Image credit: Kent Simmonds/CFJC Today

By Marty Hastings

EYES ON HEALTH CARE

Retiring Kamloops ophthalmologist, Dr. Jelfimow, urging Interior Health to open new position

May 28, 2024 | 7:00 PM

KAMLOOPS — Dr. Peter Jelfimow said his Kamloops ophthalmology clinic had more than 14,000 patient visits in 2023 and he sees about 70 patients per day.

When he leaves the profession in August, he wants his patients’ care to continue, but said Interior Health Authority is putting that wish in jeopardy.

“They’ve been with me for the past 16 years, many of them,” Jelfimow said. “You build a rapport and you care. I want these patients to have a place to go when I go.”

Jelfimow said he has found his own replacement, a doctor willing to move to Kamloops to take over the practice, but IHA is not willing to open a new general ophthalmologist position in the Thompson Shuswap Cariboo Health Service Delivery Area, which includes a catchment population of about 250,000.

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“The division of ophthalmology here is under-resourced to accommodate all those patients upon my departure,” said Jelfimow, who has been practising in Kamloops since 2008. “I have no answer as to why we don’t need a third [ophthalmologist]. They [IHA] saw the need eight months ago. They acted on it. Now that I’m departing, we’re back down to two. It doesn’t make sense.”

Jelfimow said last fall IHA identified a need for three general ophthalmologists in the area and hired one to meet that need.

“IHA, in their dealings with me, indicated they feel the new ophthalmologist, the pediatric-focused one, has capacity in her practice to absorb all of my patients, which is really quite improbable,” Jelfimow said.

“If I provide that ophthalmologist with 70 patients per day, mostly elderly patients, the question arises – what happens to the pediatric patients in this town?”

Jelfimow said the provincial average for B.C. is about 3.8 ophthalmologists per 100,000 individuals, citing the Canadian Medical Association Ophthalmology Profile.

The retiring doctor said he appreciates the opinions of the other two general ophthalmologists in the region, but notes they seem to disagree on the need for IHA to open a new position when he retires.

“There’s been no support [from the two other ophthalmologists],” he said. “I think it’s a matter of operating-room time and allocation of such. Ophthalmology seems to be where you make a bit of your renumeration in this field. There is some reluctance, so it sems, to have access to that for a third ophthalmologist. I really can’t say entirely how it would affect their practices, but I think if there was allocation of equal distribution of OR time, we wouldn’t be having this conversation.”

Jelfimow said there is plenty of OR time to go around and his issues are with IHA senior management and staffing.

“The OR time is something for IHA to distribute based on need,” he said. “I’m identifying a need. It’s up to IHA to recognize the need and act on it accordingly.

“The issue is that any ophthalmologist coming to Kamloops will require some of that time to take care of their patients in a comprehensive manner. There has been some reluctance to provide OR time to a new ophthalmologist. That is the grassroots issue.”

Judy Gibbard is among Dr. Jelfimow’s longtime patients.

“If things stay status quo, there are going to be a lot of us who are either on the road, driving to Kelowna, Vernon or Vancouver, which doesn’t make any sense because we’re a vulnerable population. We’re older,” said Gibbard, who is 70 and suffers from two forms of glaucoma.

“We often hear, ‘Oh, people don’t want to move to Kamloops.’ That is not true in this case. In this case, there is someone lined up and wants to come to Kamloops. But for some reason, IHA has not approved the hiring of another person. I believe Mr. Dix can change that and I believe that once he knows the facts, he will want to change that because in today’s climate, you do not want to have this many people with a reason to not vote for you.”

Health Minister Adrian Dix was not able to respond to request for comment prior to publication deadline on Tuesday.

CFJC reached out to Interior Health with a series of questions. Among them: Will it open a new position? Why or why not? What is the problem with the replacement earmarked by Jelfimow? Will the region be underserviced when Jelfimow departs? If need for a third ophthalmologist was identified in the fall, why would a third not be necessary when Jelfimow retires?

IHA responded with a statement from Dr. Elizabeth Parfitt, Royal Inland Hospital Chief of Staff:

• Interior Health medical leadership has met with Dr. Jelfimow to discuss his retirement, future ophthalmology services in Kamloops, and encouraged him to work with his peers to transition patients as he retires.
• We are committed to ensuring the continuity of care for Dr. Jelfimow’s patients as he retires, and as always, Interior Health will work with physician groups to monitor demand for a service and recruit a replacement ophthalmologist if required.
• Recruitment of new specialists is a collaborative process involving RIH’s division of ophthalmology and site leadership. Collectively, they develop a medical staff resource plan, conduct impact analysis, engage in transparent job posting and hiring panels, and make a recommendation via the Health Authority Medical Advisory Committee to the IH Board. In addition to the process to determine needs, any new specialist would need to go through credentialing and receive privileges at the hospital involved.

Jelfimow said there are four ophthalmologists in the region, but one of them is a sub-specialist who works in a limited capacity.

Kamloops-South Thompson MLA Todd Stone said it is not enough.

“There is no rational explanation for how you can say Kamloops and the surrounding area, a catchment area of 225,000 people, including all the way up to Williams Lake, is supposed to get by with two ophthalmologists moving forward, not the three we’ve had, and there is 18 ophthalmologists down in the Okanagan. This is an outrageous situation, it’s inexplicable and it’s time for Adrian Dix to step in and say enough is enough, pave the way for this new ophthalmologist to come in and assume Dr. Jelfimow’s practice.”

Jelfimow said he has not heard from IHA since he last emailed on May 1 and his concern for patients lingers while retirement draws near.

“Many cannot travel and recognize this plan of IHA’s to have my patients be transferred to our pediatric-focused ophthalmologist is not feasible and they’re looking at the prospect of having to travel for further health care. What will happen to them?” Jelfimow said, noting IHA does not understand the full scope of ophthalmology. “I’m concerned. They may wind up losing vision. Vision is a very important component of healthy aging. If they have an accident or fall down the stairs, this could all be prevented by providing ongoing care. It will cost IHA nothing to replace me. Formally post a position. If that happens, this will not be a problem very quickly.”