Re: Who wants to be a GP?

Issue: BCMJ, Vol. 59, No. 5, June 2017, page(s) 257 Letters
Robert Shepherd, MD

In training we learned about pathophysiology, empathetic interviewing, choosing tests, making a differential diagnosis, recommending a treatment, and always supporting the patient to improve quality of life and to postpone death. Many patients would like a half-hour visit, but we have an office to run and overhead to pay, so we have to stay on schedule. Doctors have to keep up to date and sort through what the pharmaceutical companies want us to prescribe and what is good for patients. We must always be polite.

Patients and lawyers and insurance companies demand paper stating that the patient can or cannot work or fly or drive a motor vehicle. Revenue Canada, Employment Insurance, and Veterans Affairs ask for information that we don’t gather. Requests from Pharmacare are like drips on a tin roof at night, interrupting sleep. The 30-page provincial application for persons with disabilities is a nightmare. And the federal government has abdicated its responsibility with regards to marijuana. Marijuana is not approved by Health Canada as a drug. Marijuana is not the first-line treatment for any condition. There is no such thing as “medical marijuana.”

We cannot look after patients while doing paperwork. Dr Albrecht bemoaned the “intrusions into the GP’s office that are beyond the doctor’s control and invoked by government, lawyers, and …  the medicolegal octopus of ICBC claims.” He asked, “Where is the carrot for new MDs planning a family medicine career?” I agree. We are in a purgatory designed by Franz Kafka.

Governments and companies should do their own work, not ask for a doctor’s note. Years ago I tried without success to enlist the help of the Canadian Medical Association and the BC Medical Association to convince [Superintendent of] Motor Vehicles to assess older drivers.

The CMA is interested in matters of national interest such as threats to the Canada Health Act. Doctors of BC prepares for the next round of negotiations about fees. The Ministry of Health and the BC College of Family Physicians are pursuing the adoption of the Patient Medical Home. Ambitious doctors or civil servants will not advance their careers by reducing a GP’s paperwork. Bureaucrats and journalists wonder why millions of Canadians can’t get a GP.
—Robert Shepherd, MD