Health committee urged to ease barriers for doctors

The committee is charged with identifying potential strategies to maintain a sustainable health-care system

Dale Bass – Kamloops This Week

At the conclusion of his presentation on how to improve health care in the province, Dr. Mark Fromberg was asked a blunt question by Abbotsford South Liberal MLA Darryl Plecas.

“What percentage of physicians think like you do and why is it so damn difficult to get these ideas to have wheels?” Plecas asked Fromberg.

The recently retired Kelowna doctor appeared in Kamloops on July 5 before the province’s Select Standing Committee on Health, which is also holding public sessions in Vancouver, Victoria and  Prince George. The committee is also accepting written submissions until July 29.

The committee, of which Plecas is a member, is charged with identifying potential strategies to maintain a sustainable health-care system in B.C. and consider health capital-funding options.

Fromberg told the committee he believes letting general practitioners create interdisciplinary teams of other medical professionals would help resolve the doctor shortage in the province and improve health care. However, he told the committee, barriers exist that make this impossible, including the legislated prohibition imposed on them that does not allow them to delegate care.

“Visit-type services may not be delegated,” Fromberg read from the B.C. Guide to Fees, adding the colleges that govern physicians and nurse practitioners uphold this inability to have others take on medical care they are qualified to do.

In the model he presented, Fromberg said he envisions a team with a dietitian, a physical therapist and a nurse practitioner, among others — medical professionals who could deal with a patient’s dietary issues or muscle sprains — which would free him up to provide improved care for those who need to see a medical doctor.

Fromberg said the legislated daily volume cap is another barrier, noting the medical profession is the only one where “the harder you work, the less you get paid.”

The cap is set at 50 patients a day. If a general practitioner sees more than 50 patients, the fee for services rendered is cut in half and, if the volume is greater than 60, no fee is paid. The cap is not imposed on specialists or doctors in remote areas, Fromberg said. Eliminating it would allow general practitioners to see more patients, generating revenue to create an interdisciplinary team that would assist in providing health care, he said.

The cap is one reason medical students often look to specialty rather than family practices, Fromberg said.

In response to Plecas’ question, Fromberg said leadership is needed to get the governing colleges together to hear the concerns and ideas being suggested. He said he attended a conference at which a representative of the B.C. College of Physicians and Surgeons gave a presentation.

“And then he just left,” Fromberg said. “I wanted to talk to him, but he didn’t stick around.”

Fromberg suggested leadership needs to come from politicians because his colleagues “are barely treading water, they’re so busy.”

But, he concluded, if the model he suggested was in place, if it could offload one-third of patient care to other disciplines qualified to treat it, the capacity it would create could resolve the province’s doctor shortage.


If you have an idea for the committee, go online here or send a fax to 250-356-8172 by the July 29 deadline.