Well this is going to be interesting. How often will the BCMA speak out of both sides of its mouth as it relates to provisions for private medical care? The recent BCMJ interview with Dr Golbey (BCMJ 2005;47[7]:354-357) [9] had him repeatedly voicing support for a strong, publicly funded system. Can we believe what Dr Golbey says as it relates to the ensuing debate over “boutique” clinics?

In a recent Medical Post article (Medical Post 23 August 2005;41[28]:46), the BCMA is reported as supporting a new boutique clinic in Vancouver (the Copeman Healthcare Centre) saying that the clinic is “simply answering a need.” At the same time, the BCMA recognizes that GPs joining such clinics will result in more orphaned patients in the public system, serving only to escalate an already profound problem.

On one side you have the market enthusiasts saying that via the market, such clinics will even things out and deal with delays in care. Contrast this to the BCMA’s attempts to have GPs provide “comprehensive care.” In this we see direct opposition to where the market has taken things and an active attempt by the association to maintain the broad work of GPs rather than to confine it in the way a boutique clinic would.

Notwithstanding the GP comprehensive care issue, the common mantra of the BCMA officials is in support of the market as arbitrator. If the BCMA truly supports a strong public system, it will publicly acknowledge that the market will not always allocate fairly. Until I hear this public proclamation, I will remain skeptical about the BCMA’s real support for public medicare.

—Donald J. Young, MD
Campbell River

Dr Golbey responds

I appreciate the opportunity to respond to Dr Young’s concerns about the BCMA’s support of a strong, effective, publicly funded health care system. This is indeed the BCMA’s position and is congruent with the position reaffirmed by delegates to CMA’s General Council this summer in Edmonton. However, the system in its current state isn’t working and we need to be open to ways in which to address the shortcomings. The BCMA has always supported the inclusion of private health care providers in the delivery of publicly paid for services—after all, doctors are private practitioners. Clinics such as the new Copeman Clinic are indeed answering a need, but that is a result of the failure of the present system to meet that need. We should be working toward a system that provides first class care in a timely manner.

—Michael Golbey, MD
BCMA President