DoBC President’s Letter: Primary Care Consultation Update
July 21, 2022
Primary Care Consultation Update
Dear Colleagues,
I am writing to provide an update on our discussions with government to develop solutions to the primary care crisis in our province. While the work right now is focusing on the issues in primary care, please know that we are very aware of the issues that specialists are experiencing. Work has begun to help solve these problems too, including through our negotiations to renew the Physician Master Agreement, but first we must get the problems in primary care under control. It is at this critical time that we are advocating for your needs in our collaborative relationship with the Ministry of Health. The solutions we seek with the Ministry are designed to make a significant difference in the lives of physicians.
Payment Model
The development of new or improved compensation models to address the long term sustainability of primary care in the community was a strong theme that we heard throughout the recent engagement sessions, and is now center stage in our discussions. Government has approved, in principle, the development of a payment model that better compensates physicians, addresses rising business costs, and recognizes the complexity of providing longitudinal care. A final decision on funding will follow once a proposed payment model is developed and presented to government.
We hope to reach an agreement and have the payment model available for Family Physicians to access this fall. The goal is to make this available to all community longitudinal family physicians who wish to switch.
Doctors of BC and the Ministry have agreed upon a set of principles that will guide further discussions. This is really important because it means we understand each other and are unified on the key elements that we are striving to achieve. For example, we have jointly agreed that the model will:
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Increase compensation for family physicians who provide longitudinal care so that, after overhead payments, it is equitable with compensation for family physicians in other areas of practice (such as hospitalists and UPCCs).
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Compensate for both patient encounters and clinical administrative time.
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Provide a mechanism to integrate nurses and allied health providers to enable team-based care.
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Be simple to administer and easy to access for all family physicians who commit to providing community longitudinal primary care.
New stabilization funding
One of the key things we heard in the recent engagement sessions is the importance of ‘stabilization’ – that we must take action now to address the potential closure of more clinics because doctors simply cannot continue to fund their operations. We continue to advocate for a solution to stabilize clinics.
PMA Negotiations
Members have been asking us about the status of negotiations for a new Physician Master Agreement. I want to assure you that these negotiations are continuing and we hope to have a draft settlement for members in the fall.
PMA negotiations are funded by government from a bargaining mandate that is linked with the expiry of all provincial contracts and collective agreements, which was March 31 of this year. These negotiations address the rising cost of living for employees and physicians across the Public Sector, as well as other problems that typically arise between rounds of bargaining. In this context, we are pursuing the interests of all of our members through PMA negotiations.
We fully understand that Family Physicians are experiencing unique challenges that have led to major issues of physician recruitment and retention, effectively reducing our ability to care for patients and leaving too many of us with no alternative but to walk away from our practices. This cannot continue.
Consultations with government on a payment model for family physicians are taking place separately and at the same time as bargaining the PMA. Doctors of BC and government recognize the importance of addressing these issues independently given the experiences of family physicians whose practices are suffering and leading to the crisis in family medicine.
Our intention is to address both the PMA negotiations and the discussions on FP payment models simultaneously. At the time we seek support for a new PMA by all of our physician members, we hope to be in a position where a new payment model is also available to family physicians who are seeking relief from the crisis they face.
New to Practice contract
We are aware of the Ministry of Health’s recent adaptation of the New to Practice contract on offer to recently graduated doctors in an effort to attract them to family practice. The proposed contract includes an overhead contribution in addition to base compensation, is applicable to both Canadian and international medical graduates, and offers student loan forgiveness as well as a bank loan – and could be considered a good starting benchmark demonstrating the value of family medicine. This contract was discussed at the Resident and New to Practice Engagement session on July 20, and after receiving feedback, we have reported back your thoughts to the Ministry.
My commitment to you
We know that you are frustrated at the pace of progress on the primary care front. Doctors of BC is advocating vigorously for you and your patients every single day, and have established some dates for when you can expect the next set of actions: end of August for information on the amount and process for allocation of stabilization funds, early fall for news about a new compensation model.
I am also hearing from members that you want more communications from me. I commit to communicating with you every one to two weeks with updates on the work that is underway. Please send me your questions, and I will attempt to answer key themes in future letters. If you have suggestions on how I can better communicate with you, please let me know.
Your association is changing. We are committed to greater openness and transparency. How we used to communicate doesn’t work anymore – today’s doctors want to be kept abreast at all times on the issues that are important to you, you want to know the good and the bad, and you want to know that your association is representing you. We hear you, we are acting on your feedback, and we are taking action. Together we can and will make positive change through what I like to call “the power of us.”
Thank you for your patience, support, and help in creating a change that is desperately needed.
Sincerely,
Dr Ramneek Dosanjh
President, Doctors of BC
president@doctorsofbc.ca
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