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Doctor shortage prompts changes to West Kootenay cancer care

Family doctors are being asked to fill in more with oncologists scarce
Kootenay Boundary Regional Hospital still offers cancer treatments despite a shortage of oncologists in the West Kootenay. File photo

by John Boivin

Local Journalism Initiative Reporter, Valley Voice

Cancer patients in the West Kootenay are going to have to rely more on their family doctor for management of their case, says an Interior Health official.

Lannon DeBest told a meeting of the West Kootenay-Boundary Regional Hospital District board of directors in June that a doctor shortage has prompted a change in the region’s cancer treatment system.

One of the region’s medical oncologists retired last year, and the second just last month. No replacement has been found for either, despite an extensive search, DeBest said.

“Efforts to recruit medial oncology specialists, in partnership with BC Cancer Agency, have been unsuccessful,” he told the WKBRHD directors. “We are not unique in our challenges to recruit medical oncologists. There are demands in every community that employs a medical oncologist, including Kelowna, Victoria, and Vancouver – throughout the entire province.”

That has prompted a need to restructure cancer care in the region. DeBest says the “journey of care” for a West Kootenay cancer patient has now changed.

“The journey now will incorporate your family doctor or nurse practitioner more than it has in the past,” he said. Previously those who presented to their family doctor with cancer symptoms would be referred directly to the two regional oncologists.

“Under this new model, the GP will order new diagnostic tests to obtain what’s called a ‘diagnosis of tissues’… to determine what kind of cancer it is,” said DeBest. “Once that is known, the patients will be referred to the BC Cancer Centre in Kelowna, where they will receive a consultation with a medical oncologist based in Kelowna. Sometimes that will be in person, sometime virtually.

“The consultation will be as in-depth as in the past, and in conversation with the patient there will be a decision about a treatment plan.”

If someone is going to receive chemotherapy or other systemic therapy, those services will still be provided in Nelson, Trail and Grand Forks, DeBest said. Other ongoing care would be shared among the eight general practice oncology specialists in the region.

But what about someone who doesn’t have a family doctor?

“In short, a process and discussion is happening regularly to ensure those individuals don’t get lost,” he said, with a system in place for prioritizing patients who are waiting and wanting a doctor.

“Based on a diagnosis, the physician can manipulate the wait list in an effort to ensure those with the highest need get first access to a primary care provider.”

The new system is now “going live,” DeBest told the board’s directors.

“This is moving, and the team is working to work out the bugs,” he said. “At the end of the day, we are still committed to providing the best possible care as close to home that we can.”

DeBest said medical staff have been working to ensure that the exact same level of cancer care can be delivered in all three of the region’s hospitals that provide cancer care.

Directors at the meeting thanked DeBest and staff for coming up with the new system.

“I really sincerely appreciate the efforts IH is going to, to deliver this type of care as close to home as possible,” said Silverton councillor Leah Main. “Because obviously the option is to ship everyone to Kelowna or Vancouver, and that’s not acceptable.”

Meanwhile, DeBest said the recruitment for new medical oncologists continues. Should a medical oncologist be hired, the new system would be reviewed and adjusted.


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