FEATURED COMMENT – New family doctors have unrealistic demands
Re: ARMCHAIR ARCHIVES – Losing one the community’s very best family doctors
I found out that my family doctor is also retiring. I booked a final appointment to make sure all my meds were updated and refilled plus my family doctor has become a friend and I wanted to make sure they knew how much they had meant to me. They got me through some really tough times. I know my doc was really trying hard to find new GP’s to take over the practice.
I was stunned to hear what had been happening. The practice came , free of charge, with 4 exam rooms, all the equipment as well as a plethora of patients and an ideal location. Several new MD’s applied and here are some of their responses. Once they looked over the site they were interviewed by my doctor. One asked how many “old patients” were in the patient roster. Old meant over 60. Far too many for this young fella. He only wanted younger healthier patients. Applicant number 2 asked about hrs. the clinic was open during the week, as they only wanted to work 2 days a week.
They loved the outdoor life style so needed time to chillax, after all, 2 full days of work in a week would be exhausting. Applicant number 3 wondered who ran the office. Along with one front end staff, my doctor ran the clinic. Apparently they didn’t want to do that. My doc suggested to all of them, that maybe they could work with several other doctors so that they could work only 2 days a week on rotation, somebody can deal with the old folks and they could hire somebody to “run” the office.
OMG, not only do they have unrealistic demands, they insist on interviewing the patients and they decide on the basis of age, health and how much time a patient will need per appointment, whether they will take them or not.
It was suggested that there would be no GP’s in 5 years, instead we would be seeing an online doc and then shuffled off to a specialist and then 5 yrs. after that it would go to just folks diagnosing themselves and making appointments with whomever they felt they needed to see. What a fiasco.
I was lucky to have a doctor who actually went into medicine because they wanted to help and who is sad and feeling guilty because they are leaving their patients in a lurch. It seems that some of the new doctors are only practicing medicine to finance their lifestyle not to help others. Doctors from out of the country come in, work their allotted time under a licensed practitioner and then some leave to go back east where they are paid more.
Possibly the answer is fully staffed and equipped offices that new graduates could step right into. There are several examples of this in many countries. They would only see patients and somebody else would do the footwork of billing, taking messages, stocking supplies and sending reports. I totally agree that the doctors are responsible for way to much paper work and are burning out because of all the extra time they are spending doing non medical work. I thought our gov’t was looking into this but have not heard anything else.
So now I call 811 and hope, before I die, I get a GP. With my luck my cell will ring during my service saying I have an interview with a GP.
ANNE EVANS
ArmchairMayor.ca 
Somewhere along the path of “getting to this ridiculous point” courageous politicians with resolve should have told the whole profession to smart up, quit the wining and get on with providing the best healthcare they were supposedly trained to do.
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Look at the various College of Physicians as a part source of Doctor shortages and burnout and for putting up huge hurdles for well trained foreign doctors to certify here.
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Actually:
– and I speak as a husband of someone who does this for a living,
– and over the decades, we have in our friend and associate groups many, many people who hold this position throughout town … and the province, and this view of the job is likely echoed throughout the country,
– so am intimately aware as to the job description and working practice of the position, whether the practice they are working in is a public walk in clinic, or a GP or a specialist office,
The people who ‘work the front office’, or work within a practice at the desk or on the phone, is known and accredited as a ‘Medical Office Assistant’ … or MOA for short. This is a position that for decades, and still does, requires a certification course be successfully completed, and a great many of them also have decades of real world experience performing all tasks surrounding the paperwork and patient scheduling needs within the office.
MOA’s own as their primary tasks, MSP billing code knowledge and billing, scheduling patient appointments and the doctors schedule if the doctor has hospital duties as well as office, taking messages, stocking supplies and sending reports … in fact every single task associated with what happens functionally when your GP says ‘Im going to send you to a … (specialist)’ is performed either by your GP’s MPOA or the specialist MOA.
This means that they handle lab or service requisitions, and any and all referrals to any other point of care in the system, at times across the province, and sometimes cross provincial … to ensure that the patients needs are dealt with. This also can involve out of province medical insurance paperwork.
Doctors dont do any of this, they are focused specifically on the medical needs and requirements of the patient. When a doctor finishes with the patient in the office, he informs the MOA of the task list to facilitate the orders … then moves on to the next patient. Everything else is on the MOA.
Every time you phone their office about anything, the MOA is the one that has to parse, adjudicate and facilitate whatever you are asking about, and determine the best course of action; follow up appt with the doctor, a note to the doctor, or if in their scope – do what you need done.
Bringing this back to Ms. Evans ‘feedback letter’, yes … there has been seen by all experienced MOA’s, a new and modern approach by new doctors entering practices who dont think the same way as established doctors, and dont seem to want to be available to handle the workload, also do not want to pay MOA’s historic wages, as a way to maximize their own income for working as little as possible … and yes, this is due to this new appreciation of the work / life balance.
This is real, and I am just stating that and not getting into judging the appropriateness of this approach.
My goal is to point out that the way described above is how medical offices and practices have always worked. Doctors dont do this remedial paperwork, and never have, this is a job that experienced healthcare MOA professionals do, and are very good at.
Part of the reason why the system operates like this, is because this is how for the most part doctor billing with the province works. Doctors that see more patients in the day earn more money, as in our system they get paid per patient … so it makes sense to delegate as many tasks as possible away from the doctor themselves … so they can maximize how many patients are seen.
These new Primary Urgent Care clinics operate differently, as the govt pays for the doctors time, but also provide them with the supports they need, MOA’s ect.
There have been other updates to the billing system to answer to the problems, but I’m sticking to the historic system to keep it simple.
If you asked an experienced doctor if they are burning out ‘from doing paperwork’, they will tell you that its more about the volume of patients and the need to move and think as quickly as they can to maximize billing … and thats hard to do, day in and day out.
Consulting specialists do have the added task of completing the consultation reports, which no one else can do, so that does add to this stress even more.
So where I absolutely agree with Ms. Evans viewpoint regarding her difficulty in obtaining a GP, there is more to this conversation regarding how the system works on the ground, and I hope all this adds to it, in a positive way.
‘Fixing this system’, is multi-pronged and involves changing a lot of how stuff works, with the goal being to entice doctors and professional to want to work in the system, provide a doctor to anyone who wants one, and enjoy that work/life balance we are all trying to achieve.
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I am fortunate to have a great Doctor that I call a “Family Doctor” to me, but in reality, I stand in line hoping to get in to see him, just like everyone else in town. I just funnel all my medical reports to him, so I know who has them. I know he does the best he can, but he is governed by idiotic regulations of the Medical Board of B.C. ( in other words, the Prov Government Beurocrats ) He is forced to follow a stringent time limit, but is regulated as to how many patients he can see in a day, so he plays the game to afford to be a Doctor. He is very good, but now, I am glad he takes a couple days off once in a while to clear the air, get his head straight, and enjoy life. Dr. Yanko was our family Doctor, and I’m so fortunate to have had him look after me and my family. But, he is the last of a whole generation of Doctors. Something has to be done to correct the problem we are creating. The Beurocrats and the Health Boards need a serious shake up. The direction we are taking is not good.
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