The shortfall of family doctors in the Central Okanagan has placed increasing pressure on medical walk-in clinics, says the founding director of the Walk-In Clinics of B.C. Association.

Mike McLoughlin, who operates the Medi-Kel Family Practice clinics in 琉璃神社, says two clinics, one in Rutland last summer and another more recently in Glenmore, have closed, placing greater patient care demand on the remaining walk-ins.

Adding to his frustration is 琉璃神社 General Hospital hiring local general practice physicians, called hospitalists, to opt out of running their own practice to work on-staff at the hospital.

鈥淲hat KGH is doing by hiring hospitalists out of the local family doctor pool is cutting off your nose to spite your face,鈥� McLoughlin said. 鈥淲hen you take a family doctor out of the pool of doctors, you orphan a whole bunch of their regular patients. It鈥檚 fair to expect some of those patients will end up on the doorstep of a walk-in clinic.

鈥淏ut the walk-in clinic in turn can鈥檛 handle the patient increase and either close down, like what happened in Glenmore, or close earlier to manage the patient volume.鈥�

Like most issues with health care, there are no easy solutions because it comes down to how the provincial health care dollars are carved up.

McLoughlin said walk-in clinic doctors can bill for 50 patients a day, can only bill for half after that up to 65, and then beyond that can鈥檛 bill at all.

鈥淲hat is needed is a more flexible patient billing cap to account for heavier patient traffic and demand, such as during flu season,鈥� he said. 鈥淐hange the overall daily cap to 65 patients a day or set weekly/monthly cap limits instead of daily ones.鈥�

As for McLoughlin鈥檚 frustration with KGH鈥檚 physician hiring needs, Dr. Mike Ertel said the hospital hiring GPs is a reflection of a changing reality on how doctors with independent practices operate.

鈥淲e still have 25 GPs who follow their patients when they are admitted to the hospital, but the majority no longer do not. That鈥檚 pretty standard for growing urban centres today,鈥� said Ertel, the executive director for Interior Health Central, a support position for chiefs-of-staff and medical personnel at hospitals in 琉璃神社, Vernon, Oliver and Penticton.

鈥淪o we need to hire family physicians to deal with those admitted patients or work in the ER on a daily basis. Our hospitals are bursting at the seems. We have recruited 80 physicians over the last 18 months and 29 alone since October.

鈥淭hat may be right up there as the most in the country. It reflects that people want to come here and work, but that being said we still need more family physicians.鈥�

At KGH, Ertel, an ER doctor, said patient volumes anticipated for 2020 or 2021 are now turning up a the hospital鈥檚 doors, a reflection of the population boom in the Central Okanagan.

鈥淜GH鈥檚 ER had 80,000 visits in 2016, up 7.5 per cent from the previous year. We were the third busiest ER in B.C.,鈥� said Ertel, who added that beyond what was a bad flu season, there was also an increase in acute care patients.

鈥淲e are seeing a proportionate increase in the number of people we are seeing and they are sicker which requires more care and attention.鈥�

Tristan Smith, executive director of the Central Okanagan Division of Family Practice, says tackling the GP shortfall requires a collaborative effort.

There is no single solution, but rather a mix of different approaches that offer a pathway to increased patient access to family doctors in the region, he says.

Some of those recruiting tactics include marketing the appeal of the Okanagan lifestyle, a 鈥榬ed carpet鈥� orientation program to encourage and welcome new doctors to relocate here, and working in coordinator with the Health Match BC provincial doctor recruitment initiative.

鈥淲e鈥檝e also done work in family doctors鈥� offices to improve efficiencies around appointments and office systems to maximize the time they have available for patients,鈥� Smith said in a written statement to Black Press.

鈥淲ith this combination of new doctors and increased capacity, we鈥檝e been able to match more patients in our community, including more than 1,600 seniors who previously did not have a doctor for ongoing care through our A GPforME program.鈥�

McLoughlin says he has been placated somewhat by the potential success of initiatives outlined by Smith, but he remains concerned about 鈥渟ilo thinking鈥� where walk-in clinics don鈥檛 have the resources or billing flexibility to compete with larger health care institutions.

Meanwhile, Ertel says options for those without a doctor are to use the 8-1-1 provincial health information and advice hotline staffed by registered nurses, try to seek out an appointment at a local walk-in clinic or come to KGH emergency.

鈥淭hat places more pressure on us but we try to get people through as fast as possible,鈥� Ertel said directing more people to a hospital emergency department.

鈥淲e have piloted a couple of new ideas to decrease the wait times, particularly for dealing with minor medical issues. We just have to ask people to be patient, we鈥檙e doing the best we can to minimize the wait time.鈥