A retired pharmacist in Kaslo has set up a non-profit society that will try to attract doctors to town. The Kaslo and Area Medical Care Society plans to lease the piece of land behind Kaslo Drugs Ltd. and build a clinic.
James Morris is spearheading the group. Its goal contrasts sharply with that of the Kaslo village council’s health care select committee, which has attracted three new contracted doctors to fill two positions and is now negotiating with them about hours of work.
The village’s initiative and Morris’ plan are predicated on two different health care models.
Morris is hoping to attract doctors to work under the fee-for-service model that applies to most doctors in the province: independent physicians running their own practices and billing the province for their services. That model was discontinued in Kaslo about ten years ago. Since then, doctors in Kaslo have been working on contract with Interior Health.
In 2012 the health authority announced its contracted doctors would be restricted to working 9 to 5 weekdays and that the emergency ward would not be open outside those hours. This was an attempt to solve a problem of doctor burnout and high turnover.
According to Dr. Curtis Bell of the health authority, 40 hours per week for two doctors are the maximum the Ministry of Health will fund because of Kaslo’s small population.
Now village council’s committee wants to extend the contracted hours beyond 9 to 5 or make them more flexible. They negotiating with three new doctors hired by the health authority to fill two positions. The village’s committee includes Kaslo mayor Suzan Hewat and regional district Area D director Aimee Watson.
Morris says the council committee is not open to his ideas.
“I have gone to them two or three times and I get the same answer. They say the situation is stable and I should not rock the boat. They say if we push too hard we will jeopardize what we already have.”
But Hewat says Morris has not approached the council committee.
“We applaud them for trying to be creative in regaining services,” she told the Star, “but at this point we have not been able to meet face-to-face with that society to see if there is common ground. So we cannot say too much about what they are doing.”
Watson says Morris’ group came to the regional district asking for funding.
“I said I would not do that because health care is funded through the province and through property taxes already,” Watson told the Star. “So using community development funds for that would be against the principle (that we do not fund services already provided by government).
“They are going for fee-for-service,” said Watson. “We studied fee-for-service and found it was not feasible. So we have gone past that. What we were told is that having contracted doctors in a rural setting is more of an incentive because you have a guaranteed income.”
Morris, who worked as a pharmacist in Kaslo for 30 years until 2011, argues it hasn’t been much of an incentive.
“I estimate there have been 30 doctors here over ten years plus dozens of locums,” he says, stressing the reason for his proposed clinic is that Kaslo has been underserved by too few doctors with too much turnover.
“People’s lives are in jeopardy here. With 40 hours a week, that means over three-quarters of the time there is no doctor here, and the reality is some people are going to suffer. We want emergency services restored because of our lack of proximity to a good emergency ward.”
The health authority’s Dr. Bell says he has no problem with Morris’ group fundraising for a fee-for-service clinic. But he doubts the community could support both models — fee-for-service doctors working out of a new clinic, and doctors working out of the current heath centre on salary — simply because of Kaslo’s small population.
“In our arrangement we provide an infrastructure and staff,” Bell told the Star. “But under [Morris’] proposal he will have to hire staff and find a physician as well so there is overhead which could be as low as 20 per cent or as high as 40 per cent of the doctor’s fees.”
Bell said he didn’t want to discount the idea outright.
“It is possible it could work,” he said. “But the volumes are such that it could be very difficult.”
Asked about his group’s building plans, Morris said “It is an expensive proposition. We are looking at about $150,000. We started our society by selling memberships and have 300 now. We have started fundraising and applied for charitable status and then we will go to Columbia Basin Trust and maybe the gaming corporation for funding. By next summer should have enough to start building and buy a modular.”