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A year after the mandate: where B.C.'s unvaccinated doctors ended up

In the Interior Health region, while unvaccinated staff were barred from IH property immediately, the health authority’s board of directors delayed formally terminating medical staff who refused the vaccine until August.
Unvaccinated healthcare workers have been able to see their patients in their private practice.

A year after it became mandatory to be vaccinated against COVID-19 to work in healthcare, the B.C. government is showing no signs of lifting one its last pandemic restrictions.

While most unvaccinated healthcare workers—those employed directly by health authorities—have been off the job since Oct. 12, 2021, those in private practice have been able to continue working and seeing patients.

Castanet spoke with one former and three practising physicians who refused the vaccine to see where they have ended up.

In the Interior Health region, while unvaccinated staff were barred from IH property immediately, the health authority’s board of directors delayed formally terminating medical staff who refused the vaccine until August.

The terminations were the culmination of a behind-closed-doors process—set in motion by provincial health officer Dr. Bonnie Henry’s vaccination requirement—that saw IH’s board quietly hold hearings involving impacted staff.

The process crawled forward while most pandemic-related restrictions were being dropped in other parts of society, according to doctors involved in the process.

Dr. Theresa Szezepaniak worked as a hospitalist physician at Royal Inland Hospital in Kamloops prior to being fired for refusing the vaccine.

She says IH’s Medical Advisory Committee was quick to recommend to the IH board and CEO after the mandate was issued in October 2021 that unvaccinated physicians should have their medical staff appointments revoked.

Several months later in June 2022, Szezepaniak said hearings were held before the board involving legal representation on both sides.

“At that time, the board couldn't make a decision and wanted more information from the hospitals as to how it is possible that revoking these physicians' privileges fulfills their mandate to provide health care.”

Szezepaniak claimed no new information of value was presented, but the IH board followed the recommendations of the CEO and Medical Advisory Committee and formally cancelled her medical appointment along with others in August.

Interior Health’s board is made up of an appointed mix of doctors, First Nations leaders and other non-healthcare community leaders from the region.

In a statement to Castanet News, Interior Health says the hearing process “takes time to coordinate and was not delayed by the availability of the board.” The health authority did not elaborate on why it took 10 months for the board to formally accept the vaccine mandate.

Interior Health declined to provide a figure of the number of medical staff involved in the summer hearings, but said the decision in August impacted 0.4 per cent of medical staff. Medical staff are defined as physicians, dentists, midwives and nurse practitioners who have been granted privileges to practice in IH facilities.

Szezepaniak says she fears the decision will result in a permanent black mark on her doctor’s registration, making it difficult for her to return to hospital practice if the mandate is lifted or practice in another province. Multiple other doctors in a similar situation to Szezepaniak that Castanet spoke with echoed those concerns.

But in a statement to Castanet, the BC College of Physicians and Surgeons said certificates of professional conduct do not list current or revoked privileges at health authority facilities.

Szezepaniak has since transitioned to family practice, as the vaccination mandate does not apply to private practices. She said it was difficult to find a clinic that would accept her vaccination status, but has found a home in 100 Mile House, joining Dr. Gerald Lubbe at the Village Medical Clinic.

Lubbe, who refused the vaccine himself, has been a family doctor in the South Cariboo for 24 years. He, like other family doctors who refused the vaccine, was in essence cut off from the rest of the healthcare system in October 2021 when the mandate was issued.

He has continued to see patients in his private practice, but in the event that those patients end up in long term care or the hospital, he is barred from interacting with them.

Lubbe shared a recent example of what he calls a “deficiency” caused by the mandate.

Previously, he would write instructions for his patients and send them to the hospital, in the form of a direct admission. “And then in the evening, I'd go up and then dictate a note on the condition. And also, of course, go check on them.”

“What's happening now, because I'm not allowed to write instructions to the hospital, that patient has to go and sit, some of them desperately ill— there was one in heart failure who waited for four hours to be seen, to be admitted. They’ve got to wait in line in the emergency department. So that, of course, is detrimental to the patients on a whole.”

Lubbe says he grateful he's been able to continue working in private practice, and near the end of his career, he could opt to retire any day if he wanted to. But he enjoys helping his patients.

Lubbe’s situation is similar to that of Dr. Joshua Nordine in Kelowna, general practitioner who has continued to work in private practice and has been publicly advocating for the lifting of the healthcare vaccine mandate.

