A new interim clinic to address a family-doctor shortage in Port McNeill and the surrounding area welcomed its first appointments Wednesday, but the physician who raised alarm bells about the crisis says he’s been shut out.
“From the very beginning, there has been no collaboration or transparency or dialogue with me at all and so they’ve gone ahead and planned in isolation,” said Dr. Prean Armogam.“They haven’t really talked to me as the only provider left.”
Armogam, 49, is the sole family practitioner remaining at Port McNeill Medical Collaborative at 2161 McNeill Rd., which he owns.
He spoke out earlier this year when his physician partner, Dr. Joy Mijares, announced she was leaving the practice at the end of April. That left Armogam as the only family physician serving the area and hospital for the last three weeks.
Port McNeill is home to roughly 3,500 people, and its physicians are supposed to also serve the Mount Waddington area and isolated regions including Kincome Inlet, Gilford Island, Alert Bay, Rivers Inlet, Zeballos and Sointula.
The departure of three of the four physicians from the Port McNeill Medical Collaborative “placed it at significant risk of closure,” Island Health said Tuesday. In response, the health authority said, it hired two temporary physicians with rural health-care experience as “additional primary care supports” for the community and existing clinic.
But the two physicians — Dr. Nicole Bennett-Boutilier and Dr. John Fitzgerald — will not work out of the Collaborative clinic. Instead they are being housed in a new temporary office at 1584 Broughton Blvd.
That’s because Island Health aims to own and operate its own clinic — whether that’s in the existing Medical Collaborative building or elsewhere is still being decided.
For now, people who want to see Bennett-Boutilier, who will offer primary care services as well as coverage at Port McNeill Hospital throughout May, or Fitzgerald, who will provide services in June, can phone 1-866-956-2007 to schedule appointments, said Island Health. (The First Nations Health Authority also offers virtual “doctor of the day” services seven days a week via 1-855-344-3800).
The leased space and locums will be used “until a long-term primary care model for the community is established,” Island Health said in a statement, adding “there is no timeline for this.” It says it is still trying to recruit permanent doctors for the clinic.
Island Health plans for its clinic to take appointments only. The health authority did not confirm if doctors will be paid on salary, as opposed to the traditional fee-for-service model, but the province has set up many team-based clinics as salary-based operations.
Armogam said the health authority “flat out” rejected a plan to temporarily use his clinic and filing system to streamline the process for patients and everyone involved.
Armogam had originally asked the health authority and province for help in attracting new family physicians to the area, as well as looking at a team-based model where the health authority owns and operates the business.
He said Island Health expressed interest in purchasing his clinic space, but said they weren’t interested in taking him on full time, nor in him keeping some of his 3,000 patients — many with chronic conditions, elderly and vulnerable — and preferred to start with a “clean slate” under the new model.
Armogam said he can’t get a straightforward reason as to why. He said he was offered six months of work to transition patients, and then possibly another six months of working a half-day a week, and that’s it.
“I said: ‘So what becomes of me after that’ and they said: ‘Well, that’s not our problem,’ ” said Armogam, who came to Port McNeill from South Africa via England about 15 years ago.
On the clinic’s Facebook page, some patients have written words of support and gratitude for his loyalty to their families and the town. “Thank you again for all your excellent health care, you have taken care of my whole family for years and years,” wrote Tina.
Another patient thanked him for being the “one constant Doctor on the North Island and surrounding area” after Dr. Granger Avery retired.
About 360 people have signed a petition calling on Island Health to hire Armogam to work in the new medical clinic.
Asked if Armogam is being forced out amid a doctor shortage, the health authority said physicians are independent business people and “Island Health does not have purview over decisions with respect to their private practices.”
“Additionally, Dr. Armogam continues to hold privileges to practice within the Port McNeill Hospital and we thank him for his ongoing clinical support,” said the health authority.
If Island Health does purchase the Collaborative building, Armogam said there’s no guarantees about what would happen to his staff. His spouse is the administrative director, while he is the medical director.
The proposed price for the Medical Collaborative building was $400,000, according to a source close to the negotiations.
A request for proposals seeking suitable clinic space has closed and the process is underway, said Island Health, which would not disclose more details.
Armogam said the irony is that for 10 years, he has been advocating for a team-based health clinic that’s owned and operated by Island Health. “And they’ve gone ahead and done it, the whole thing in isolation — no collaboration, no timely messaging to the public, leaving us to fumble around in the dark and try and guess what their plans are.”
Forty kilometres away, the Port Hardy Primary Health Care Centre is a team-based clinic owned and operated by Island Health offering doctors, registered nurses, a diabetes educator and dietitians. It has about six family physicians.
For three weeks, Armogam has been working weekends and nights to see patients while providing emergency and community visits to Sointula, Woss, Zeballos and Rivers Inlet. He also covers shifts at the Port McNeill hospital, which is staffed by acute-care nurses employed by Island Health.
Armogam believes for now, patients may switch back and forth between the two clinics, choosing one once a new permanent Island Health clinic is established.
In response to Armogam’s comments, Island Health said the doctor has been told of the direction and plans for the Island Health-owned and operated clinic where appropriate, “and has been invited to provide input on various aspects of the clinic’s short-term and long-term models.”
