This story is part of Situation Critical, a CBC British Columbia series that reports on the barriers people in this province face in accessing adequate and timely 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.
He made his home in Calgary before crossing the Rockies in 2006, when he moved to the small town of Port Moody in the Tri-Cities area of BC’s Lower Mainland, east of Vancouver. He worked there for 13 years before following the Barnet Highway east to Coquitlam where he joined Meadowbrook Family Practice.
The family doctor said she currently has a patient panel of 2,100 people, and she’s not sure 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’m leaving my patients without finding someone to replace me, leaving them alone,” Chodyra said, adding that she never planned to leave BC.
“We tried to find a substitute doctor, but we couldn’t. No one is in charge of the practices anymore.”
Chodyra closed her BC practice 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.
Dr Anna Chodyra said she has struggled to find a new doctor to take on her patient list since announcing plans to close her practice at the end of June. (Justine Boulin/CBC)
She said the decision stemmed from a need to be closer to her husband’s family in Australia and “the state of primary care in BC,” including the province’s current fee-for-service system and the shortage of personnel which according to her will be less. of a problem in New Zealand, where he will have five nurses and three doctors helping patients.
“Family physicians, we don’t feel supported and we really feel undervalued,” she said.
His imminent 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 Britons no longer have a primary care physician.
The Fraser Northwest Division of Family Practice (FNDFP), a not-for-profit organization that works with and supports family doctors in Anmore, Belcarra, Coquitlam, New Westminster, Port Coquitlam and Port Moody, said its membership has declined seven percent during the past. course Across the six communities, there are an estimated 170 primary providers, approximately 49 of whom live in Coquitlam.
The nonprofit’s program director, Jessie Mather-Lingley, said since 2014, Coquitlam has lost nearly 50 family doctors. He said 15 of them have been since 2021, either due to retirement, relocation or changing roles within health care.
BC’s 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 doctors has increased by almost nine per cent since 2016-17 to 6,760 FPs (family doctors) in the province in 2020-21. That’s an average annual increase of 2.1 per cent.”
Still, Chodyra and other doctors worry that patients who can’t find new doctors are turning to acute care providers like hospital emergency departments for non-urgent care because they have no other options, making the British Columbia’s health care system with delays and rising costs. .
Doctors without doctors
For family doctor Mahsa Mackie, Chodyra’s departure hits particularly close to home. In addition to working in Coquitlam, he is also one of the patients Chodyra leaves behind.
“If someone we think has many years ahead of them closes their practice or leaves the community, that’s never a good sign,” Mackie said.
Mackie, who finished her residency in 2014, said the hardest part of her doctor’s decision to close up shop is knowing that she and her colleagues at the Manhas Health Co. they will not be able to accommodate all the “orphans” of Chodyra.
“I have a couple of thousand patients and my wait time is already a couple of weeks. Taking on more patients means my current patients wouldn’t get access to care in time.”
Mackie said he has taken some of Chodyra’s patients, but many more are stuck on the clinic’s waiting list, which has been growing since he joined in 2021.
“Orphan” patients can strain ER resources
Emergency physician Dr. Ali Abdalvand, who is also on Chodyra’s current roster, tells CBC that orphaned patients will turn to temporary loopholes like urgent primary care or acute emergency care if they can’t find a family doctor in your community.
“The purpose of having emergency medicine as a specialty and having the emergency department as part of the health care system is to provide unscheduled acute care,” Dr. Abdalvand said.
A paramedic is pictured at St. Paul from Vancouver in January. The emergency physician, Dr. Ali Abdalvand, worries that patients turn to temporary loopholes like acute care if they can’t find a family doctor in their community. (Ben Nelms/CBC)
“If you end up sharing an emergency department’s resources to provide primary care, that leaves fewer and fewer of those resources for providing unscheduled acute care.”
Meanwhile, data from the Canadian Institute for Health Information show that emergency department spending across Canada has increased in recent years.
The cost of an emergency department visit increased from $96 in 2005-2006 to $158 in 2018-2019, an annual growth rate of four percent.
Emergency physician Dr Ali Abdalvand worries a surplus of primary care patients is straining his department’s resources as more and more Britons struggle to find a family doctor. (Shawn Foss/CBC)
The same data set also shows that in 2018-2019, emergency department staff in BC worked more overtime than anywhere else in Canada except the Northwest Territories, 9.14% of all the hours worked.
As he searches for a new family doctor, Abdalvad tells CBC the province is losing “one of the best doctors” he’s ever known.
“I know patients who have told me that [Chodyra] he went and got [their] prescription filled … and left,” he said. “This is above and beyond [care]. And that makes me sad.”