“I learned that the north is a big place, and providing care in rural and remote areas is more complicated than I as an urban physician have given credit for,” Dr. Cavers said. “My own minor experiences in driving these huge distances with the weather; it really highlights the difficulties that the patients have accessing care and the doctors have in providing it.”
Dr. Cavers adds, “We don’t have enough doctors in the rural areas; we don’t have enough nurses in the rural areas. There’s a real health human resources issue going on in B.C. right now.”
Doctors of B.C. estimate the need to produce 450 new graduates per year, which at this point is only at 288 per year.
“We need to be able to attract more of our own graduates into rural areas and keep more of our graduates within British Columbia.”
Dr. Carvers goes on to say while this issue is not unique to B.C, let alone just Fort St. John, it’s an issue that’s been “front and centre” during the organization’s meetings – a particular interest in creating a “made in B.C.” solution.
“We also need to work smarter and better – we have to sort out ways where the physicians can provide care more easily and more efficiently so that they can expand their umbrella of care to cover more people,” Dr. Carver explained.
Enter telemedicine; which Dr. Carver asserts to have the ability of working “for good or for evil.”
“We can use telephone medicine for a whole bunch of follow-up care so that patients don’t have to worry about mobility or travelling problems, and physicians can ‘see them’ in a much more efficient manner,” Dr. Caver says he concluded after experiencing the drive from Dawson Creek to Fort St. John.
Dr. Carver adds, “If telemedicine is brought in without any constraints, there’s a risk of creating a whole generation of ‘don’t even bother to walk-in’ clinics; in which people will phone in to talk to a physician for what I would call some relatively minor issues, and if the advise they’re given is unconnected to any longitudinal care – it can prove to be expensive and fragmented way of getting care.”
Dr Carver says this can increase the risk to patients, reduce positive outcomes, and push up the per capita cost.
Dr. Carver concludes by saying the doctors within a community experiences a physician shortage are imperative in creating a solution.
“A lot of physicians feel somewhat disconnected from the health authorities and the way the health authorities make decisions in terms of resource allocation, organization of health authority, work flows, etc.”
Dr. Caver does however concede that these conversations have already, and continue to be held between heath authorities, the Ministry of Health, and Doctors of B.C.
“We know the physicians have a unique perspective; they’re on the front lines of care, they know what can work and make a positive difference, and they have very good ideas and deserve to be heard.”