A commentary by the board co‑chairs of the South Island Division of Family Practice.
As family physicians on the South Island, we have observed significant transformations in health care within our city, province, and country over the past 22 years.
Despite a substantial increase in the number of physicians, access to primary care — having a family doctor who takes care of you over a long period of time — has dramatically decreased.
According to the Canadian Institute for Health Information, the number of physicians per 100,000 people in British Columbia was 162 in 1976 and rose to 270 in 2022 — the highest rate in Canada.
Merely increasing the number of physicians alone will not resolve the access issues in health care. We face a multifaceted health-care crisis that necessitates a comprehensive and collaborative approach involving all levels of government and sectors of society (such as community groups, non-governmental organizations, labour unions, Indigenous groups, charitable organizations, and professional associations).
Not all family physicians are engaged in longitudinal care, where they manage patients’ preventative care, diagnosis of disease and treatments, health management and coordination of care. Many work in hospitals or specialty clinics, part-time, or hold roles in teaching, leadership, and/or administration, alongside personal commitments.
The medical field is increasingly complex, with escalating chronic health issues, rising administrative burdens and a culture of overwork that is unsustainable.
According to the National Physician Health Survey, 53% of all physicians in Canada meet the criteria for burnout; 48% feel depressed and one in four of us experience high anxiety.
Consequently, due to the daunting working conditions, many new physicians are opting to diversify their work (away from longitudinal care), reduce their hours, or focus on areas of medicine that offer greater personal and professional satisfaction.
We appreciate the Aug. 16 editorial in the Times Colonist, “Tell us where we stand in queue for a doctor,” which reflects the widespread frustration felt by many British Columbians regarding the health-care crisis.
As co-chairs of the South Island Division of Family Practice and family physicians in the community, we are acutely aware of these frustrations from both our physician members and the hundreds of thousands of patients they serve.
The South Island Division of Family practice represents the diverse communities south of the Malahat, excluding Victoria, although we work closely with the Victoria Division of Family Practice on common issues.
Our board is elected by our family physician members and includes physicians as well as non-physician community members. We have four staff and 295 members.
The Divisions of Family Practice were established through a joint initiative of Doctors of B.C. and the Ministry of Health in 2009 to support family physicians through regional organization and collaboration, and address common health-care objectives within communities in order to enhance patient care.
Since their inception, these 35 divisions have provided a platform for family doctors to amplify their voices, influence health-care delivery and policy, and engage in collaborative partnerships with health authorities and the Ministry of Health.
They offer a local, evidence-based perspective on primary care issues, representing the family physicians in the communities we serve and addressing frontline challenges for family physicians and their patients.
In addition to supporting the primary care networks in our communities (a network of health-care providers who work in a team-based approach, ensuring patients are linked to the necessary parts of the health-care system), Divisions of Family Practice have strategic priorities that include physician wellness, increasing and retaining the number of family doctors in our regions, supporting clinics and clinical practice, and collaborative conversations with partners across the community, and at every level of government, to enhance primary care.
Effective solutions to the primary care access issue must consider the health-care system in its entirety.
This includes improving recruitment and retention of family physicians, expanding team-based care models, educating community members on how to practise preventative health care and how to navigate the health-care system effectively, and balancing resource allocation between actual health care and disease management.
In addition to ensuring timely and compassionate care for patients, it is essential to support health-care providers by reducing administrative burdens and addressing the critical factors that contribute to burnout.
The Divisions of Family Practice are integral to this dialogue and solution.
To tackle the complexity of the health-care crisis, it is imperative that we work collaboratively, fostering innovation and adaptation across all levels of government, community representation, and health provider organizations.
In health care, there is no “us” and “them”; there is only “us.”
>>> To comment on this article, write a letter to the editor: [email protected]
