A Chilliwack family doctor says the mismanagement of healthcare dollars at the new Chilliwack and Fraser Heath Rural Primary Care Centre (PCC) “is completely staggering.”
The doctor, who agreed to speak on the condition of anonymity, says the B.C. Ministry of Health has been unable to recruit any physicians to work at the clinic, which opened May 17, 2022, at 7955 Evans Road. What’s more, he says there are four nurse practitioner spots that remain vacant.
The doctor said there were four physicians and “a handful” of nurse practitioners working at the old PCC at Chilliwack General Hospital (CGH), and all four have decided to leave within the next few months or so. One physician had reportedly been hired for the new PCC, but the doctor believes that person has since backed out.
“This has largely been due to the poor experience of the negotiations process and significant loss of autonomy that comes with working under the (Fraser) health authority,” the doctor said. “A few of the physicians were considering going elsewhere already but this has solidified the decision for them.
“So we have a shiny, brand new clinic in Chilliwack that cost millions to build, and we actually have a net loss of physicians to work there.”
The doctor believes B.C.’s Ministry of Health prefers to rely more on nurse practitioners, and said Chilliwack has some wonderful people in that role. But they are part of the solution, not the entire solution.
“When they work in teams with physicians, truly excellent care can be delivered,” the doctor said. “However, they are more expensive per patient, and will not solve our current crisis. We need to incentivize community-based family medicine, to attract new graduates and convince family doctors in semi-specialized niche practice that full scope community practice is just as well compensated and valuable.”
The big problem, the doctor noted, lies in how the province has chosen to set up the clinic.
Chilliwack’s primary care clinic had been based at Chilliwack General Hospital (CGH) for over a decade before the new building opened.
The doctor said that on the surface it was wonderful news.
It was a collaborative effort between Fraser Health, the Ministry of Health, the Chilliwack Division of Family Practice and other community partners.
It was named Momíyelhtelaxwt, which means ‘helping one another.’
“Teams of medical providers working together to care for patients is the future of medicine,” the doctor said. “This clinic is unique in its efforts to integrate traditional First Nations healers and culturally sensitive care as well. The research around team-based care is robust in that it serves patients better and actually saves the medical system money by preventing hospitalizations and ER visits.”
But there is a contrast between how B.C. and Alberta do things, and the doctor believes Alberta has the better model.
“Alberta provides funding directly to physician clinics based on the number and complexity of patients they cared for, and the clinics are free to use this funding to hire whoever they feel will best serve their patients,” the doctor said. “The funding was not allowed to be used for anything other than supporting team-based care.
“B.C., on the other hand, has relied on the various health authorities to implement and administer the funds for these teams. This has resulted in significantly more bureaucratic processes and expenses in order to accomplish the same things.”
For the Chilliwack clinic, Fraser Health has taken on oversight from the Chilliwack Division of Family Practice. The health authority is in charge of negotiating to bring physicians on board and the doctor said it hasn’t gone well.
“Small groups of local physicians wanting to provide care and attachment for local patients have been pitted against well-oiled health authority negotiating machines,” the doctor said. “This has resulted in many cases of prolonged negotiation processes costing thousands in redundant meetings alone.”
The doctor also said the doctors have lost autonomy working for the health authority.
“Physicians are generally passionate about quality improvement and tweaking their practices to ensure they deliver the best care to their patients,” the doctor explained. “This becomes significantly more challenging under a health authority as the layers of bureaucracy add both cost and time to any meaningful changes.”
Fraser Health was asked for comment, but did not replied before going to press.