Town Plaza Medical Clinic is the latest doctor’s office to shutter in Whistler, exacerbating a years-long family physician shortage and ramping up the urgency behind a community-centred, primary care model currently being developed for the resort.
Dr. Ian Tamplin confirmed to Pique this week that Town Plaza would be closing its doors on May 1 after more than 25 years of operation. He noted the property’s new owners were looking to maintain it as a medical clinic.
“Our hopes are that the practice will reopen in the near future as the new owners plan to make it attractive for a new physician to set up practice,” Tamplin wrote in an email. “We have been informing our patients for some considerable time that we will be closing and many of them have found alternate MDs in Whistler and other communities. Unfortunately, a significant percentage remain without a regular family physician.”
The Main Street clinic counts about 100 regular patients, and serves approximately 200 patients a week.
With both Tamplin and Dr. Janice Carr at retirement age, the decision to close the clinic was delayed by several years “because of our inability to get an interested physician,” Tamplin noted. “Unfortunately, there comes a time that a line must be drawn.”
Town Plaza represents the third family practice in Whistler to close in recent years, along with two naturopath clinics. Prior to Town Plaza’s announcement, it was estimated that 40 per cent of Whistlerites were without a family doctor, and an additional six to eight full-time-equivalent GPs were needed to shore up the gaps in care.
A multitude of factors
There are multiple factors driving Whistler’s doctor shortage, most of which are not exclusive to the resort. Recruiting GPs, particularly to a town with such a high cost of living and steep commercial rents, has proven a tall order. But along with the economic realities of operating in a tourist town, the pressure points on family practices have only worsened in recent years. This has led to calls, both locally and provincially, for a complete reimagining of a family practice model that essentially asks GPs to double as small business owners.
“Traditional family practices are small businesses with all the expenses of overheads, staffing problems and management issues that any small business must endure,” explained Tamplin. “Funding for the current fee-per-item model is completely inadequate. Government must address the funding issues if practices like ours are going to continue existing.”
GPs are generalists by design, which limits the kinds of services they can bill for. Factor in the escalating overhead costs to run a family practice, and a more specialized role “is increasingly attractive for young people going through medical school,” said Jordan Sturdy, MLA for the Sea to Sky. “So I suppose it’s also about making the billing structures better for them.”
What’s more is family doctors are often left to deal with the administrative burden of running a practice: managing medical records, bookings and billings, which pulls them away from patient care.
“[Doctors] sure don’t get into this field to manage electronic medical records and figuring out file transfers and stuff like that,” said Councillor Jen Ford, who sits on the board of the recently formed Whistler 360 Health Collaborative Society. “The administrative burden of medical practice has changed substantially, and taking that part out of it, I think will make it much more attractive.”
That burden has only grown as technology has lagged behind the trove of medical data that physicians now have to contend with.
“Ten years ago, I would spend half an hour looking at results, and I wouldn’t do it on my days off. Now, I can spend a couple of hours a day looking at results,” said the Whistler Medical Clinic’s Dr. Karin Kausky, who is also a Whistler 360 board member. “There’s just so much more information being downloaded and information that needs something to be done about it. So we should try to put systems in place that allow them to work at the top of their scope so that hopefully, the primary care providers that we get—family physicians or nurse practitioners—can actually spend way more time seeing patients.”
A new vision
Emerging out of Whistler’s Primary Care Task Force formed in 2019 to address the community’s health-care gaps, the Whistler 360 Health Collaborative Society unveiled its ambitious vision last September for a primary care centre that would dramatically transform health-care delivery in the resort. The community-led, non-profit centre is aimed at improving physician accessibility and offering a more holistic care model that would include general practitioners, nurse practitioners, and a range of other health-care professionals under one roof.
Ideally, the centre would be co-located either inside the existing Whistler Health Care Centre (WHCC), a renovated one, or as a standalone facility close by, making use of existing lab and imaging services and easily accessible from the village. Vancouver Coastal Health has agreed to provide two rooms within the WHCC to begin the process of adding providers.
The concept is more than just a facility, however, Kausky explained.
‘This is a building, but a community health centre, really, is an operational model,” she noted.
Providers at the Whistler Medical Clinic have already taken a step to transition to the society, “so we will no longer be cost-sharing associates; we’ll be part of Whistler 360, and we’re trying to get a couple of other physicians on board,” Kausky said.
The next step for Whistler 360 is achieving charitable status so it can fundraise in earnest, which would allow it to hire professional management that would then assist in hiring new physicians or nurse practitioners that would ideally be housed in the VCH-provided spaces at the WHCC. Although achieving charitable status can take time, the society is hopeful to add the new providers in the coming months.
Such a model would ostensibly help in the recruitment process as well, as the society expects taking administrative duties out of physicians’ hands would make Whistler a more attractive destination. Not to mention getting the opportunity to work within an innovative health-care model that relies on collaboration with other providers.
“People want to work at a place where they’re providing the best care, so I think all those things together are really motivating and quite frankly, we do need to recruit, but we also need to retain,” Kausky said.
Whistler 360 looked at eight different primary care models from across B.C. in coming up with its vision, and aligning closest to what the group has in mind is Shoreline Medical, a not-for-profit primary care network based in Sidney and Brentwood on Vancouver Island where doctors work in a team-based model, collaborating with nurses, pharmacists, social workers and dieticians. The original Sidney clinic started with just four physicians, and now counts 14, while the Brentwood location started with no doctors, and now has seven.
In the short term, for those without a family physician, the Whistler Health Care Centre remains an option for care, as well as a virtual walk-in clinic established during the pandemic that provides non-emergency care online between 12 and 4 p.m. daily. That option does have its drawbacks, however, as availability is limited. Learn more at divisionsbc.ca/sea-sky.
Beyond that, Kausky encourages residents to let their concerns be known to the powers that be.
“They should let their MLA and our local government know their concerns. Both are very committed to improving the situation,” she said.
Learn more at whistler360health.org.
-With files from Robert Wisla