Fredericton family doctor of 40 years retiring, no one to take his patients

Dr. John Beal worked the Canada Games at Crabbe Mountain, near Fredericton, this month on the Alpine site and the fast, acrobatic moguls.

Like a moguls course, his career has had its up and downs. And just as the games were winding down, so was Beal's 40-year career.

"Some of the people I've been with for many years, they said, 'Geez, you've known me all my life … you delivered me.' And these are people in their 40s," he said.

Over the course of his career, which began with a residency at the Dr. Everett Chalmers Regional Hospital, Beal has seen the field transformed culturally and technologically. Part of that transformation includes a bigger focus on preventive care and spending more time with each patient. 

Another less positive transformation has been the dwindling number of family doctors in the province. He said this is something he saw as he tried to find someone to take over his practice at the Nashwaaksis Medical Clinic on Fredericton's north side.

After months of searching, he was not able to find anyone to take on his 1,800 patients.

"It's just too difficult to get people to take a practice that has that many old, sick people. And besides, we're looking for doctors all through the province right now, so it's very hard to recruit," he said.

He was also working with Horizon Health Network to see if his practice could be made into a co-operative care clinic — a new model where a nurse, physician, pharmacist and other practitioners work under one roof.

"It was just too expensive," he said.

He started working with the province on this model in November, but by February he saw it wasn't going to happen, so he decided to officially retire and close down his clinic by April 30.

Those 1,800 patients will likely have to go on the province's primary-care wait list. As of January, there were 56,000 people on the list.

Fewer hours, but work is just as hard

It used to be typical to work 60 or more hours a week, then pick up a weekend shift at the emergency room and also be on call for labour and deliveries, he said.

"In fact, the joke was that the kids would say, 'Hey, dad is coming home for a visit,'" he said. 

"It was quite stressful in the family."

Family doctors may work fewer hours now, he said, prioritizing family time, but that doesn't mean they don't work just as hard.

"We may have worked longer hours, but we didn't work harder. Family doctors these days work very hard, but the practice has changed," he said.

A family doctor may have fewer patients now, he said, noting you'd be hard pressed to find anyone with even close to 1,800 patients, but there's a lot more time spent on each patient's preventive and chronic care.

"If someone had high blood pressure, we take their blood pressure, give them a pill and they go home," he said. "Nowadays they discuss the causes of the blood pressure, what they can do that's non-pharmaceutical, what their diet would entail, what the exercise would entail.

"We were rushed in the old days and we did have to do that in order to make a living."

He said the family physician model is going in the right direction, and the co-operative care clinic is the way of the future, but it's not clear to him how the province will get there.

"I don't know the solution to this problem," he said. "The way medicine is practiced is different now, but in many ways better than it used to be and I have nothing but praise for the new doctors and the hard work they're doing."