by Doug Graham
When the Yukon’s doctorless patient registry closed at midnight on Sept. 30, 1,830 individuals had registered themselves as being without a family physician. This number will likely be adjusted in the coming weeks, as we know that some on the list have since found a doctor and others have mailed in registrations that we have yet to receive.
Many on the list chose to provide contact information, in case government was able to match them with physicians.
However, the registry was never intended as a matching service or to allow for the active management that the Yukon Medical Association has suggested.
The registry was created to provide government with a snapshot of the situation, to help determine the number of people without a doctor and to see if the number provided by the YMA (8,000 doctor-less patients) was accurate.
The confusion over the purpose of the registry was further aggravated when the president of the association, Dr. Rao Tadepalli, recently encouraged people to get on the registry so they could get a physician. He added that the YMA did not support the closure of the registry but rather thought it should be maintained permanently as a means of pairing patients with physicians.
Attaching patients to physicians is not the responsibility of the government. Our responsibility is to ensure that citizens have access to health care that is appropriate, timely and effective. The hard data from the temporary registry will help us determine how many physicians and other health care providers Yukon needs and assist us in looking for new and innovative ways of providing health care services, aside from independent physician businesses.
The YMA has said four physicians are coming early in the new year. Through our work with the physician recruitment officer and with Yukon physicians, we are aware of additional physicians who will come north over the next year. This physician complement should be adequate to serve the needs of Yukon residents, both at present and well into the future. That said, we know that other physicians will retire or leave Yukon and we will include that factor in our overall recruitment planning.
Government will welcome all new doctors to the territory and offer them, as in the past, a free ad to let citizens know they are here. It is the patients’ responsibility to follow up, and the physicians’ responsibility to take on new patients.
In the midst of the government’s ongoing efforts to ensure Yukon has enough doctors, there is an element that most Yukoners will not be aware of: a proposal from the YMA that would see government pay physicians thousands of extra dollars for taking on new patients. It’s a proposal we are resisting.
Physicians are self-employed and like all self-employed workers, they can work as much or as little as they choose, either part-time, full-time, or with many extra hours. The government pays the physicians for each service a patient receives. The resulting pay for general practitioners ranges from $140,000 to a current high of $959,000 for the top paid family physician in Whitehorse. The average hovers around the $317,000 mark, with a number who make in excess of $650,000 per annum. These are fee-for-service general practitioners, not specialists such as general surgeons or obstetricians.
Government also provides physicians with funding for continuing medical education, education support, locum support, maternity/paternity benefits, office start-up, office renovation, physician re-location, assistance to new graduates of the College of Family Physicians and the Royal College of Physicians and Surgeons to cover some educational expenses, medical practice insurance, and recruitment and retention bonuses for physicians.
From our perspective, the Yukon government is already doing its share to support physicians. Our responsibility now is to ensure recruitment efforts continue and to examine new service delivery models that will benefit Yukoners, along with the valuable services traditionally provided by physicians.
Doug Graham is Yukon’s minister of health and social services.