (May 13/2022), poignantly illustrating the reality of independent family practice in BC.
I am writing as the last man standing, so to speak, as owner of Shelbourne Medical Clinic. Former partners have retired or died. In 2018, when I invested as a shareholder, there were 20+ doctors working some combination of part time and full time or Locum hours in the clinic. Now we have 3 and sometimes 4. The clinic has served the public for 30 years as a combined site hosting family doctors and a walk in clinic. In 2020 we were down to only 1.2 FTE physicians in the general practice side. Our lease was coming up for renewal. Knowing we could not sustain the footprint we had, we approached the powers that be for help knowing then that millions of new dollars were just around the corner for Primary Care Networks (PCN). We didn’t get any help.
So we chose to downsize and become a smaller facility with only a walk in clinic. Meanwhile the government spends millions creating UPCCs that do nothing more than we were already doing, but at many times the cost.
In recent months one of our doctors has left to become a Hospitalist. He will get better pay. Another has left because the hassle of transition to a new electronic medical record EMR system was too much for them. The transition was forced upon us by Telus (big business monopoly) because they were phasing out the program we used to use. The huge cost of this transition has been born entirely out of our operating revenues. And the hassle factor is huge.
For most of its existence the clinic was open 12 hours a day 365 days a year. Now there are many days with no doctors and even more days with only 6 hours of doctor availability. We know and deeply regret that it is becoming more and more difficult for the public to access care at our facility. Every day we see dozens of new patients that we have never seen before whose family doctors have recently retired or who are away and can’t find coverage or who are simply overwhelmed themselves. But our capacity to absorb more patients is shrinking, along with revenues.
The government must recognize that all the venues in which care is delivered were created by entrepreneurial doctors who put their own capital at risk. Now we have to compete with the government itself for the same scarce human resource, the scarce family doctors. The bright and shiny new facilities are not creating new doctors out of thin air. They’re taking them from the same pool that we depend upon. And Health Authorities are also drawing family doctors into Hospitalist jobs and out of community practice, with better hours, better pay, and better working conditions.
Soon I will also be competing with one of the world’s largest corporations, Walmart, when they open a new clinic in the Hillside Mall Supercenter. They will also siphon off any potential doctors that may be looking for walk in clinic work in our neighborhood by subsidizing their overhead.
Summer is approaching and our doctors will be taking much deserved and much needed vacation time. We will not be able to find locums. Without doctors services, there is no fee for service revenue. Without revenue, business suffers losses. The clinic may not survive much longer.
May 28: See the incredible reaction to Dr. Verhulst's story — please share it widely!