Image: Supplied by Dr. Darren Joneson /

By Mike Vanden Bosch

Health care

Chilliwack doctor says Ministry of Health can’t keep ignoring family physicians

Jul 19, 2022 | 7:18 AM

CHILLIWACK — As the number of British Columbians without a family doctor grows daily, a Chilliwack family doctor figures the current system needs to change immediately.

Dr. Darren Joneson, who runs Spectrum Medical at 6640 Vedder Road, believes the present healthcare model, from fee-for-service to medical education deserves a massive overhaul.

Joneson says physicians typically bill the same fee code whether it’s a short or long visit. The longer a family physician spends with patients for a regular visit, the less they bill on that day.

“There are some nuances here, but if I spend an hour with a patient going over their new cancer diagnosis, I make the same if I spend five minutes on a quick chart review and medication refill,” said Joneson. “This comes down to the basics of economics and psychology. Our current system does not incentivize the type and quality of care that our patients and communities deserve.”

In other words, the current system encourages physicians to be fast with their patients.

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“It pays to be fast, not to be thorough,” Joneson said. “But this isn’t necessarily a fee-for-service (FFS) issue as some laud it to be. It’s a bad FFS issue. It is completely realistic to reform the FFS model in a way that creates less administrative burden and incentivizes family doctors to set up shop.”

Physicians who focus on speed can bill up to three times more per hour than those who take time to be thorough, Joneson estimates. Doctors who address multiple issues in a visit typically bill less than half of what a high-volume physician will bill in a year. Meanwhile, administrative overhead like expensive leases, staff salaries, utilities, and electronic medical record systems remain the same regardless of what doctors bill.

When it comes to bringing in more family doctors through university and medical school, Joneson says the issue transcends simply opening up more seats.

“The issue is not just with opening up seats for new students,” Joneson said. “Each seat needs to have classroom and lab space. They need preceptors willing to teach both in class and clinically in their offices. The only organization that values family doctors less than the government of B.C. is UBC. Their clinical preceptors make about half of their clinic hourly wage. The government needs to lead by example, pay family doctors fairly, and mandate that any organization, like UBC, follow suit.”

Unpaid work, usually 1-2 hours a day is a significant contributor to burnout in family physicians. Doctors can’t go offline for days at a time unless someone can fill in, an insurmountable task for many physicians.

“First, family physicians who run longitudinal practices spend a significant amount of time doing unpaid work; hours are spent reviewing labs,” Joneson pointed out. “The College of Physicians and Surgeons of B.C. is completely out of touch with the reality of family medicine right now. They expect more of doctors with no thought of the plausibility or financial viability of these demands. They want us on call 24/7 with no additional pay.”

During the past two years of COVID-19 lockdowns and public health restrictions, the physical and mental health of many patients declined, Joneson acknowledged. The pandemic has been hard on everyone, but especially difficult for front-line workers.

“On top of all this, some patients have become aggressive and belligerent because we enforce public health recommendations,” he said. “We have had to call the police on multiple occasions to help us. My staff don’t deserve to be treated that way.”

At the end of the day, Joneson believes patients deserve better than what the current system offers.

“Patients are the ones who are suffering without access to a family doctor,” he said. “Diagnosis and treatments are delayed. Doctors want to help their patients. They simply need to be paid for the time they spend helping them. We need more doctors opening family practices because we know that people with regular access to a family doctor are healthier and live longer. Yes, it’s great that it saves the system money, but most importantly, it saves patient lives.”