Patient lists being equalized amongst physicians to ensure space is available for everyone

Derek Kilbourn

Sounder News

With the addition of Drs. Ramak Shadmani and Erin Cusack, there are now five primary health practitioners at the Gabriola Medical Clinic.

With more clinicians at the clinic, the main goal of the team at the Gabriola Medical Clinic is to ensure that everyone on Gabriola that wants a practitioner at the clinic will be able to have one.

This past week, Dr. Ramek Shadmani and Dr. Erin Cusack spoke to the Sounder about how there will be some adjustments to the practices within the clinic now that they have joined the team.

Dr. Cusack explained that currently, Drs. Thorne and Mierzewski have very large patient lists or panels. Rural family doctors should have between 800-1000 patients in their practice. On Gabriola that also has to account for the number of visitors that require urgent care, and for the time required to provide emergency care to the community, both during clinic hours and after hours on-call.

Dr. Thorne and Dr. Mierzewski both have overloaded patient lists, and in order to equalize the workload between doctors going forward there will be more flexibility around scheduling. Now when patients call for an appointment they will be offered an appointment with the first available physician, especially for new issues or concerns that require more timely access.

Dr. Cusack said it works out to that in order to bring panel numbers to a reasonable place for the existing practices Dr. Thorne needs to reduce her list by roughly 150 people and Dr. Mierzewski by 300 patients. Dr Cusak and Dr Shadmani are happy to take on that work. Dr. Cusack said there is no preference being given to any particular doctor, or patient, “we’re just trying to equalize them.”

“If we can do this, it improves access for all patients. Right now – if Dr. Thorne has a three week wait, it makes no sense for someone to wait rather than seeing me.

“If we can get people shuffled around, we will have more access to doctors.”

The clinic goal, she said, is the same as that of the public. Everyone wants people to have a practitioner.

Dr. Shadmani said, “we need to work on it all together to make sure the doctors are not overloaded at the same time.

“So collaboration of patients is necessary.

“Tracey and Maciek are overburdened they have too many patients.”

Dr. Shadmani said if Drs. Thorne and Mierzewski continue as they are, “they will burn out. We are here to help.”

Dr. Cusack said “We’re trying to make this job as sustainable as possible to try and keep people here as much as possible.

“I’ve had friends and colleagues who have burned out. The pandemic has worsened that. it’s a big problem in many communities across the province.”

She said said the shortage of doctors is a systemic problem in BC.

“So many people [in BC] don’t have doctors. What we’re trying to do is provide better care for our community – this is our solution for Gabriola.

“There are thousands in Nanaimo and Victoria who don’t have a family doctor.”

Asked if people need to stick up their hands and volunteer to be moved to another practitioner, Dr. Cusack said, “yes. With the understanding that this is a benefit to the community.

“The only way we can do that is if people are on board. We have a unique opportunity to have a functional and supportive team of health practitioners to continue to support our community and have most people have a Primary Health Care Practitioner.”

Dr. Thorne also spoke to the Sounder, saying there is a national and provincial crisis in primary care and family medicine. Currently there are 20,000 unattached patients in Nanaimo, and upwards of 100,000 people in Victoria without family doctors. The only way to ensure long term stability in any community is to create a wonderful working environment that allows for timely access for patients and a manageable balance for physicians.

She said, “I am the Provincial Lead for the Rural and Remote Division of Family Practice and know that there are rural communities in major crisis across the province. Places that have been unable to recruit new doctors, or keep the doctors that have been working. Health care in rural communities is precarious because it depends too much on a small number of people doing all of the work. We are so blessed to have, first Nurse Practitioner Jennifer Lewis, and now Dr. Cusack and Dr. Shadmani join our team. They could have gone to any number of communities, and we are grateful they chose Gabriola. Erin and Ramak are both excellent physicians and wonderful people, we are excited to add them to our team.

“Gabriola is a beautiful place and our population continues to grow. Everyday we have more people join the already lengthy wait list. NP Jennifer Lewis will continue to accept people from the wait list, and once the workload between physicians is equalized there will be room for Dr Shadmani and Dr. Cusack to accept new patients as well. If all goes as planned over the next 12-18 months we should be able to reduce the wait list significantly.”

Originally published September 8, 2021

Dr. Ramak Shadmani

Bio: Immigrated to Canada in 1995.

Proud mother of two.

Finished my masters in epidemiology in 1998 from Université Laval. Worked for Quebec public health 1998-2001 and BCCDC 2001-2005

Finished training in rural family medicine in 2007 at the University of Alberta.

Worked from 2007 to 2021 in Vancouver.

“Fell in love with the Gabriola Clinic when I was doing locum on Gabriola, and wanted to be a part of this team.”

Love dogs, painting, and gardening

Dr. Erin Cusack

Bio: Grew up on Prince Edward Island. Med school at McMaster, Residency at UBC/St. Paul’s in Vancouver

Also used to be a teacher and have a BEd and Masters of Ed from UBC. And a BA from UPEI.

Most recent work was rural family medicine in Nelson BC.

Moved here with husband, 4yo daughter, and aussiedoodle puppy,

“We missed the ocean and love being a part of a small community, and want to raise our family in a place close
to nature.

“I also paint, and love creative writing.”

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