Psychiatrist says he's been treated unfairly by Yukon gov't, threatens to close clinic

A Yukon psychiatrist says he's closing his practice in March because he can't cover his costs — and he blames the territorial government for treating him unfairly and ignoring his pleas for help.

Dr. Leo Elwell says he's been operating under a fee-for-service agreement with the government but wants to instead work under contract. That will help keep his Soulshine Health clinic running, he says.

"I did not want to do this, OK? I have been backed into a corner," he told host Elyn Jones on CBC's Yukon Morning. 

"I have been in negotiations with this government for well over a year to get this issue resolved and there's been a lot of words, but so far no action."

Elwell describes Soulshine Health as a "low-barrier kind of clinic" that provides specialized psychiatric care, including addictions treatment, to people who do not have a family doctor. Many of his patients are referred to him by psychologists or addictions counsellors. He's been working in Yukon for a decade, he says.

In a letter recently sent to patients, Elwell says he'll close his practice on March 29, 2024, and move to another jurisdiction "where structures are in place to ensure psychiatrists and all other specialists are treated fairly."

His letter describes "many meetings, emails and phone calls" with government officials over the last year, where he's requested moving from a fee-for-service model to a contract. Those efforts have gone nowhere, he states.

In the letter, Elwell also urges patients and their families to contact their MLA or the Yukon government to push for the issue to be resolved. 

Speaking to CBC News, Elwell called fee-for-service "not a sustainable model of doing psychiatric care in this territory."

"I can't do it on fee for service. I have tried and I've worked most of my life with the fee-for-service model in other jurisdictions — so I know how to work underneath that kind of a system. And it can't be done," he said.

Minister 'disturbed' by letter to patients

The psychiatrist's complaints were raised in the legislature on Tuesday by the opposition Yukon Party. The party's health critic Brad Cathers blasted the government for seemingly ignoring the matter.

"The government themselves committed to providing this option to doctors, including psychiatrists, in the last agreement they negotiated with the YMA [Yukon Medical Association]," Cathers told reporters.

"What we are hearing from Dr. Elwell is that they're not living up to this."

Cathers called it "just one of a series of problems" with health care in the territory. Earlier this week, the Yukon Party also raised concerns about possible cuts to some imaging services at the hospital such as CT scans and mammograms.  

Asked by reporters on Tuesday about Elwell's letter, Health Minister Tracy-Anne McPhee said she was "disturbed" by his approach. 

She said the government is currently reviewing the way the territory's psychiatrists are paid, by collecting data from the territory's four resident psychiatrists to ensure "Yukoners are properly served."

"We have reviewed some of that data. We're asking for more data and we committed to a timeline whereby we would have a review of the psychiatric services contracts by January of 2024," McPhee said.

"That's the commitment that the department made and have been speaking to [Elwell] for some time about."

McPhee said she believed her department had been working with Elwell to resolve his concerns.

"I'm disturbed by the letter, to be frank. I'm disturbed by at least the part that asks patients to advocate on behalf of the doctor for a sort of a financial issue," McPhee said.

"I don't know what the [Yukon] Medical Council will say about that or whether they'll address it at all, but it's disturbing."