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COLUMN: The family physician dilemma
I had a doctor’s appointment earlier this month.
Time for my post-40 physical.
Even though I had an appointment, I was made to wait a couple hours. As frequently happens—because my doc delivers babies too—she was out bringing new life into the world.
Frustrating. Even when she returns she’s rushed, trying to catch up. And I’m lucky.
According to A GP for Me, an initiative of the provincial government and the BC Medical Association, approximately 176,000 people in B.C. don’t even have a family doctor. My bet is that number is actually much higher, but regardless, A GP for Me aims to fix that.
For now, many people just go to the walk-in clinic and get whomever is on duty. From my experience, the service is curt, and a far cry from what you’d get when you see the same person, year-in, year-out.
Dr. Baldev Sanghera, a local family physician, agrees.
A family doctor provides continuity and a consistent connection that helps the patient stay healthy between visits too, says Sanghera, who is the lead doctor in the Burnaby Division of Family Practice, which represents almost all family doctors in Burnaby with the goal to support local doctors to benefit the whole community. The group is also the local lead on A GP for Me, and is in the process of surveying residents and medical professionals to find ways to boost the number of family doctors and the amount of patients served.
It’s important, Sanghera says, because people with a family doctor are healthier and put less stress on the medical system. Even if you’re just in the office with a bad cold, he says, it’s a chance to receive coaching on healthy lifestyle, stress reduction and the need for strong relationships.
“We know stressful lifestyles make people sick,” he says. “We’re coaching as well as treating and diagnosing.”
So what has caused the family doctor shortage?
Sanghera says women becoming family doctors has led to a “more sensible” idea of full-time work. They’ve pursued a more family friendly 35- to 45-hour work week instead of the 60-70-hour weeks common in the past. A positive development, he says, but it also means less service from the same number of doctors.
The health care system shifted too, from a focus on primary care through family physicians to a greater emphasis on specialists and acute care. Med school teachers today are usually specialists, and students tend to gravitate the same way, Sanghera says. And with the costs of training rising, students seek areas with better earning potential (read: specialization) to pay hefty student loans. Though family practice often pays less, the training costs the same.
But if the A GP for Me initiative succeeds, everyone wins, Sanghera says. “We’re all coming to the same realization that things can’t continue the way they have. The only way to reduce the cost of health care is to keep people healthy—and there’s lots of things we can do to help people achieve that.”
Sanghera says they plan to release the full results of their consultations in June. The goal is to recommend workable solutions that provide lasting results.
“We want to align all the information we get and come up with a full, comprehensive plan.”
Ironically, despite my frustration with long waits at my doctor’s office, Sanghera says she is going above and beyond, adding he stopped delivering babies 10 years ago due to the stress of running his office simultaneously.
“She’s one of our heroes—she’s trying to do all she can. The rest of the people can wait, the baby won’t.”
And he says the best way to improve my satisfaction is to improve her work life. “The system needs to provide her more support, and more physicians.”