There is no short-term relief for patients who’ve been paying out of pocket for dermatalogist services in Kamloops, BCMA president Dr. Shelley Ross said Tuesday.

But there is provision within a new physician master agreement with the provincial government to begin addressing shortages of rural doctors and specialists in B.C., Ross said.

On a provincewide tour after the agreement was ratified, Ross met Tuesday night with local BCMA members.

“It was a long, hard-fought negotiation,” Ross said, adding that it is a good agreement for the economic times.

The pact includes a two-year re-opening clause — in expectation that government revenues will improve — which may have encouraged doctors to ratify it. Ninety-two per cent voted in favour of ratification in July.

The political climate as well as the economic one figured prominently, since there could be a different government in office when the agreement is re-opened, Ross noted.

Fees were increased modestly but, unlike in Ontario where fees were unilaterally decreased, there was no clawback, she noted. Significantly, the agreement includes $10 million for recruitment and retention of specific specialties, $18 million to improve access to specialty services as well as $10 million for improved access to physician services in rural and remote communities.

Those funds could be tapped to enable more locum services and education leave, for example, to attract more physicians to rural practices, she noted.

Some of the other $10 million could be used to fund more specialists outside of the more heavily populated southwestern corner of the province. Kamloops, for example, has only two dermatologists. Doctors Dick Lewis and Chris Sladden opted to de-enrol from the medical services plan earlier this year to offer services privately.

They must wait a year to re-apply to join the system, though neither one has indicated he plans to do so at this point. Ross said there is no immediate remedy for specialist shortages.

The agreement also includes subsidiary programs specific to GPs, specialists and rural programs.

“The main issue is physician supply — having to be available too often and not having downtime,” Ross said. “We’ve got a new generation coming up to replace the aging doctor population and they’re not going to be willing to work 24/7.”

A team approach — with several doctors taking turns managing a patient’s care — could be one option, she suggested.

“BCMA wants to be on the leading edge — with doctors and government — and we’ve got to see how we can lead that change.”

That will involve working closely with UBC to determine what kind of doctors need to be put in place. It may mean recruitment of more general practitioners.

“We need to look down the road a little bit further.”

Drawing on another example, Ross pointed to Canadian students who have obtained their medical training abroad. Her son is one of them. Obtaining a seat in medical school at UBC is almost like a lottery, so many well-qualified students go abroad. When they return, they can’t get a residency spot.

They’re currently grouped in with immigrant MDs, who may not have practised for several years, when there should be a separate process, Ross said.

There should be more effort as well to recruit doctors who grew up in rural communities where shortages exist, Ross said. That way, there would be greater chance of a long-term commitment to practice medicine.