The revolution in primary care

Issue: BCMJ, vol. 65, No. 10, December 2023, Pages 367-368 Letters

It was just 6 years ago that the Ministry of Health embarked on a mission of transforming primary care and the concept of patient unattachment entered the health administration lexicon. Over the last 5 years, we as frontline health care providers have been subjected to the machinations of a health ministry obsessed with unattachment.

Reflecting on the countless hours we have spent attending meetings and webinars sponsored by health authorities, divisions of family practice, Doctors of BC, and the Ministry of Health to address issues on how to accurately measure unattachment, how to register unattached patients, and how to best collect and interpret data related to unattached patients, one cannot help but wonder if we should have spent some time dealing with the question of why we are deploying much-needed resources chasing solutions to questions that will have little or no benefit in getting us out of the crisis we are in.

Unattached patients do not benefit from knowing how staggering their numbers are. Hospitals and social media are quite able to provide the public with information on primary care providers looking to increase their panels. Studying data will not increase the resource base required to achieve full attachment.

Could it be that this all has more to do with politics than solving the current crisis? It is concerning that primary care providers who want to access the new longitudinal care option for remuneration must agree to submit their complete panel data to the ministry and register with the provincial attachment list. We have been reassured so many times by the ministry that we will not be required to take on additional patients that one cannot help but conclude this is a case of “methinks the maiden doth protest too much.”

We need to be careful that we are not being duped into sharpening the blade of the guillotine that is soon to sever us from the long-serving autonomy of practice that we fought so hard to preserve over time.
—Bruce Nicolson, MD
100 Mile House


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Bruce Nicolson, MD. The revolution in primary care. BCMJ, Vol. 65, No. 10, December, 2023, Page(s) 367-368 - Letters.

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