This story is part of Situation Critical, a series of CBC British Columbia reports on the barriers people in that province face in accessing timely and appropriate health care.
Dr. Anna Chodyra has crossed land and sea to practice medicine.
Originally from Poland, the 47-year-old first immigrated to Canada as an international medical graduate in 2001.
She made her residency in Calgary before crossing the Rockies in 2006, when she moved to the small town of Port Moody in the Tri-Cities region of British Columbia’s Lower Mainland, just east of Vancouver. . She worked there for 13 years before following the Barnet Road east to Coquitlam, where she joined Meadowbrook Family Practice.
The family doctor said she currently has a patient panel of 2,100 – and she is unsure where any of them will go when she and her family move to New Zealand this fall.
“It’s a very difficult decision, knowing that I leave my patients without finding someone to replace me, leaving them alone,” said Chodyra, adding that she never planned to leave British Columbia.
“We tried to find a replacement doctor, but we couldn’t. No one is taking over the practices anymore.”
Chodyra closed her practice in British Columbia at the end of June as she prepares to join a new group of family doctors in the small town of Waihi, about two hours southeast of Auckland.
She said the decision stemmed from a need to be closer to her husband’s family in Australia and because of “the state of primary care in British Columbia”, including the current fee-for-service system. of the province and staffing shortages that she says will be less severe. of a problem in New Zealand, where she will have five nurses and three doctors to help patients.
“Family doctors, we don’t feel supported and we feel really undervalued,” she said.
His impending departure, however, has sent shockwaves through the Tri-Cities, as his patients scramble to find new family doctors amid a shortage, where an estimated one million British Columbians are already without a doctor. of first resort.
The Fraser Northwest Division of Family Practice (FNDFP) – a non-profit organization that works with and supports family physicians in Anmore, Belcarra, Coquitlam, New Westminster, Port Coquitlam and Port Moody – said its membership has declined by 7% over the past year. He estimates that in the six communities there are 170 primary providers, of which about 49 live in Coquitlam.
The nonprofit’s program director, Jessie Mather-Lingley, said since 2014, Coquitlam has lost nearly 50 family doctors. She said 15 of them have been since 2021, either due to retirement, relocation or changing roles in healthcare.
The British Columbia Ministry of Health said in a statement that it is “committed to ensuring that all British Columbians have access to health care when they need it.”
“The number of family physicians has increased by almost 9% since 2016-2017 to reach 6,760 FPs (family physicians) in the province in 2020-2021. This is an average annual increase of 2.1%.
Still, Chodyra and other doctors worry that patients unable to find new doctors will turn to acute care providers like hospital emergency departments for non-emergency care because they have no other choice. , which will further strain BC’s healthcare system with delays and increased costs. .
Doctors without doctors
For family doctor Mahsa Mackie, Chodyra’s departure hits particularly close to home. In addition to working in Coquitlam, she is also one of the patients Chodyra leaves behind.
“If someone who we think has a lot of years ahead of them closes their practice or leaves the community, that’s never a good sign,” Mackie said.
Mackie, who completed her residency in 2014, said the hardest part of her doctor’s decision to close shop is knowing that she and her colleagues at the Manhas Health Co. health clinic won’t be able to accommodate all of them. the “orphans” of Chodyra.
“I have a few thousand patients and my wait time is already a few weeks. Taking on more patients means that my current patients would not have access to care in time.”
Mackie said she’s taken some of Chodyra’s patients, but many more are stuck on the clinic’s waiting list, which has grown steadily since it arrived in 2021.
“Orphan” patients can strain ER resources
Emergency physician Dr Ali Abdalvand, who is also on Chodyra’s current roster, told CBC that orphan patients would turn to temporary interruptions like urgent primary care or acute emergency care if they couldn’t. find a family doctor in their community.
“The whole point of having emergency medicine as a specialty and having the emergency department as an integral part of the health care system is the provision of unplanned acute care,” Dr. Abdalvand said.
“If you end up sharing the resources of an emergency department to provide primary care, it will leave fewer and fewer of those resources for providing unscheduled acute care.”
Data from the Canadian Institute for Health Information, meanwhile, shows that emergency department spending across Canada has increased in recent years.
The cost of an emergency room visit rose from $96 in 2005-2006 to $158 in 2018-2019, an annual growth rate of 4%.
The same dataset also shows that in 2018-2019, emergency service personnel in British Columbia worked more overtime than anywhere else in Canada except the Northwest Territories, 9.14% of all hours worked.
As he searches for a new family doctor, Abdalvad tells CBC the province is losing “one of the best doctors” he has ever met.
“I know patients who have told me [Chodyra] went and got [their] prescription filled…and dropped it off,” he said. “It’s beyond [care]. And that makes me sad.”