This story is part of Situation Critical, a CBC British Columbia series reporting on the barriers people in this province face in accessing timely and appropriate health care.
Dr. Anna Chodira has crossed land and sea to practice medicine.
A native of Poland, the 47-year-old first immigrated to Canada as an International Medical Graduate in 2001.
She resided in Calgary before crossing the Rockies in 2006 when she moved to the small town of Port Moody in the Tri-City region of Lower British Columbia, just east of Vancouver. She worked there for 13 years before taking the Barnett Highway east to Coquitlam, where she joined the Meadowbrook family practice.
The family doctor said she currently has a patient pool of 2,100 – and she’s not sure where any of them will go when she and her family move to New Zealand this autumn.
“It’s a very difficult decision, knowing that I’m leaving my patients without finding someone to replace me, leaving them alone,” Chodira said, adding that she never planned to leave British Columbia
“We tried to find a replacement doctor, but we couldn’t. No one is taking over the practices anymore.”
Chodira closed her BC practice at the end of June as she prepares to join a new group of family doctors in the small town of Waihi, about two hours southeast of Auckland.
Dr. Anna Chodira said she has been struggling to find a new doctor to take over her patient list since announcing plans to close her practice at the end of June. (Justin Boulin/CBC)
She said the decision stemmed from the need to be closer to her husband’s family in Australia and because of “the state of primary care in British Columbia,” including the province’s current fee-for-service system and staff shortages that she said will be less of a problem in New Zealand, where she will have five nurses and three doctors helping patients.
“Family doctors, we don’t feel supported and we really feel underappreciated,” she said.
Her impending departure, however, has sent shockwaves through the Tri-City as her patients struggle to find new family doctors amid a shortage where an estimated one million British Columbians are already without a primary care physician.
The Fraser Northwest Division of Family Practice (FNDFP) — a not-for-profit organization that works with and supports family physicians in Anmore, Belcarra, Coquitlam, New Westminster, Port Coquitlam and Port Moody — said its membership has dropped seven percent in the past year . There are an estimated 170 primary providers in the six communities, approximately 49 of whom reside in Coquitlam.
The nonprofit’s program director, Jessie Mather-Lingley, said since 2014, Coquitlam has lost nearly 50 family practitioners. She said 15 of those are since 2021, either due to retirement, relocation or changing roles in health care.
British Columbia’s Ministry of Health said in a statement that it is “committed to ensuring that all British Columbians have access to health care when they need it.”
“The number of family physicians has increased by nearly nine per cent from 2016-17 to 6,760 FPs (family physicians) in the province in 2020-21. This is an average annual increase of 2.1 per cent.”
Still, Chodira and other doctors worry that patients who can’t find new doctors will turn to urgent care providers like non-urgent hospital emergency rooms because they have no other option, further straining the nation’s health care system. British Columbia with delays and increased costs.
Doctors without doctors
For family doctor Mahsa Maki, Chodira’s departure hits particularly close to home. Besides working in Coquitlam, she is also one of the patients Chodira leaves behind.
“If someone we think has many years ahead of them is closing their practice or leaving the community, that’s never a good sign,” Mackey said.
Mackey, who completed her residency in 2014, said the hardest part of her doctor’s decision to close shop was knowing that she and her colleagues at Manhas Health Co. Health Clinic will not be able to accept all Chodira’s “orphans”.
“I have several thousand patients and my waiting time is already several weeks. Taking on more patients means my current patients will not be able to access care in a timely manner.’
Maki said she has accepted some of Chodira’s patients, but that many others have been stuck on the clinic’s waiting list, which has grown since she joined in 2021.
“Orphaned” patients can strain emergency department resources
Emergency physician Dr. Ali Abdalvand, who is also part of Chodyra’s current roster, tells CBC that orphan patients will turn to temporary stops like urgent primary care or acute care if they can’t find a family doctor in their community .
“The goal of emergency medicine as a specialty and the emergency department as part of the health care system is to provide acute unplanned care,” said Dr. Abdalvand.
A paramedic is pictured at St. Paul’s Hospital in Vancouver in January. Emergency physician Dr. Ali Abdalvand worries that patients will turn to temporary braces as an emergency if they can’t find a family doctor in their community. (Ben Nelms/CBC)
“If you end up sharing emergency department resources to provide primary care, that will leave less and less of those resources to provide acute unscheduled care.”
Meanwhile, data from the Canadian Institute for Health Information shows that emergency department costs in Canada have risen in recent years.
The cost of an emergency room visit rose from $96 in 2005-2006 to $158 in 2018-2019, an annual growth rate of four percent.
Emergency physician Dr. Ali Abdalvand worries that an excess of primary care patients will strain his department’s resources as more and more British Columbians struggle to find a family doctor. (Sean Foss/CBC)
The same data set also shows that in 2018-2019, emergency department staff in British Columbia worked more overtime than anywhere else in Canada except the Northwest Territories, at 9.14 per cent of all hours worked.
As he searches for a new family doctor, Abdalwad tells the CBC the province is losing “one of the best doctors” he’s ever met.
“I know patients who have told me [Chodyra] go and get [their] a prescription filled … and I left it,” he said. “This is above and beyond [care]. And that makes me sad.”
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