From Dr. R.J. Lewis, Dermatologist, Kamloops, B.C.

 

I am seeking your support as I face a difficult situation that affects my rights and capability to continue to provide locally accessible dermatological services. Allow me to introduce myself and explain my circumstances.

 

For over thirty years, I have been a full time dermatologist, based in Kamloops. Prior to that, I spent a decade providing dermatological care in Nanaimo, B.C.. For the past decade at least, I have been the only full-time private dermatologist serving the British Columbia interior from Hope to the Yukon and Alberta and U.S. borders

 

 My mission as a dermatologist has been to reduce the suffering from skin disease. In effect, my practice has always focused on both prevention and treatment. My services have been available to all, regardless of financial means.

 

 To meet my interest in prevention, I have, throughout my career, organized and provided up to date information sessions to general practitioners, nurses, health care workers, massage therapists and others having an interest in skin health. In these sessions I teach basic skills in managing skin anomalies. Patients can then be provided relief, and in a timely manner, sent on to dermatologists for assessment.

 

 In addition, I have tried to reach the general public by appearing on local television and radio in order to explain the proper ways to protect oneself against the negative effects of UV rays from the sun or artificial tanning devices. I have promoted and delivered “Sun Sense” presentations to Rotary and other organizations. 

In my office practice, I have logged, since graduation, an average of 500 patient-visits per month. Among many skin diseases and conditions requiring my expertise, early Melanoma diagnosis is one of my special interests.

 

I am gravely concerned that my services to these patients have been put on hold indefinitely.

 

Why has this happened? Here are the circumstances.

 

After the onset of Covid19 in March'20, as we were all coming to grips with the best practices of contact with one another socially and in doctor-patient examinations, an observation was shared with the College of Physicians and Surgeons of B.C. that I had adjusted my cloth mask behind my face shield without immediately scrubbing my hands and re - gloving.

 

I have absolutely no objection to any patient registering observations of my actions directly to me or to the College of Physicians and Surgeons. The situation I face is not that an observation was registered, but with the ensuing actions and inactions taken by the College.

 

The College initiated a review of my Covid-19 prevention measures by the local Public Health authority. There were several non-medical circumstances identified that my staff and I quickly addressed..(ie: outdated fire inspection certificate), and a few medically related practices that were referred back to the B. C. College of Physicians and Surgeons.

 

For example, the College was not aware that many physicians and specialists, dermatologists included, have been providing needy patients the un-used balance of their prescribed creams. Creams are often packaged in larger quantities than needed by one person. Patients might purchase a 100 gram tube of cream but ultimately use only 50 grams to complete their treatment. For some, the expense is covered by private insurance. For others with no insurance, the cost is prohibitive. Instead of tossing the balance of their prescribed product into landfill, some cured patients offer their physicians the unused portion to pass along to needier patients. Until a Universal Drug Program addresses this inequity, it's the least any caring physician and compassionate citizen can do.

 

In my case, this act of compassion was one of a list of harmless infractions which spurred the College to investigate my mental competencies. My license category was altered to “temporarily inactive”, which meant immediate suspension of my clinical license to practice, until I underwent expensive private psychological testing in Vancouver.

 

The College needed assessment of my mental faculties, and inferred that independent of the outcome ,they would then independently assess my MEDICAL MENTAL abilities. Having passed my eightieth birthday, I was loathe to speculate on the possibility that an ageism bias was afoot as suggested to me by persons who know me well and are confident in my abilities. Assuming the matter would be resolved in short measure, I willingly agreed to stop working and to be examined.

 

 However, to my detriment financially, the ensuing memory testing took two months to complete. During this period, my income was nil while the rental of my office space, leasing expenses for specialized laser treatment equipment, continued. I chose to use my personal retirement savings to pay my two employees to inform my patients of my situation and to temporarily assign their cases to specialists in Vancouver. As the College's process dragged on, I had no choice but to place my staff on indefinite leave to collect unemployment.

 

After what was an extraordinarily long wait, the assessment was finally scheduled and conducted. The assessment test did not test for my medical knowledge, my personal conduct with patients, nor the efficacy of my patient-doctor relationship. The assessment tool used was a standardized series of questions commonly used to assess seniors to track their acuity. It might involve such challenges as counting backward by 7's from hundred, and similar exercises. 

 

AMNESTIC MEMORY LOSS was diagnosed. These findings were interpreted by the College as serious enough to issue a permanent withdrawal of my license to practice.

 

My position is that the College has a duty to justify its actions by organizing a one-to-one professional assessment of my actual ability to diagnose and treat patients safely. This would involve me working next to another B.C. dermatologist in a practice setting or a teaching setting at the University of British Columbia School of Medicine out-patient training facility for the specific purpose of assessing my dermatological and clinical skills and knowledge.

 

A direct UBC sanctioned, supervised testing of my memory status regarding my actual ability to diagnose and treat patients safely would be very expensive for me to incur personally. Having had no income since the end of March 2021, my expenses have continued unabated to the point that I am rapidly draining all of my retirement savings.

 

No one has offered to take over my practice in Kamloops, leaving thousands of patients, some with melanoma and other serious conditions, waiting months for an appointment elsewhere. The loss of my job has also meant that there may eventually be foreclosure on my home. Despite months of alternative job searching, nothing has come up so far.

 

I am reaching out at this time in the hopes that I can raise financial support needed to secure the testing, if permitted by the College. With your financial support I could complete the assessment and if successful, return to providing my services to the community that I love, and enable me to remain in my home. 

 

I hope that my application for assistance will meet with a favourable response,

 

Sincerely,

 

Richard Lewis MD FRCP(C)

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