A new report calling for primary care reform in B.C. is written by the exact group most impacted by the province’s health-care crisis: patients.
Last spring, a national initiative known as OurCare randomly selected 31 British Columbians from a pool of interested volunteers to share their experiences, spend 30 hours learning from experts and, ultimately, produce a set of 25 recommendations for change. Those calls to action were released on Tuesday (Sept. 19).
“It feels like there’s a massive failing within the government of just mismanagement in general,” one of the patient panelists, 30-year-old Malika Lim, told Black Press Media.
Living in New Westminster, Lim is one of an estimated one million British Columbians without a family doctor. The repercussions of that lack of healthcare became painfully clear to Lim in 2018 when she began to lose feeling in half of her body.
For months she went from walk-in clinic to walk-in clinic, waiting in line for hours only for her symptoms to be dismissed by the doctors she saw. It took close to a year before someone finally ordered her an MRI and confirmed Lim had multiple sclerosis.
“Since then it’s been a real struggle.”
Lim said in volunteering for the panel she wanted to be a voice for the queer community, people of colour and anyone who has suffered in B.C.’s health-care system. Others in the group of 31 included a dental hygienist living in East Vancouver, a temporary accountant who cares for their aging parents, a Nanaimo-based advocate for neurodiverse people and a transgender woman living below the poverty line.
Seven of the panelists said their health was less than good, 12 identified as part of a racialized group, three live in the northern half of B.C., and many indicated they had immigrated to Canada or lived in other parts of the world and experienced other health-care systems in their lives.
Together, the group agreed the number one priority for reform has to be accessibility. They recommended the creation of community health centres, to be staffed by a coordinated team of family doctors, nurses, social workers and other health professionals. Importantly, the panel said those centres should be prioritized in remote, rural, Indigenous and low-income communities.
They also suggested a new approach for linking patients to primary care providers, in which everyone would fall within a catchment area and be attached based on their location. Ideally, the panelists said, patients could choose their provider within the area and would have the option to keep their care team even if they moved elsewhere.
Care coverage should be expanded too, the panelists said. They recommended things like dental work, prescription drugs, mental health supports and physiotherapy be covered.
Echoing the calls of many health professionals, the panelists further suggested the creation of a central medical database, where all of a patient’s health-care records would be stored and easily accessed by both them and care providers. As it stands in B.C. now, family practice clinics, urgent care centres, specialists offices and hospitals often operate on different platforms, and sharing information between them is convoluted.
Lim knows the impact this can have on a patient first hand.
She had several surgeries in 2020 and 2021, during which it was discovered she likely had endometriosis and polycystic ovary syndrome. But Lim said she wasn’t told that at the time and only learned about the possible diagnoses when she later requested her medical records be transferred elsewhere.
“It’s heartbreaking to realize the lack of care and follow up.”
A few months ago, Lim said something similar happened again. She went to the emergency room in extreme pain and was told to take some over-the-counter pain killers and go home. Tests done at the hospital later showed Lim actually had a severe infection, but she said no one ever informed her of that. It wasn’t until she went into an urgent care centre a couple weeks later that she said someone validated her pain.
In both cases, Lim said having a database she could access or a family doctor who her medical results could be sent to would have made all the difference.
The panelists recognized in their report that their requests are expensive ones. They suggested health-care spending be regularly monitored by an independent third-party to determine outcomes and impacts. They also recommended the creation of provincial patient advisory group to provide ongoing feedback to government.
Dr. Goldis Mitra, a North Vancouver family doctor and the B.C. lead for OurCare, said hearing directly from patients was enlightening and left her “reinvigorated” to transform the system.
“Our future efforts need to be driven by the public voice,” she said.
Lim said she doesn’t necessarily feel hopeful that things will radically improve in her lifetime, but feels confident people like herself and health-care experts are at least pointing to the areas that need to change.
Black Press Media reached out to the Ministry of Health for comment.