Province announces funding for clinics as region loses third walk-in this month

Photo: Darren Stone / Times Colonist

ook Street Village Medical Clinic is the latest walk-in clinic to close its doors in the capital region.

The B.C. government will spend $3.46 million to keep five south Island walk-in clinics open, but the money won’t save three ­others set to close this month.

The short-term stabilization funding announced by Health Minister Adrian Dix on Friday will go to hire more doctors, nurses and other health-care workers to support walk-in services at Esquimalt ­Medical Clinic, West Coast Family ­Medical Clinic in Sooke, West Saanich Medical Clinic, and Shoreline Medical clinics in Brentwood Bay and Sidney.

“This gives significantly more options to those providers to recruit people and to recruit people with the types of contracts people are trying to seek,” said Dix. “We’re confident we’ll have success with it.”

The clinics are part of what’s called a Primary Care Network — clinics that get support to provide team-based care — and the funding comes through the South Island Primary Care ­Network walk-in clinic task force.

The $3.46 million will ­support about 10 full-time equivalent family doctor positions across all five clinics through Dec. 31, about six ­registered nurse positions, and other health-care ­professionals.

Money is also available for ­overhead payments and a ­steering committee to support the work over the next nine months. The funding will not, however, stop the closure this month of View Royal’s Eagle Creek Medical Clinic walk-in, the Colwood Medical Treatment Centre, or Cook Street Village Medical Clinic.

Dix said only five of seven clinics in the South Island Division of Family Practice Primary Care Network accepted the offer of short-term funding to keep their walk-ins open. Eagle Creek Medical and Colwood Medical remain set to close April 15.

Matthew Ward, medical director of Eagle Creek, said he doesn’t have the doctors to replace a wife-and-husband physician team leaving this month, who helped serve patients who didn’t have their own doctors via the walk-in clinic, and had a patient load of about 1,500 each.

“The reason I am closing the walk-in is I don’t have the doctors for it and I cannot take on — safely — all these orphan patients that are being lost because of the two doctors that are leaving,” said Ward, noting he has hired a high-priced recruiter to search for physicians internationally.

“There’s just no one who want to come and practice family medicine in Victoria,” he said. “We need to really incentivize doctors back into community longitudinal family practice, understand what the market forces are, and really push for this.”

Compensation for a family doctor in traditional practice is probably insufficient by $100,000 annually, said Ward. The average overhead is about $85,000.

The Cook Street Village Medical Clinic walk-in clinic is part of the Victoria Division of Family Practice PCN, which is also in talks with the province.

While Dr. Ian Bridger, medical director for five family-practice walk-in clinics in the region, including the Cook Street clinic, didn’t get short-term funding for his clinics, he found Friday’s announcement promising.

“It’s fantastic,” said Bridger, who wants to see the province do everything it can to attract physicians. “I think to step in with some interim funding while they try and sort out the long-term answer is so smart.”

Dr. Ramneek Dosanjh, president of the Doctors of B.C., said she welcomes the “short-term fix” by the provincial government, but many communities around our province are experiencing the same problems as the south Island. “Every week we are learning more doctors that are closing their practices and more patients are scrambling, quite honestly, to find primary care.

As the province and Doctors of B.C. negotiate the Physician Master Agreement, doctors are in part looking for alternatives to the fee-for service plan — which pays physicians about $31 per patient visit — such as contracts and salaried work, as well as more payments for work that is currently not in the fee code.

“We need to appreciate the high costs of running clinics,” said Dosanjh. “It must be addressed because business costs are rising quickly and doctors can’t keep up.

“We are at big risk that doctors might just fold and close their practices and so we need a strategy to retain the doctors that are doing longitudinal primary care right now.”

Victoria family physician Dr. Jill Norris recently wrote to a letter to Dix, co-signed by thousands of primary-care physicians, asking for urgent measures to address “inequitable pay for family physicians,” saying there isn’t time to wait for the Physician Master Agreement to be concluded.

Norris pointed to colleagues closing their practices, missed or delayed diagnoses because of the growing number of unattached patients, ER physicians and specialists faced with cases that could have been prevented with primary care, and increased hospital admissions.

“The morale of family medicine, for those that do longitudinal, full-service family practice under fee-for-service, is decimated,” she wrote.

The ministry is looking at piloting an urban locum program, where new doctors are given incentives to provide coverage within their local primary care network. It’s also examining an after-hours call coverage service supporting local clinics.