Squamish doctors issue cry for help from province

"All of us have a breaking point."

That, according to a letter sent by doctors in Squamish at Diamond Head Medical Clinic to Health Minister Adrian Dix.

The letter is a cry for help from the physicians, who have been wrestling with significant difficulties in attracting and retaining new doctors to the clinic.

The end result has been that, by their estimate, there are thousands of people in Squamish who have no family doctor. As the town grows, thousands more will encounter this problem.

"We're close," said Dr. James Cranston.

"There is a small chance that we could dissolve the clinic entirely. I don't think that's going to happen. But almost every other physician in this clinic has another source of income that actually pays them well. And, you know, in my case, for me, emergency medicine really allows me to do family practice. You know, I can accept that I'm not making as much here. And I can support that with emergency medicine. For other people, it's obstetrics, anesthesia, hospital work [and] working out of town doing various things."

The key issue is that the financial situation faced by family doctors has made it very hard to attract new physicians, he said.

There have been several retirements from the clinic, and finding replacements has been an arduous task.

There were 13 doctors three years ago, but the clinic is now down to eight.

Attempts to attract new doctors have been challenging.

The average new doctor will have about $200,000 in student loan debt, Cranston said. On top of that, they face high overhead and living costs in Squamish.

"So the compensation has moved to a point where we have not been able to recruit people to move to Squamish and join a practice," said Cranston.

The physicians of Diamond Head bought the space their practice resides in. A new doctor would have to buy a share of the unit and then find a place to live in a town where the valuation of a house has reached about $1.4 million.

"We've had five people leaving our clinic, which means that the remainder of us have to keep buying real estate from them," said Cranston. "And we're not able to do it anymore. But unfortunately, we can't get new people to buy it, which is what we've always done in the past when somebody leaves. Somebody [else will come] and buy it. But there's nobody left."

The doctors of Diamond Head are considering selling the clinic and hoping to strike a deal that would allow them to lease the majority of the clinic back, he said.

This will help remove one barrier, Cranston said, but it does not fix the underlying problem that many doctors aren't going into family practice anymore.

"80% to 90% comes down to money," said Cranston. "You can look up what I earned in the blue book and it looks pretty good. But then subtract from that many, many tens of thousands of dollars in overhead … huge overhead for most [general practitioners], you know, 30% to 40% of their money's lost overhead."