When the governing BC Liberals campaigned ahead of the 2013 election, they promised to connect every British Columbian with a family doctor. The party's platform set aside $132-million for the GP for Me program to help an estimated 200,000 people who wanted a family doctor but couldn't get one.
The program failed to meet those targets, and now the province's doctor shortage is again becoming a campaign issue. Platforms for both the Liberals and the New Democrats include promises designed to address the problem.
But evaluating those proposals – and measuring their success – will depend in part on defining the scope of the problem. And that hinges on how the numbers are calculated.
The NDP, which is proposing building team-based urgent-care centres, estimates that there are 700,000 people without a family doctor, with about 200,000 still looking for one. The Liberals, who are promising to increase the number of graduating doctors and fund community-based health care, haven't offered their own assessment, but the GP for Me website says the program connected 178,000 people who did not have a family physician with one. However, it also says that between 2013 and 2016, the population of B.C. increased by 162,600.
The NDP's statistics are in line with results from the Canadian Community Health Survey, conducted by Statistics Canada in 2015.
Lindsay Hedden, a postdoctoral fellow at UBC's School of Population and Public Health, said that although this number is not ideal, it's not surprising.
"British Columbia is exactly on the Canadian average," Dr. Hedden said. "If it is a problem, it is not a problem that is unique to B.C."
The Statscan survey estimated the number of people in B.C. without a regular doctor was closer to 745,000. The survey estimated nearly 40 per cent – or about 290,000 – either could not find a doctor in their area taking patients or had a doctor who left or retired.
The rest were people who either hadn't tried finding a doctor, didn't think they needed one or had some other reason for being without a regular health-care provider.
But Dr. Hedden said they can't be ignored when measuring what's happening.
"It's not a simple answer, the gap between the two is a complex group of individuals," Dr. Hedden said.
"I think the biggest explanation is that those people just don't feel the need for one. They rather navigate the system with walk-in clinics when they need it."
This isn't to say they don't want a family doctor, Dr. Hedden said, but it just may not be worth it to them.
"It's a balancing act for the amount of effort it takes to find a GP and the amount that one will use one. I would be surprised if there was a significant number who would say, 'no I don't want a GP,'" she said.
"There is also a subpopulation of people that would be interested in finding a health-care worker but don't have the computer skills to navigate the website."
There is evidence, Dr. Hedden says, to suggest there are fewer family physicians per capita in lower socioeconomic groups, but a greater number of walk-in clinics.
NDP spokesman James Smith said even people who are not considered to be actively seeking a family doctor "are likely to need one in the future and are not receiving regular care, which could have long-term effects on their health [such as] prevention and screenings."
The GP for Me program was created to connect more people and communities with physicians and clinics that were accepting new patients, with the goal of matching every patient that wanted a family doctor. It is still up and running, though the Liberals make no mention of it in their 2017 platform.
The Liberals did not make anyone available for an interview, instead providing a statement outlining their platform. The party is promising to spend $90-million over three years to bring "integrated team-based primary-care services" into more communities.