Afraid of burnout, this Grand Falls-Windsor family doctor is closing her practice

A doctor in Grand Falls-Windsor says she's closing her family practice later this year because of rising costs and what she says is a lack of government support.

In a Facebook post on Tuesday, Dr. Sarah Clancy announced she is closing her family practice of 10 years in the central Newfoundland town in December, blaming the Newfoundland and Labrador government for "obliterating family medicine."

"I want to keep caring for my patients, but they have made it an impossible task to do it in a way that provides quality of care for patients and quality of life for family doctors," she wrote in a post that has been widely shared.

In an interview with CBC News, Clancy said the costs of running a family practice are going up but doctors don't have the ability to adjust fees to account for inflation but must accept the rates paid by the provincial government.

Along with the responsibility of caring for patients, Clancy faces the expenses of keeping a business running — like rent, staff salaries and insurance costs — all influenced by inflation, and all paid from her own pocket.

"None of that comes from the government. The only money that we get as family physicians from the government is when we see a patient or now talk to them on the phone, we get a rate. And so if I see 30 people in a day, I send 30 bills to the government."

No matter how her costs change, she said, she has to maintain the same rate imposed by the government.

"So we're stuck in terms of, how do we give better care when we can't really provide that care in an environment that's fully supported?"

She said the situation is affecting her colleagues as well.

"In this office we used to have, you know, six or seven family doctors, aside from myself and another doctor that's closing in December," she said, describing the current model for family practice as a one-way ticket to burnout.

"I'm very alone and isolated."

The Newfoundland and Labrador Medical Association says the situation is a loss for people in the Grand Falls-Windsor area.

"Unfortunately, this is not an isolated case. We know that at least five family doctors have closed their community practices in Grand Falls-Windsor over the past year. Twillingate and Botwood also saw the closures of a community family practice and two family doctors in Gander recently closed their community clinics," NLMA president Dr. Gerard Farrell said in a statement to CBC News.

Health hubs costing resources, says doctor

The provincial government has touted health hubs as a potential solution for the thousands of people in the province who don't have a family doctor. Working together under one roof are physicians, nurses, pharmacists and even psychiatrists. But Clancy says health hubs take the support that family doctors could have used, like a nurse who chooses to work in a hub instead of a private family practice.

"You've drawn people right out of longitudinal family practice where they were looking after their own, you know, 1,000 patients. And you've attracted them across the street, quite literally, to go work there," she said.

"And that that's good for those people, but what about those other people that you were following for 10 to 15 years? Ten years of a relationship with a family doctor that you know cannot be replaced by reviewing 10 years of a chart, you'll never get there."

In a statement to CBC News late Friday, the provincial health department said it has created a shared agenda for family medicine to focus on "high priority issues and projects."

"Government and the NLMA both believe that this agenda will not only address critical issues related to the recruitment of new family physicians, but will also contribute to the retention of [our] existing physician workforce," the statement read.

The department also said family physicians received a 13 per cent increase in the most recent memorandum of agreement, bringing them in line with doctors elsewhere in Atlantic Canada.

Clancy is calling for the government to offer a solution where she and fellow health practitioners receive support to alleviate the financial and mental strains that, she says, lead to overwhelming burnout.

"They simply haven't found a way yet to make what they've created in, say the health hub situation and apply it to us family doctors."

Without a plan that addresses her concerns, she said, she's set on closing her practice at the end of the year.

"I'm waiting. I will gladly take down my signs if they can come up with something that really makes this an effective practice and a quality of life for me and quality of care for my patients."

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