The waiting room of Dr. Elena Romero’s family practice in East Vancouver tells a story familiar to many British Columbians. The small space overflows with patients—some who’ve waited weeks for this appointment, others who’ve spent years searching for a family doctor at all. A young mother gently rocks her feverish toddler while an elderly man checks his watch, already an hour past his scheduled time.
“I’m sorry for the wait,” Dr. Romero tells me when we finally sit down in her cramped office during her lunch break. She hasn’t eaten yet today. “This is actually a good day. We’re only running 45 minutes behind.”
For nearly 900,000 British Columbians without a family doctor, Dr. Romero’s packed waiting room might seem like a luxury. The province’s primary care crisis has reached a breaking point that transcends political lines, prompting the long-awaited Primary Care Review that launched last month as part of the confidence agreement between the governing NDP and the Green Party.
“We’ve been patching a system that needs fundamental reimagining,” explains Adrian Dix, B.C.’s Minister of Health, during our conversation at the Legislature. “This review isn’t about scoring political points. It’s about creating a primary care model that works for the next generation of British Columbians.”
The review, led by independent healthcare policy expert Dr. Jennifer Baumbusch from UBC’s School of Nursing, will examine everything from physician compensation models to the integration of nurse practitioners and community health centers. What makes this process unique is its explicit mandate to center the experiences of patients and healthcare workers.
When I visit the Musqueam Nation’s primary care clinic—one potential model for community-based care—nurse practitioner Samantha Williams shows me their collaborative approach. “We don’t separate physical, mental, and cultural health here,” she explains while touring the bright, open facility where traditional medicines sit alongside modern equipment. “Our elders tell us when you fragment care, you fragment healing.”
The clinic serves approximately 2,400 community members with a team that includes physicians, nurse practitioners, traditional healers, and social workers. Their patient satisfaction rates exceed 90%, according to internal surveys provided to Mediawall.news.
This integrated model echoes recommendations from the BC Family Doctors association, which has advocated for team-based approaches that free physicians from administrative burdens. Their 2023 report, “Rebuilding Primary Care,” documented how the average family doctor now spends nearly 19 hours weekly on paperwork—almost half their clinical hours.
“I didn’t go to medical school to become a data entry specialist,” Dr. Romero says, gesturing to her computer screen filled with electronic forms. “Every minute I spend clicking boxes is a minute I’m not listening to my patients.”
The financial structure of primary care presents another challenge. Currently, most family physicians operate as small business owners under a fee-for-service model that rewards volume over comprehensive care. Statistics Canada data reveals these physicians earn approximately 25% less than specialists while carrying higher overhead costs and longer hours.
Dr. Priya Sharma, a recent UBC medical graduate, explains why she chose emergency medicine instead of family practice: “I watched my mentors burn out trying to maintain their clinics. They were essentially running money-losing small businesses while caring for complex patients. The math simply doesn’t work.”
The Primary Care Review will examine alternative payment models, including the promising “blended capitation” approach being piloted in several communities. Under this system, physicians receive a base salary for their patient panel plus additional fees for complex care—creating financial stability while rewarding comprehensive treatment.
On a rainy Tuesday, I join community organizer Maya Lewis as she helps seniors navigate Vancouver’s Urgent and Primary Care Centre (UPCC) in South Vancouver. The province has opened 29 UPCCs since 2018 as partial solutions to the doctor shortage, but results have been mixed.
“These centers were supposed to take pressure off emergency rooms and provide continuity,” Lewis explains while helping 78-year-old Jin Wong check in. “But many patients report seeing different providers each visit, which means starting their story from scratch every time.”
Wong, who lost his family doctor three years ago when the physician retired, adds: “I keep all my medications in this notebook because nobody knows my history anymore. Sometimes I feel like a ghost in the system.”
The review will assess whether these UPCCs are delivering value or if resources might be better directed toward supporting existing practices and community health centers. Initial data from the Provincial Health Services Authority suggests UPCCs cost approximately $380 per patient visit—significantly higher than traditional family practice encounters.
Patient voices like Wong’s will be critical to the review process. The Ministry of Health has launched public consultations across 12 communities and an online survey that has already garnered over 8,000 responses in its first three weeks.
For Indigenous communities, the review represents both opportunity and caution. Dr. Nadine Caron, co-director of UBC’s Centre for Excellence in Indigenous Health and member of the review’s advisory council, emphasizes the need for cultural safety alongside clinical competence.
“We have the chance to build primary care that respects Indigenous knowledge and healing practices,” she says during our phone conversation. “But that means moving beyond token consultation to actual shared decision-making about resources and priorities.”
Dr. Caron points to successful models like the First Nations Health Authority’s community-directed clinics, where governance includes significant Indigenous leadership and traditional practices are respected alongside Western medicine.
Back in East Vancouver, as her next patient knocks on the door, Dr. Romero offers a final thought: “Whatever comes from this review needs to remember that healthcare is fundamentally about relationships. You can’t heal people through algorithms or fifteen-minute appointments.”
The Primary Care Review will deliver preliminary findings this summer, with final recommendations expected before the provincial election in October. For the nearly million British Columbians without a family doctor and the overextended providers trying to fill the gaps, those recommendations can’t come soon enough.
What remains unclear is whether the political will exists to implement meaningful change. Previous reviews have identified similar issues, yet the crisis has only deepened. As Dr. Baumbusch noted at the review’s launch: “We don’t need another report that sits on a shelf. We need action that transforms how primary care serves British Columbians—all of them.”
For patients like Jin Wong and physicians like Dr. Romero, that transformation can’t come soon enough.
