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To deal with a doctor shortage, this B.C. city has decided to start paying them directly

admin, December 29, 2024

A new clinic opening early next year on British Columbia’s Vancouver Island has a different structure it hopes will help attract and retain family doctors amid an ongoing physician shortage. 

The Colwood Medical Clinic will be run not as a private practice, as is normally the case, but by the Greater Victoria municipality itself. The mayor says they have now hired their first doctor and plan on bringing on seven more. 

All eight will be paid as municipal employees, receiving full medical benefits, vacation and a pension. They will also be free of the administrative and financial tasks doctors typically handle when running their own clinics, instead handing that work off to the city. 

Colwood Mayor Doug Kobayashi said some people called the plan “crazy” when they first proposed it last year, but that it’s now drawing interest from municipalities across the country that are also suffering doctor shortages. 

“I can tell you right now, the phone, texts, emails, it’s just going off like crazy from all the other municipalities,” he said. “They call me curious about what the heck we’re doing.”

LISTEN | Colwood brings 1st physician on board for innovative health clinic model:

On The Island9:11The new municipally-funded cllinic in Colwood has hired its first family physician

The new municipally-funded cllinic in Colwood has hired its first family physician, Dr. Cassandra Stiller-Moldovan. She chats with Gregor about what attracted her to the position.

Kobayashi said data gathered two years ago showed more than 50 per cent of the population of Colwood was without a family doctor. Each of the eight physicians expected to be hired at the Colwood Medical Clinic will be able to be connected with 1,250 local residents, according to the city. 

Kobayashi said while the doctors will be paid as Colwood employees, the program will be funded by provincial revenue billed by the clinic through the Ministry of Health in the same way doctors in other clinics bill for their time and office assistants.

First doctor jumps on board

Dr. Cassandra Stiller-Moldovan, who will be moving with her family from London, Ont., to be the clinic’s first family doctor, said the new model immediately appealed to her. 

“This clinic really matched my core values as a physician and the way I wanted to practise medicine. That really convinced me,” she said speaking on CBC’s On The Island. 

Dr. Cassandra Stiller-Moldovan is the first family doctor to join the Colwood Medical Clinic, which is set to open in February 2025. (City of Colwood )

Typically, family doctors run their practices as businesses and are responsible for overhead costs, like office space, staff and equipment. 

“We have two full-time jobs,” Stiller-Moldovan said. “We have the job of taking care of our patient roster, but also the job of running a small business.” 

By removing that second responsibility, Stiller-Moldovan said not only will her work-life balance improve, but it will also allow her to focus fully on caring for patients. 

“Being able to hand that over to people who know it well and can do it well, where I can just focus on health-care delivery, is very much a stress relief for me and allows me to focus on what I love doing.”

LISTEN | The daily realities of B.C.’s family physician shortage: 

On The Coast7:58BC Doctor shares insight into the realities of the BC family physician crisis

<p>The BC Family Doctor shortage has been an ongoing issue for decades, and today we gain some insight into the daily realities that Canadians seeking medical care and doctors face alike.</p>

Model could be expanded to other municipalities 

Kobayashi said his goal is to connect every person in Colwood to a physician. 

He originally proposed the clinic concept to the B.C. government in the summer of 2023, where it was quickly given the green light to explore. Now, it’s expected to open in February. 

“It’s been quite the adventure, but we got there, and I’m doing what I said I was going to do,” Kobayashi said. “People thought I was a crazy guy. I am. I’m an out-of-the-box thinker. But this is so logical.”

He said if the clinic is successful, the Ministry of Health may look at expanding it to other municipalities.  

B.C. Health Minister Josie Osbourne said new approaches at all levels of government are essential to solving challenges in health care. 

“When we see the kind of ingenuity and innovation that are happening in different communities … it just goes to show what the hard work can do in benefiting people,” she said speaking on CBC’s All Points West. 

Ahmer Karimuddin, president of Doctors of B.C., said the Colwood plan is a “bold” initiative in an era of physician shortages.

He said the old model where a family doctor looks to set up a practice in a local mall or shopping centre is outdated and communities need to look for new ways to attract physicians.

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