Eliminating paperwork for doctors is key point of Colwood's city-run health clinic

Vaughn Palmer: As first physician recruited for Colwood clinic says, model will eliminate her second job

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Published Jan 03, 2025  •  4 minute read

The city of Colwood near Victoria is opening this city-run medical clinic soon, hiring the doctors as city employees. Photo by City of Colwood

VICTORIA — Late last month, Colwood Mayor Doug Kobayashi posed for a picture with his municipality’s newest employee: a family doctor.

She’s Dr. Cassandra Stiller-Moldovan, the first doctor recruited to what Colwood bills as Canada’s first municipally run health-care clinic.

The family doctor and sports medicine physician is moving to the suburb of the B.C. capital from London, Ont. She and her partner Steve have bought a house, she is setting up practice this month and the clinic itself opens in February.

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The goal is to have the Colwood clinic fully operational in two years, with eight doctors and support staff, providing family medical care for as many as half of the residents of the city of 22,000.

Kobayashi says when he first suggested setting up the clinic, “people thought I was a crazy guy. I am — I am an out-of-the-box thinker. But this is so logical.”

With word now spreading about Colwood’s audacious experiment, the mayor ended the year fielding inquiries.

“I can tell you right now, the phone, texts, emails — it is just going off like crazy from all the other municipalities,” he told Dirk Meissner of The Canadian Press. “They call me curious about what the heck we are doing.”

The clinic was Kobayashi’s response to a familiar crisis for many communities. Colwood’s walk-in clinic was having trouble retaining staff and keeping its doors open.

Rather than pass the buck to higher levels of government, in 2023 Kobayashi floated the idea of the city establishing its own clinic. The initial response from the Health Ministry was favourable.

A city-run survey later that year found that the most important concern for 70 per cent of Colwood residents was lack of a family doctor.

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In January of 2024, the city funded a business-case for the project. “You can build all the new facilities you want,” said Kobayashi. “But if you can’t attract and retain the doctors, you’re not solving the problem.”

Come September of last year, Colwood council voted unanimously to approve the five-year experiment in partnership with private companies Agora Lifestyle Medicine and Pure Integrative Pharmacy.

The city is spending $500,000 in startup costs. The space is leased from the pharmacy for a “shockingly low” rate according to the mayor. The funding will be provided by the Health Ministry on the same basis as other clinics.

The doctors and support staff will all be municipal employees, getting full benefits, including maternity and paternity leave. They’ll be part of the municipal pension plan.

For doctors, the salary is $280,000, the pension $130,000 after 30 years’ service.

One of the biggest selling points for doctors is relief from paperwork. The Canadian Medical Association estimates that administrative burdens consume up to 40 per cent of a family doctor’s time.

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Not so at the Colwood clinic.

“The city is well equipped to do the administration,” Kobayashi told Cindy E. Harnett of the Victoria Times Colonist. “We are taking away all of the business side for the doctors so they can practice being a physician for eight hours a day.”

Stiller-Moldovan says the city has effectively eliminated the second job associated with family medicine — being a small business operator, swamped with paperwork.

“For me it was a great life fit, both for myself professionally, but for myself personally,” she told Canadian Press. “I have a young daughter and a spouse and this really was a perfect model for me to focus on the thing which I really love to do — which is take care of patients.”

Colwood targets recruits from outside B.C.: “Come for the exceptional seaside lifestyle and full municipal benefit package, including paid vacation and maternity leave, 100 per cent medical coverage and a defined pension.”

Kobayashi expects the clinic to be fully staffed before two years are up. He also expects to hit the target of providing family medical care for 10,000 Colwood residents on a preferential basis.

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Health Minister Josie Osborne hails from a smaller Vancouver Island community herself — she was mayor of Tofino — and welcomed the Colwood experiment.

“When we see the kind of ingenuity and innovation that is happening in different communities — it just goes to show what hard work can do in benefiting people,” she told the CBC’s All Points West.

The Colwood clinic is getting underway just as Osborne’s ministry launches a review of primary care at the community level.

The exercise was prompted by the Green party, which campaigned against the top-heavy bureaucracy in the health care system in favour of community care centres in every one of the province’s 93 ridings.

The concern was incorporated in the recent accord between the Greens and the NDP.

“Government will support the growth of the community health centre (CHC) model for primary care facilities,” it reads in part. “Performance analysis of the health system is critical — Government will assess all elements of the primary care system, CHCs, Urgent and Primary Care Centre’s (UPCCs), and family practices.”

Details are still being worked out. But Colwood’s municipally run clinic surely belongs in the review as a possible model for the future.

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