Dr. Shelly Eckland Jetzer
My journey in family medicine started with a love for people and their stories. I was an Emergency and ICU nurse before becoming a doctor, so I was used to dealing with patients of all ages and backgrounds. When I moved into family medicine, I thrived on building relationships and getting to know my patients over time, caring for everyone in the family from “cradle to grave.”
But as much as I loved it, the financial strain of traditional family practice was overwhelming. I was never one to rush through ten patients an hour. I preferred to take my time, seeing three to four patients an hour and addressing multiple issues in each visit. Unfortunately, the practice model at the time didn’t support this approach financially. Most of my earnings went to overhead costs, and I was left with little to show for my hard work. By 2020, just before the pandemic, I had to make the difficult decision to leave family medicine and move to hospital work.
The Longitudinal Family Physician (LFP) Payment Model, introduced last year, was a turning point for me. It allowed me to return to family practice without the constant stress and financial strain. One of the most significant changes was the ability to bill for indirect care—tasks like paperwork, filling out forms, and connecting with other healthcare team members. Before, I’d spend 10-12 hours on weekends doing unpaid paperwork. Now, I could finally be compensated for that time.
After returning to family practice last September to cover a friend’s maternity leave, I took over a small practice with many elderly patients. The new LFP model allowed me to book longer appointments, ensuring that my patients felt heard and cared for without the rush. The difference in my stress levels was incredible. I no longer had to worry about running behind schedule or being overbooked. I could focus entirely on my patients’ needs.
The change didn’t just impact my professional life; it improved my quality of life. The constant background stress of running a traditional practice was gone. I could now build my schedule to meet my patients’ needs without feeling like I was compromising my financial stability or personal well-being.
I’ve seen a renewed interest in family medicine among my colleagues since the LFP Payment Model was introduced. Some who had left family practice have returned, and now new graduates are more interested in office-based family practice. This is a promising trend, but there’s still work to be done. Access to care remains a significant issue. Walk-in clinics, which used to be a safety net for many, have struggled under the new model. They can no longer see many patients from outside the clinic’s practice , leading to decreased access to care when family doctors are fully booked.
Moving forward, we need to address this gap. One solution is to develop community Primary Care Networks with interdisciplinary teams of healthcare providers. These teams would include doctors, nurses, nurse practitioners, counsellors, social workers and other allied health workers that can collectively work together in caring for patients; each health care provider working in their scope of practice. This collaborative care model enables doctors to focus on medical issues while other team members provide nursing, counselling and other care. For example, nurses could conduct home visits, reducing the burden on doctors and improving patient care. Nurse practitioners could see patients for community doctors when they are fully booked and help to address any urgent issues for physicians.
The new LFP Payment Model is a huge step in the right direction, but there’s still room for improvement. We need to ensure that patients can find family doctors and access care without resorting to emergency departments. This means continuing to build on the current model and ensuring that the Ministry of Health remains a supportive partner.
My return to family practice has been a whirlwind, but it’s been good. The reduced stress and ability to spend adequate time with patients have made a significant difference in my practice and my life. I hope we can continue to build on the LFP model, ensuring that every patient has access to the care they need and that every family doctor can provide that care in a sustainable, fulfilling way.
Dr. Shelly Eckland Jetzer is a family doctor practicing in Ladner and Co-chair of the Delta Division of Family Practice Primary Care Network (PCN) Committee.