How a small B.C. town is fighting to recruit family doctors amid provincewide shortage

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.

Whoever said an apple a day keeps the doctor away hadn't met Johnny Chang.

The family physician says the proverbial fruit, which he snacked on during an impromptu gathering with Creston's doctors while on a 2020 recruitment trip, was part of what convinced him to relocate to the town of about 5,500 residents, near the Canada-U.S. border in southeastern B.C. 

"It was the best apple I've ever had," said Chang, who graduated from the University of Sydney. Originally from Vancouver, Chang was recruited by Creston Valley Health Working Group as part of a mandatory two-year return of service contract due to his international schooling.

So his family moved from Sydney, Australia, to the other side of the world.

Another major selling point is Creston's close-knit community of doctors, Chang says, nearly all of whom were similarly recruited as part of the town's efforts to attract physicians.

Chang says he plans on staying at least three more years.

"Great community, great food," he said. "I was like, 'Oh this is where I want to be.' "

As communities across B.C. struggle with an increasingly short supply of family doctors, Chang and others recruited by the Creston Valley Health Working Group say they're attracted by the town's unique situation. 

"When I first came ... all the doctors in the community showed up for an informal gathering that was arranged in less than a week," Chang said, "and it's obvious that the medical community ... really lean on each other."

He said part of the appeal is also the Creston Valley Hospital, which has 20 inpatient beds and round-the-clock emergency services, allowing recruits to practise a variety of medical services. Doctors in Creston must also work at the hospital as well as their own clinics.

"Part of the draw for me to choose Creston is that I get to practise full-scale family medicine ... and I get to do a bit of emergency medicine," he said.

Marilin States, Creston's physician recruitment co-ordinator, says some town's  doctors come from Health Match B.C., an umbrella organization funded by the provincial government that focuses on bringing doctors to the province. Others are from medical conventions, which States used to attend in-person before the COVID-19 pandemic.

States, who was hired by the Town of Creston, says costs associated with recruiting doctors are covered by the town in partnership with Regional District of Central Kootenay Areas B  and C directors. Interior Health Authority handles the credentialing and hiring of applicants because of their work in the hospital.

"The physicians we are looking for are physicians who do full service, meaning they don't just look after their clinic patients but they also provide in-patient hospital coverage and emergency room coverage," she said.

But while the system has netted 16 successful hires since 2011, all of whom continue to call Creston home, she says some residents still need a family doctor. The program originally dates back to 2006. 

"There is a certain pot of funding available in British Columbia for physicians ... and it's based on population demographics.... Even so, there are still people without a family physician and when we bring in someone new ... people are anxious to be a part of that intake."

Still short of doctors

Canadian citizen Lorraine Donald, 67, who relocated to Creston from Birmingham, Ala. with her husband in February, says she "got lucky" after a friend tipped her off that a local medical clinic was taking 150 new patients.

Donald's friend, Debra Barlee, 66, was not as lucky.

"There's a doctor coming to town next month and I'm hoping I'm early enough to get in that line," said Barlee.

Dr. Nerine Kleinhans, who was recruited by the town's Health Working Group in 2013, says though the recruitment of physicians is going well, it's hard to get ahead of the game.

"We've had a huge influx of new patients with the pandemic and everybody in B.C. deserves a family doctor," she said. "I think we will get there, but sometimes we face surprises like retirement or somebody leaving for family reasons." 

She said and her husband, who is also a family physician, were recruited by States during a conference for rural and remote doctors.

"One of the reasons we chose Creston is because we want to do everything. We want to do caesarean [deliveries], we want to do anesthesia ... so Creston was one of the towns we could do complete longitudinal medicine."

Elkford explores physician housing

In the Rocky Mountain municipality of Elkford, also in southeastern B.C., the lack of doctors is more pronounced, in part because the district has no hospital, according to Elkford Mayor Dean McKerracher.

McKerracher, who has fought to attract more doctors throughout his 17-year tenure, estimates between 600 and 900 of the town's 2,700 residents are without a family doctor. Recently, two more full-time physicians relocated to the nearby municipality of Sparwood.

Subsequently the community finds itself relying on a primary care physicians who split their time between Elkford and Fernie, B.C. — a 45-minute drive away.

Like Creston, McKerracher says Interior Health is the final decision-maker when it comes to hiring for the municipality. But where Creston has decided to fund a recruiter, McKerracher says Elkford is limited to whatever recruiting the health authority can provide.

In a statement, Interior Health writes that it "appreciates community support in recruitment of family physicians" and that such supports have been "successful in boosting recruitment efforts."

McKerracher, though, says he's exploring new ideas on how to attract talent.

"I suggested to the council that we build a new fourplex … and we supply it to Interior Health for nurses or doctors," he said, with the idea that doctors fresh out of school, and potentially saddled with student debt, might be tempted by more affordable rent.

If that's not enough, McKerracher says he's willing to field personal inquiries from any interested candidate.

"I'll even go pick them up at the airport in Cranbrook and bring them up."