Dr. Mei-ling Weidmeyer, Dr. Rita McCracken, & Dr. Ruth Lavergne: Community Health Centres are the best solution to the primary care crisis

In the final days of election promises and political sparring, one truth stands clear: fixing healthcare isn't about headlines and vague promises —it's about having the courage to do what the research tells us actually works. The fact is British Columbia is facing a critical primary care crisis, with many people living here struggling to access consistent, longitudinal healthcare and we need a government who will work to solve this core issue. 

Research shows that episodic care, versus longitudinal, lacks continuity and this can result in poorer health outcomes and unnecessary hospitalizations, particularly for patients with chronic conditions who need consistent management. Episodic care is available at walk in clinics, urgent primary care centres and emergency departments and in our current primary care access crisis is often the only care people can find. Episodic care can also lead to duplication, repeat testing, and extra paperwork, which makes the system less efficient and more expensive. 

Community Health Centres or CHCs stand out as a better model for providing this continuous, integrated care. They are in a community, serving the health needs of its members, much like how public schools are organized. And,unlike episodic care clinics, CHCs offer a comprehensive range of services that not only address immediate health concerns but also tackle the social determinants of health. These determinants—such as income, housing, and education— influence our long-term health outcomes. For example, people living in poverty may have worse health outcomes and CHCs can address these issues by integrating medical care with social services, mental health support, and preventive programs, creating a holistic approach to healthcare. This model is particularly effective for populations made vulnerable in our society, including low-income communities, Indigenous peoples, and seniors with complex care needs.

In 2022, 9000 Canadians participated in the OurCare survey, and the results found strong support for continuous relationships with a primary care provider. The public and the research recognize the benefits of a long term health relationship over time and we need changes to our system to make this more available - like we would have with Community Health Centers.

Evidence from other provinces, particularly Ontario, tells us CHCs work and can improve healthcare access and outcomes. Ontario's CHCs have successfully reduced emergency department visits by providing consistent, team-based care and addressing health inequities. Few trips to the emergency department means better health and less hassle for patients and less costs to the health system. CHCs are community-governed, allowing them to tailor their services to the specific needs of their populations and letting people have a voice in the care they receive. This type of structural flexibility is essential for BC, which has a diverse and geographically dispersed population. CHCs can adapt to the unique health challenges of both rural and urban communities, providing responsive and equitable access to primary care.

The OurCare survey also reveals that the public is open to new models of care that prioritize accessibility and continuity. More than 70% of respondents agreed that family doctors and nurse practitioners (NPs) should be required to accept any patient living near their office. This aligns with the CHC model, which is designed to serve local communities without barriers to access. Additionally, 91% of survey participants indicated they would be willing to see the same NP for most of their care, highlighting public support for team-based care models that include non-physician providers—an integral aspect of CHCs.

One of the most significant advantages of CHCs is their ability to attract healthcare professionals, especially new family medicine graduates. Many doctors are seeking team-based environments with alternative payment models where they can focus on patient care rather than managing a private practice. CHCs offer these settings, making them an attractive option for doctors, nurse practitioners, and allied health professionals. This is especially important for BC, which is currently experiencing a shortage of healthcare providers. By expanding CHCs, the province could better recruit and retain healthcare workers, ensuring more residents have access to primary care.

Whoever wins the provincial election, we need the next government to find real solutions to the primary care crisis in BC. Community Health Centres offer a comprehensive, sustainable solution to BC’s primary care crisis. Their focus on team-based, continuous care, integration of social services, and community governance makes them ideally suited to address the province's diverse healthcare needs. The OurCare survey shows that the public is ready for change and supports models that prioritize continuity and accessibility. By investing in CHCs and making them a central component of the province’s healthcare strategy, BC can create a more equitable and effective healthcare system for all its residents.

Dr. Mei-ling Wiedmeyer

Primary care physician in Metro Vancouver and a Clinical Assistant Professor in the UBC Department of Family Practice.

Dr. Rita K McCracken

Family Physician, Assistant Professor | Family Practice | UBC

Dr. Ruth Lavergne

Associate Professor in the Department of Family Medicine at Dalhousie University