CHARBONNEAU – B.C. Clinics: a new business model for doctors


I SUGGEST that a new government agency, I’m calling BC Clinics, be established to deal with the crisis in accessibility to health care. The fee-for-service model no longer works and that leaves many British Columbians without a doctor.

Modeled after BC Housing, BC Clinics would build clinics to be operated by non-profit societies.

It’s not a new idea. BC Housing now builds thousands of housing units for low-income individuals and families, then hands them to non-profit societies, such as the one I belong to, to operate. It’s not a gift. We pay back BC Housing as the mortgage holder.

The fee-for-service model is a barrier to doctors entering a medical practice.

That pay model isn’t working for anyone: not for doctors and not for patients. With real estate prices going through the roof, with expensive medical diagnostic tools and equipment, with the rising cost of wages for staff and the cost of utilities, doctors who attempt to set up private practices end up working long hours — much it in unpaid administrative work.

There’s no shortage of doctors in B.C. — there’s a shortage in doctors who want to start up their own medical business. British Columbia has about 6,800 family doctors by training but less than half of them are practicing traditional family medicine.

New graduates are choosing more hospital-based work instead and specialized practice, which provide a predictable income, team supports, a vacation and maternity leave.

Doctors identify fee-for-service as the path to minimum wages. There has to be a better way. Fortunately there is and it’s being modeled right here in Kamloops.

I’m referring to the non-profit society called Supporting Team Excellence with Patients Society (STEPS).  STEPS Community Health Centre provides medical care to more than 14,000 people in the Kamloops area, one of them being me, and includes health services for women, refugees and trans and Indigenous people.

“We’re helping family physicians with this unique business model and keeping them in Kamloops and able to practice,” STEPS executive director Christine Matuschewski told Kamloops city council on June 14.

“The landscape of family practice has changed and STEPS’ model allows physicians to focus on patients in an integrated team, instead of being focused on doing business.”

STEPS leases clinics and pays doctors, Matuschewski told me. That frees doctors to do what they do best: practice medicine.

With a million British Columbians without a family doctor, it might seem like there is a shortage of doctors.

However, the number of doctors trained in family medicine grew 11.2 per cent between 2016 and 2020. British Columbia has about 6,800 family doctors by training, but less than half of them are practicing traditional family medicine.

At STEPS, family doctors team up with other health and social care professionals who can take some of the workload off of their shoulders — professionals such as social workers, occupational therapists and dieticians.

STEPS operates clinics in a flexible environment where doctors want to work. With 11,000 Kamloops residents on the waitlist for a family doctor, Matuschewski hopes their Community Health Centre will continue to attract and retain family doctors.

Clinics operated by non-profit societies will increase the accessibility of health care for British Columbians. Build them and doctors will come.

David Charbonneau is a retired TRU electronics instructor who hosts a blog at

About Mel Rothenburger (9481 Articles) is a forum about Kamloops and the world. It has more than one million views. Mel Rothenburger is the former Editor of The Daily News in Kamloops, B.C. (retiring in 2012), and past mayor of Kamloops (1999-2005). At he is the publisher, editor, news editor, city editor, reporter, webmaster, and just about anything else you can think of. He is grateful for the contributions of several local columnists. This blog doesn't require a subscription but gratefully accepts donations to help defray costs.

1 Comment on CHARBONNEAU – B.C. Clinics: a new business model for doctors

  1. Steps is a step in the right direction for sure. But…do we also need better medical training?

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