The recent departure of two doctors from the Coast has put pressure on an already taxed medical community that is striving to serve a multitude of patients left without family physicians.
Dr. Nick Sparrow left this past summer and Dr. John Farrer left his practice to move back to England just last week.
"But prior to that there were a lot of orphaned patients, so I would say we are short perhaps a total of five physicians on the Coast now," said Dr. Edward Berinstein, the Coast's medical director.
Full-time doctors locally look after about 1,400 patients each, Berinstein said, leaving potentially 7,000 orphaned patients now on the Coast.
Patients without a family doctor must go to a walk-in clinic or the emergency room if they have a health concern, which contributed to the recent closure of the Sechelt walk-in clinic.
"The Sechelt clinic, I guess, felt they could not accommodate all the orphaned patients and all the people who were left without a doctor in their walk-in clinic, and so that's why they have shut down their walk-in clinic for now," Berinstein said.
Vancouver Coastal Health (VCH) is concerned the already well-used emergency room at St. Mary's Hospital will see an influx of orphaned patients in the future.
"I hope all those patients don't just turn up in the emergency department because it will just clog it up," said Dr. Richard Lupton, VCH's co-medical director. "It's already seriously congested, and as you know, we're in the middle of a rebuild at St. Mary's, so it's going to be quite challenging over the next few months if it gets very crowded."
Lupton also worries the doctor shortage could leave the hospital's emergency room short-staffed if demand increases.
"If we don't have a sufficient number of physicians on staff at the hospital who provide coverage to the emergency department, it gets more difficult to maintain that coverage, particularly in the summer time when people take vacations," he said. "So it does affect our ability to cover emergency at the hospital."
Doctors on the Coast are independent contractors, apart from VCH; however, they need to cover the emergency room at the hospital and must take care of their patients when admitted there.
Physicians generally take turns doing seven to 12-hour shifts in emergency, which can make for a very long day when individual practices still have to be taken care of.
"Most doctors who do a night time emergency shift may do a few hours in the office in the morning and then do the overnight shift at night and then take half the day off the next day, or a full day, it depends," Berinstein said. "It's a long work week."
Berinstein expects at least two other doctors to retire in the next five years, noting there are currently five Coast physicians practising in their 60s.
"That impact, I imagine, could be quite dramatic," he said.
While things look bleak there are steps being taken to improve the Coast's situation. The St. Mary's Hospital Foundation, at the request of doctors, leased a home to provide housing for physicians looking to practise on the Coast. Since opening in July of this year, the home has been used steadily by doctors doing locums at St. Mary's Hospital. So far no one has decided to stay, but there's hope a future visiting physician will make the move permanent.
Local doctors are advertising for physicians to join their practices through Health Match B.C. and medical journals, even going to medical conferences where young doctors congregate to encourage them to move here.
"In Gibsons we have had a success," Berinstein noted. "We have one doctor who just started and another one coming in December. One was from an ad and one is an international medical graduate (IMG) who is providing a return of service contract to this community."
IMGs are graduates who hold medical degrees outside Canada, but must do a two-year residency within Canada to update their skills and write the Canadian exams.
VCH is also encouraging the hiring of IMGs by offering to sponsor the medical grads, Lupton said.
A representative from VCH also sits on the Ministry of Health's joint standing committee on rural issues to discuss higher level solutions, as the Coast's issue mirrors that of nearly every other rural community in B.C.
"The committee meets every three months. It's a joint Ministry of Health B.C. and medical association committee and its primary purpose is to look at the issues that affect rural practice. A lot of its time is spent looking at the issue of recruiting because that is a constant challenge," Lupton said.
More discussion is also going on at the local level with doctors meeting as recently as last week to discuss ways to encourage more doctors to move to the Coast.
"We're always looking at solutions," Berinstein said.
