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Kelowna physician Dr. Marjorie Docherty has been practicing family medicine in Canada since 1985 when she got paid about $25 for a patient consult.

Now, 37 years later, family doctors in B.C. get just over $31 for the same visit, despite the dramatic increase in the cost of supplies, equipment, staff and rent.

“We’ve become the forgotten child in the medical family,” Docherty, the immediate past-president of the B.C. College of Family Physicians, told iNFOnews.ca. “No one wants to bring it down to billing because doctors do really care about their patients and family doctors care about their patients passionately but, at the end of the day, you do have to run your practice and you do have to supply it and take care of your staff and pay them as well.”

Over the past two years, 16 Central Okanagan doctors have left their practices with no replacements. Docherty doesn’t have stats for other parts of the region but it’s a growing problem throughout the province. Since 2019, 30 Central Okanagan doctors have retired but some have been replaced.

Doctors no longer sell their practices when they leave. They’re just lucky if they can find someone to take it over, she said.

There are currently 38,000 Central Okanagan residents without family doctors and 8,000 on a waiting list for family doctors, she said.

READ MORE: Access to healthcare in Kamloops a barrier to potential new residents

“A few years ago, if you didn’t have a family doctor, it was usually a young person who didn’t bother to keep up a relationship with a family doctor and didn’t think it necessary,” Docherty said. “For the first time in my practicing life, since 1985, this last year is the first time I continue to see people that are very sick with complex illnesses who don’t have a family doctor.”

That’s particularly evident in places like Kelowna, which was the fastest growing major Canadian city during the 2016-21 census period.

“They’re moving here from other provinces and they’re moving to be closer to their kids or they’re moving here to retire or their family doctor retired,” Docherty said. “I’ve never seen it in these numbers before. It’s a huge weight on the healthcare system because, if you have those complexities, you end up in urgent care frequently or in the emergency department.”

When she started practicing in 1985, she felt reasonably well paid at $25 per patient. In the last couple of years, especially with staff shortages, COVID issues and skyrocketing inflation, some family doctors are barely getting by.

“It’s wonderful to have universal health care,” Docherty said. “It’s wonderful to have free public health care and I truly do endorse and believe in that. But you shouldn’t do it at the expense of someone else’s survival.”

It takes at least 11 years of schooling and training to become a family doctor with the huge debt load that can easily exceed $100,000.

“I think it’s become financially untenable,” Docherty said. “There’s an expectation that you will be on call 24/7. There’s no compensation for being on call. Then there’s the record keeping and the management of your practice. I think a young doctor looks at that and says: ‘I don’t think I can do that.’”

Increasing the pay rate is only part of the solution.

“You have to make it a more attractive environment,” Docherty said. “People want to work in group practices. They want to work in a supportive environment. Really, no one in medicine is trained to be a business person. Suddenly you’re in an office and you’re running four of five staff and you’re dealing with strata arrangements, dealing with overhead and ordering supplies. I think, for a lot of the new young doctors coming out, what they want is like a start-up clinic where, perhaps, the government or health authority organizes the clinic for them and they come and work it.”

Despite the fact that family medicine can be more challenging than specialist fields and requires a broad range of knowledge, it is hugely rewarding, she said.

“Previously, when talking to my residents that I would train, they were looking forward to having a family practice and having that longitudinal relationship because, really there is nothing better than knowing somebody for years and seeing them work through something terrible in their life and get better or seeing them beat that cancer diagnosis and see them come through the therapy and start to do well,” Docherty said. “It’s just so gratifying to do that and to be part of that longitudinal journey of healthy living and being the support person for them. There are very few jobs more satisfying. If it was attractive in being able to do it, I don’t think we would have any difficulty in filling the jobs.”

It used to be that B.C. had no trouble recruiting new doctors – what some referred to as ‘sunshine doctors ‘ - because B.C. is such an attractive province.

That has changed dramatically in the past few years and is now reaching crisis proportions.

A survey done by the B.C. College of Family Physicians found that one million B.C. residents don’t have family doctors.

READ MORE: Kamloops woman among almost a million people in B.C. without a family doctor

The College has provided the provincial government with facts and figures and are lobbying heavily but, Docherty insisted, it’s the young doctors government needs to be consulting.

“They need to do a drastic rethink,” she said. “Urgent care systems are not going to cure us all. They might have a place but they only have a partial place. There really needs to be some thought put into community family care because, without it, our community is going to be a poorer place. There’s a lot of innovative ideas out there, a lot of creative young family physicians who are willing to talk if someone will listen.”

READ MORE: Nearly 50,000 sign petition pleading for more family doctors in B.C.

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