Re: Fewer patients per family physician in BC is the result of intolerable working conditions

Issue: BCMJ, vol. 67, No. 10, December 2025, Page 343 Letters
By: Ben Schwartzentruber, MD

I read with interest my colleague Dr Gerald Tevaarwerk’s article on the ongoing pressures facing family physicians [BCMJ 2025;67:273-274]. I wanted to reply to his comment regarding consulting specialists, “for whom ‘service’ means managing one disorder.” This does not reflect the scope of many specialist physicians or the pressures facing specialists who care for patients without primary care.

As a general internist, it is expected not only that I and my colleagues manage more than one issue, but also that we weigh in on almost every medical issue. I know that other medical specialists also feel pressured to follow patients for longer than we would if they had a primary care provider and to practise outside our scope for patients who do not have other access to care. This was well described by Drs Mason, Atwood, and Hodgins [BCMJ 2024;66:210-214].

I wonder if this may account for some of the increase in specialist visits Dr Tevaarwerk mentions; if so, that is another ripple of our system’s failure rather than a sign of success for specialists. The ongoing crisis in our system is affecting family physicians and specialists in different ways, but specialists are certainly not spared from the growing challenges in physician working conditions in BC. I welcome any efforts to increase support for family physicians, as I see the lack of primary care showing up in my clinic, in the ED, and on the wards.
—Ben Schwartzentruber, MD
Victoria

This letter was submitted in response to “Fewer patients per family physician in BC is the result of intolerable working conditions.”

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Ben Schwartzentruber, MD. Re: Fewer patients per family physician in BC is the result of intolerable working conditions. BCMJ, Vol. 67, No. 10, December, 2025, Page(s) 343 - Letters.


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