Dr. Colleen Lee likes to look on the bright side of things.
“I’m usually an optimist,” she said last week.
But this past year has been difficult. Everyone has put their lives on hold when they were fighting COVID in the middle of the pandemic, while also working to ensure there was not another outbreak. And lately, the family physician has taken on more management chores than she’s ever seen.
“Some of the joy has been missing lately,” she said. “It’s been hard for the last six to 12 months, that’s for sure. It is hard managing medical issues in 10- or 15-minute appointments.”
Lee, who’s one of the directors at the Delta Division of Family Practice, said something has to give in B.C.’s family health care.
“For myself, I don’t think this is sustainable. I think they have to change. If we don’t see some changes in the compensation model in the near future, you’re going to lose more family physicians before you can replace them,” she said.
Lee has practised family medicine for 29 years at Tsawwassen Medical Clinic and has seen the system evolve into today’s crisis.
Even when her own family physician retires in a few years, she may be joining the million or so B.C. residents who can’t find a doctor.
“The (current) payment schedule, it doesn’t pay us for the time we need to manage complex care," she said.
A growing and an older population that is living longer, people showing up with several health issues, more complex medical treatments, the after-effects of the pandemic, the unceasing demands of computer and paperwork are all piling, unpaid, onto family physicians.
“We’re being asked to look after issues that weren’t there 20 to 30 years ago … (and) way more forms than I ever thought was possible,” she adds. “That was never taught in medical school.”
Her usual work day involves seeing or talking to about 30 patients, either in person or by phone. She wraps up consultation about 5 p.m., which is usually followed by an hour or two of paper or computer work – or between five to eight hours a week.
According to B.C. Health Care Matters, B.C. doctors are the lowest paid in the country, with their counterparts in Alberta earning more than double the median paid salary for B.C. doctors of $162,237.
In B.C., doctors get an average of $31 for each patient visit.
That fee increases however for seniors, while doctors also get paid annually for managing chronic issues such as diabetes.
“It doesn’t pay us for the time we need to manage complex care,” Lee said of B.C.’s system.
Lee added though that there’s hope for improvement from the negotiations now on going between doctors and the province.
“I think there’s a strong recognition that how primary care is managed … needs, to change, evolve. I think the government is very much aware of that.”