Specialists say having other health-care experts in their offices to help reduces patient wait lists and physician burnout.
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Richmond gastroenterologist Dr. Nancy Fu was aghast as she saw her patient wait list grow from a few months to 10 months, and then to more than a year.
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Knowing that so many people were suffering gnawed at her conscience. She tried to work longer hours to see more patients but burnout was imminent.
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“I was so stressed out,” she said. “I would think, ‘Will I miss a colon cancer because I can’t see someone soon enough?’ ”
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Gastroenterologists and other specialists face the challenge of a growing population, particularly among seniors, and patients with more complex disorders. Fu, for instance, says she’s not just seeing patients with inflammatory bowel disease but also an increasing number of younger people with colon cancer and people with liver disease because of obesity. And such patients typically require multiple visits with a specialist.
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“In my practice I don’t say, ‘OK, I’ve assessed you. You’re fine, go back to your family doctor, and I don’t need to see you again.’ No, these patients have complex diseases, and I need to continue to see them long-term.”
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When it became clear to Fu that doing all this on her own wasn’t working, she joined a pilot initiative called the consultant specialist team care program run by Doctors of B.C. and the province to figure out a plan. The program is designed to help specialists implement a team-care model in their practices, improve access and outcomes for patients, and prevent physician burnout. Doctors and team members who are part of the program work with a physician mentor to analyze how their practice works and find efficiencies.
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Now, Fu has support in the same office from two registered nurses and a contracted dietitian, both highly specialized in the gastroenterology field, which prevents her from having to send patients to multiple health professionals across the region. One of her nurses, Sarah Bains, helps by speaking with patients and co-ordinating their care. Often, this can involve educating patients about their disorder and how to manage it day-to-day.
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Fu has reduced her wait list to about two months.
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But there’s a catch. Program funding only covers the initial integration of team members, such as physiotherapists, specialized nurses or dietitians. Fu has to pay out-of-pocket after that.
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“You can negotiate the hours, but you still have to pay your nurses yourself,” she said.
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Every specialist will have a different situation and will have to weigh the cost of more staff, but she said it was worth it to reduce her stress.
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The pilot program has gone through three cohorts of physicians over three years. The annual budget for the program is about $1.5 million and comes from the specialist services committee, a collaboration between Doctors of B.C. and the B.C. government.
