Clinic in B.C. Peace region closes after change in doctor payment model

This story is part of Situation Critical, a series from CBC British Columbia reporting on the barriers people in this province face in accessing timely and appropriate health care.

The only clinic serving a small community in B.C.'s Peace region is closing permanently on Saturday, making it more challenging for seniors living there to access medical services.

Early this month, the Fort St. John-based North Peace Primary Care Clinic (NPPCC), whose doctors provide in-person medical services at the Taylor Medical Clinic, said it would discontinue services starting Oct. 1.

According to a post on Taylor Medical Clinic's Facebook page, the NPPCC has agreed to provide the District of Taylor — about 18 kilometres south of Fort St. John, near the B.C.-Alberta border — with in-person patient care through the clinic since 2017.

The Taylor government subsidizes the clinic's operation costs, while the doctors receive from the province a fixed monthly salary.

However, the NPPCC has shifted to a fee-for-service payment model for doctors, according to Rob Fraser, mayor of Taylor.

Under the payment model, doctors are considered self-employed professionals, and are paid by the province for each office visit, test or operation. To stay afloat, they need to continuously work through a high-volume of patients and run a business at the same time.

In a letter addressed to the district in August, the NPPCC said it would be shifting to a different funding model and with this change, it would "no longer be practical" to continue providing services at Taylor Medical Clinic.

"We have enjoyed our five-year stint working with the community and are grateful for the opportunity to be of help," the letter reads.

CBC News reached out to NPPCC for comment on the change in payment model and the decision to discontinue services at Taylor Medical Clinic, but did not hear back in time for publication. 

Challenges for seniors

While patients in Taylor will still have access to their doctors, they will now have to travel to the NPPCC in Fort St. John for in-person care — which is bad news for elderly patients who may not have their own vehicle or access to a private car, says Fraser.

There isn't public transportation between Taylor and Fort St. John. About 150 residents, or 11 per cent of Taylor's population, are age 65 and over.

"Unfortunately, [for] some of those entry-level families, they only have one vehicle, and so being able to free that vehicle up when mom or dad has gone to work with it — and free that vehicle up to go to Fort St. John — is difficult," Fraser said on CBC's Daybreak North.

Fraser says council is considering other medical service options for residents, including telehealth, which Taylor Medical Clinic provided between 2014 and 2017. 

He says he hopes the province and the Northern Health Authority could provide supports to help continue in-person medical services for Taylor residents.

In a written statement to CBC, Northern Health says it is exploring options for Taylor Medical Clinic to continue operations, but did not specify what those options were.

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