In the midst of a heavy influenza season, Maple Ridge walk-in clinics are being forced to close their doors and send away patients, telling them to come back the next day.
There is a lack of doctors to fill the shifts, and a cap of 50 patients per day set by the B.C. Ministry of Health.
At Ridge Meadows Care Clinic West on Tuesday, there was no doctor between 3 and 5 p.m., so the facility closed. When it re-opened at 5 p.m., patients were lined up outside. The doctor was going to be able to see just 20 patients, because of the province’s cap, even though the clinic was scheduled to be open until 9 p.m. that evening.
At Ridge Meadows Care Clinic East on the same day, the facility closed between 1 and 5 p.m., because no doctor was available.
“The 50 limit is not as much a problem as the fact that we don’t have enough doctors working in the clinics,” said Dr. Bob Harrison, on his way to a shift.
“That’s the problem. We’ve lost five or six doctors in the last year to retirement in Maple Ridge.”
He said there are also many doctors who work less than full-time hours.
“The younger generation isn’t working as hard as the older generation,” said Harrison. “We need more doctors, or we need doctors working more hours.”
Harrison sees this as a bad flu season.
“I only see a piece of it, but I’ve seen some pretty severe cases.”
The dominant strain of flu this season, H3N2, is highly volatile and particularly tough on seniors. At the same time, respiratory viruses are circulating at above average rates, increasing the public’s chances of getting sick.
Harrison had a practice in Maple Ridge for 40 years and retired in 2013. Walking past patients wearing flu masks and into the clinic, he said, “I just do this for fun.”
Mike McLoughlin of the Walk-in Clinics of B.C. Association explained that, under the province’s rules, clinics are paid just 50 per cent of rate for any patients they serve after 50 to a maximum of 65.
After that, the doctors don’t get paid.
So clinics across the Lower Mainland are closing early.
“It’s a travesty, because the demand is there,” said McLoughlin.
The cap was a measure designed to prevent so-called “drive through” care. The cap, put in during the 1990s, when walk-in clinics were just becoming a popular, is intended to serve as an incentive for doctors to spend more time with their patients.
“The original intentions were right, but it’s an outdated policy that has the unintended consequence of forcing clinics to close when they shouldn’t be,” McLoughlin said.
The health ministry stated this month that it will not be changing the policy.
One local clinic manager suggested that an exception should be made for heavy flu seasons like this one. During the H1N1 flu in 2009, clinics could bill for flu patients without them counting against the cap. That kind of policy change would help during this busy time.
The manager said it has been a busy time, both because of the flu season, and because clinics that are scheduled to be open from 9 a.m. to 9 p.m. seven days a week can’t get enough physicians to fill the shifts.
Tasleem Juma of Fraser Health said there has been an increase in hospitalizations throughout the region, but patients cannot be confirmed as suffering the flu without a blood test. Generally they are in hospital being treated for complications arising from the flu.
Flu outbreaks began over the Christmas season and health care providers have been busy since.
“If you’re sick, stay home and gets lots of rest and liquids, so you’re not infecting other people,” said Juma.
McLoughlin asked flu patients to see their family doctors, if possible.
“For those who have a family doctor, it’s important for them to go there when the walk-in clinics are slammed,” he said. “Let others who don’t have family doctors use a walk-in clinic. It’s considerate.”