BURST
When Betty Doak heard that one of Quadra Island’s family doctors was retiring, she was not surprised. She’d been through it before.
In 2016, the island’s previous physician wanted to leave and nobody was lined up to take over. Doak, a retired nurse who has lived on Quadra for more than 50 years, helped found the Quadra Island Health Society in 2018 to manage the clinic through the gap. Eventually, they found Dr. Steve Hughes.
Now Hughes is preparing to retire in September from the Quadra Island Medical Clinic, which serves roughly half of the island’s 2,700 residents. And the community decided they couldn’t wait for the system to act.
The Quadra Island Health Society partnered with the Quadra Island Foundation to raise $50,000 to hire a professional recruiter for physicians. The community exceeded that goal in under two weeks.
“It’s a very tight community,” Doak said. “When something comes up and needs to be done, there’s lots of people who step forward and volunteer to do it.”
Paul Adams, executive-director of the B.C. Rural Health Network, said roughly 40 per cent of B.C. family physicians are currently at retirement age, and every rural community in the province is actively trying to recruit.
“Quadra is an example of that fragility of the system, where you have long-term family doctors, and the age of the practitioners is resulting in their inability to continue to provide those services,” he said.
Hughes arrived on Quadra by accident.
He came to Canada from the U.K. in 2014, settling in Mission, where he practised for five years. On a family vacation to Vancouver Island, he met the doctor who was then preparing to retire from the Quadra Island Medical Clinic.
“She said they were having trouble recruiting anyone,” Hughes recalled. “I said, ‘I’ll stop for a few years’. But sort of seven years later, I’m still here.”
Now it’s his turn to leave, and the recruitment challenge persists, partly because of the generational shift.
“New doctors don’t particularly want to come to rural areas,” Doak said. “Doctors who are retiring might be interested in coming, but we don’t offer some of the amenities that people are looking for.”
Hughes says replacing one full-time doctor now takes two or three younger physicians, each wanting a wider variety of work.
A recruiter from Victoria has been hired and is actively searching, but is having difficulty finding candidates. Adams said communities such as Quadra that have the social networks and fundraising capacity to act are the fortunate ones. Many don’t.
Life expectancy on the north end of Vancouver Island sits at 74 years, compared to 82 in Victoria, Adams said. He attributes this eight-year difference to decades of underinvestment in rural health care infrastructure.
“We need to change a system from focusing on urban populations to one which starts at the edges and works its way in,” he said.
The Ministry of Health said in a statement that Island Health and local division of family practice are actively engaged in recruitment efforts, with support from the Campbell River Primary Care Network.
Doak said the community had posted the position through Island Health for more than a year without a single applicant, which is why they hired a recruiter themselves.
“We know more needs to be done,” the ministry said.
In social media posts in April, the province said 77 per cent of B.C. residents now have access to a family doctor or nurse practitioner. But the Health Ministry acknowledges that rural areas have been slower to see those gains.
Island Health said in an email it is working to ensure continued access to primary care.
“The challenges facing Quadra Island are not unique,” the health authority said. “Many rural and island communities across the province are experiencing similar pressures.”
Hughes worries about what happens if no one is found by September. He sees about half of the island’s patients, many of them elderly.
“It’d be a nightmare for them to have to go and wait for several hours in the emergency room for problems that we could deal with here,” he said.
His other worry is the second clinic on the island.
“The doctors there are a similar age to me and retiring in a couple of years,” he said. “You could end up with an island of over 3,000 people with no medical services at all.”
Doak said the Health Society plans to apply to hire two nurse practitioners to keep the clinic open.
On nearby Cortes Island, a similar shortage was addressed through a roster model, with a small group of doctors rotating through the community sharing a house on the island. Hughes said it may be the model of the future for communities like Quadra.
The Health Society has also applied to the provincial government to establish a community health centre that would share services across the Discovery Islands — Quadra, Cortes and Read — rather than each community searching for its own doctor.
“It’s sitting on somebody’s desk, somewhere,” she said. “But we’re hoping it will eventually come forward.”