Whistler’s Primary Care Task Force presented its ambitious vision for a community-driven primary care centre last week that would dramatically transform healthcare delivery in Whistler.
Formed in 2019 in response to Whistler’s family doctor shortage, the group has spent the past two years looking at the local primary care landscape and analyzing a variety of different models in play. At a Committee of the Whole meeting on Tuesday, Sept. 21, the task force gave elected officials the fullest view yet of its concept for a community-led, non-profit primary care centre aimed at improving physician accessibility and offering a more holistic care model that would include general practitioners, nurse practitioners, and a range of other healthcare professionals under one roof.
“Canadians across British Columbia are seeing shortages of family doctors, but we know if we don’t do something about it then something is going to happen that might be suboptimal for the community. Things like virtual healthcare are going to come in and fill the gap, and we know that’s not a substitute for the continuity of having a family doctor,” said task force chair Carol Leacy. “We have an opportunity to really come up with a solution that is going to keep the best interests of Whistler in mind.”
With two family practices as well as two naturopathic clinics closing in recent years, the task force estimates that around 40 per cent of Whistlerites do not currently have a family doctor. Today, the resort counts between seven and eight full-time-equivalent GPs, and with B.C.’s health ministry recommending one physician per 800 to 1,000 patients, Whistler would need to add another six to eight doctors to meet the community’s needs.
Whistler is especially challenged with recruiting family physicians, particularly because of the steep costs of living and commercial rent here that only add to the high overhead family practices already contend with.
“Family doctors run small businesses: they find a location, they pay their rent, they hire staff, they manage them, they train them, they do all their billings if they manage their electronic medical records,” Leacy said. “So family doctors have always had these small businesses in Canada … but it really has changed in the last 10 years, let’s say, where it’s become much more complex.”
The task force looked at eight different primary care models from across B.C., and while none were a perfect fit for Whistler, they took elements from each when considering a new centre. 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.
Core to the clinics’ recruitment is the fact that the administrative workload that many physicians take on in family practice is handled by a dedicated executive director, who is tasked with everything from hiring and training staff, establishing procedures and protocols, and managing billings and medical records. Under this model, physicians would pay a portion of their billings to the non-profit society managing the clinic, something Leacy said they have been more than willing to do at Shoreline to lighten the administrative burden.
“If we can take all the day-to-day administration away and take all of those barriers that make people choose to work at the clinic and not in full-service family practice, we think we can get more people over to that medicine that we know is equally satisfying,” she said.
Ideally, the primary care 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 tentatively agreed to helping find space—the task force is hopeful for two offices—within the WHCC to begin the process of adding providers.
Task force member Dr. Karin Kausky of the Whistler Medical Clinic said co-location is “critically important” both for providers and patients.
“A lot of the literature shows that the ideal is co-location,” she explained. “I think one of the reasons the Whistler Medical Clinic has had such longevity … is because we’re in this location where we’re adjacent to the public health nurses and the homecare nurses and our acute-care colleagues and lab and x-ray.”
Co-location also helps facilitate team-based care, a model intended to fill in potential gaps.
“In addition to GPs and nurse practitioners, we would also have things like mental health support, addictions counselling; it could be social workers all working and really allowing people to do the work that is best suited to their skillset,” Leacy said. “So you might show up thinking you need to see a doctor but it turns out you might be better off actually speaking to an addictions counsellor. That seamless transition can happen there.”
The implications of such a centre would be immense, Leacy said, providing any resident who wants one timely access to a family physician. “But it could really mean more than that,” she added. “You’ve got a whole team that can proactively monitor your health and not just looking for bad health outcomes, but staying on top of regular screenings or blood work. It could mean that employers know that their employees are going to have healthcare. It could also mean the community could decide what healthcare services are to be provided on our own as opposed to being told by an entity what that would be.”
The task force has a long road ahead to make the centre a reality. Planned in three phases, the first step is achieving charitable status so the managing Whistler 360 Collaborative Health Society can start to fundraise in earnest. Phase 2 would involve the recruitment of physicians and nurse practitioners and establishing a professional management system. The third phase would require the securement of additional space before launching the full-service primary care centre.
While there are many issues to sort through before that happens, it was clear at last week’s meeting that Whistler’s mayor and council were supportive of the concept, with the presentation closing with claps from elected officials.
“I think that’s the first time we applauded a presentation,” said Mayor Jack Crompton.