B.C.'s walk-in clinic owners talk tactics to keep doctors and stem losses in their ranks

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British Columbia’s shortage of family doctors is crimping the ability of the province’s walk-in clinics to stay open, according to an organization that represents their interests.

The non-profit group Walk-in Clinics of B.C., said about 50 clinics have closed since 2013 with the difficulty in recruiting physicians high on the list of reasons why, said founding director Mike McLoughlin.

So his group is holding a conference in Richmond on Friday to talk about ways to improve operations and perhaps offer better pay to recruit physicians to their businesses, which are increasingly filling gaps in B.C.’s primary health care system.

“Right now, the case (for walk-in clinics) is there’s not enough family doctors,” said McLoughlin, who is not a doctor himself, but operates the Medi-Kel clinic in Kelowna with his wife Sue McLoughlin, who is a family physician.

“There are 700,000 British Columbians who don’t have family doctors, and of that 700,000, 300,000 are actively seeking a family doctor,” McLoughlin said. “So who’s going to look after them? It’s walk-in clinics.”

Dr. Eric Cadesky, president of Doctors of B.C., said his organization is “concerned about anything that decreases people’s access to care,” but their preference is that patients would have access to continuing care with a family doctor.

With the dilemma of not having enough doctors, walk-in clinics “provide access to people for episodic care,” Cadesky said.

In the long run, however, he sees the facilities as a potential avenue to connect patients with doctors in “a new era of primary-care reform.”

“They already have the bricks and mortar, they already have the staff, they already have doctors that work for them,” Cadesky said.

What is needed, he said, is more support in the system so that doctors choose to go into full-service family practice.

McLoughlin said the number is hard to pin down with openings and closings, but there are about 350 walk-in clinics in B.C., and he argues they are a source of innovation to help improve the system as a whole.

“If they don’t (innovate) they’re going to close, which is what has been happening,” McLoughlin said.

At the conference, McLoughlin said they will be talking about ways to use technology to streamline systems and improve the way doctors do things ranging from making appointments to handling the paperwork for establishing complex-care plans.

Creating those plans can involve a lot of work, McLoughlin said, but also trigger additional MSP payments beyond the $30 basic fee for a doctor’s visit, which helps make family practice more attractive.

“If (doctors) take on a roster of patients and bill the complex care, they can get (the fee) up to $60, if they’re doing family practice,” McLoughlin said. “But it takes a lot of time to do that and that’s the challenge.”

McLoughlin said walk-in clinics are also advocating for ways to increase the sharing of patient records between hospitals, specialists and clinics.

“That personal relationship (between a doctor and a patient) is the best thing,” McLoughlin said, “but if you can’t get that, the next best thing is you need to have a patent record that follows you around.”

And he argued that walk-in clinics are “at the forefront” of bringing those kinds of innovation to the primary-care sector.

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