“B.C. has taken a very extreme approach during the COVID pandemic, and it's at the time now, where we need to heal and come together and bring people back to work,” Nordine said in a previous interview with Castanet. “They can do so safely, and we need to have that discussion.”

Nordine said banning a family doctor who has cared for a patient for decades from visiting them in hospice—facilities that have exemptions for unvaccinated family members—makes no sense.

Lubbe said he is baffled that the healthcare vaccination mandate has persisted for a year.

“I think it was completely punitive… There are lots of people who aren't vaccinated. We know more now. We are certainly no more of a danger to anybody. I mean, why allow you then to continue working in your practice? And working in contact with people all the time, 30 to 40 people every day. So what's the difference between that and going to hospital?”

large study published in April in the New England Journal of Medicine found people who received two doses of the AstraZeneca vaccine had no protection against contracting the Omicron variant after 20 weeks. People who received two doses of Pfizer had just 9% protection after 25 weeks. Moderna drops to 15% after 25 weeks.

The vaccine remains a powerful tool in preventing serious illness and death from COVID-19.

The BC College of Physicians and Surgeons have reported that 98 per cent of their registrants are vaccinated against COVID-19. Of the doctors Castanet spoke with for this story, estimates varied wildly over how many unvaccinated physicians have continued to work in private practice amid the mandate.

The Ministry of Health has said the high rate of vaccination in registered healthcare workers like doctors has made a mandate for them unnecessary. “The PHO and the ministry continue to work with these groups and their regulatory colleges on a process for informed decision-making for patients and clients."

About 2,500 British Columbian healthcare workers, 900 in the Interior Health region, were terminated last year for being unvaccinated. With that making up less than two per cent of health authority employees in B.C., their return to work is not the solution to the healthcare staffing crisis, the Ministry of Health has repeatedly stated.

Dr. Monica Fofie worked part-time for Interior Health at community sites in Kelowna and in sexual health prior to surrendering her registration as a physician as the mandate rolled out. She says focusing on termination stats misses out on people like her, or those who retired.

“We're not really counted,” Fofie said. “But it's a significant problem, and there are still lots of us around who could work if the mandates were actually dropped and help support the system right now.”

Fofie said when she was faced with a total loss of work, she opted to forgo the financial costs associated with maintaining her physician's registration. The province's now-abandoned plan to mandate vaccination of all doctors, or strip them of their license, also played a factor in Fofie leaving the profession.

"So I was kind of looking down the barrel of well, do I pay thousands of dollars to keep my license up now, when in three weeks, they're saying you're out anyway," she said, going on to explain the financial blow to her family.

"It's definitely meant cutbacks around our house, it's meant changing the food that we buy, it's meant changing activities that my kids can go in and getting the out of some activities. It's meant going into debt, racking up a line of credit."

She said she is thankful she is not a single-income household, because some of her unvaccinated colleagues that were have sold houses, or had to move, like Szezepaniak did.

Szezepaniak agreed that lifting the healthcare worker vaccine mandate won’t fix systemic issues with the system that was “stretched to breaking point anyway.”

But the longer the mandate persists, she says fewer impacted healthcare workers will return once it does.

“What do you do with somebody like me? I've now moved region, moved my family, I’m now not anywhere close to a hospitalist program after a year's basically unemployment.”

“I'm just one of many healthcare workers that have had to rebuild their lives in order to literally eat and support their family. So even if the mandate got dropped tomorrow, I couldn't take up my job, because I've now moved and now I no longer have the resources to move again, back into the circumstances that I was in.”

Other healthcare workers that Castanet has interviewed say they are ready to jump back into the workforce right away, if given the opportunity.

Last month, when announcing that the healthcare vaccine mandate would be staying in place, the Ministry of Health said the “trajectory of the pandemic over the next few months is uncertain as there is still significant spread of the COVID-19 virus in the province and around the world.”

“Spread of disease is also expected to increase again this fall and winter. The potential for another variant of concern to emerge remains a real concern.”

British Columbia is an outlier, alongside Nova Scotia, in keeping vaccine mandates in place for healthcare staff. In Ontario, individual hospitals have the power to enact their own mandates and some have continued to do so.

The opposition BC Liberals have been calling for the end of the healthcare vaccine mandate since the summer.

Meanwhile, the BC College of Physicians and Surgeons have started disciplinary proceedings against a trio of doctors for who espoused extreme anti-vaccine rhetoric that captured headlines during the pandemic — Dr. Charles HoffeDr. Stephen Malthouse and Dr. Daniel Nagase.