New payment model for family doctors to be implemented February next year

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The government of British Columbia has approved a new physician payment model to be implemented on Feb. 1. The payment model was created by Doctors of BC, BC Family Doctors, and the provincial government. 

The new payment model factors in how long a physician sees a patient, the amount of patients they attend to, and the types of health issues patients have. The model also factors the amount of patients supported through a doctor’s office, and the administrative support doctors do and pay for themselves, and also includes an increased salary. 

The goal of the new model is to attract new family doctors and retain current doctors, according to the government press release.

President Dr. Ramneek Dosanjh of Doctors of BC calls the new payment model an “incredible opportunity with the spirit of true collaboration.” She says this new model will be a foundation for the way the province moves forward in health care and primary care. 

Dosanjh says with the pandemic and opioid crisis, family doctors in the province have felt a burden from their practice and have struggled to keep their clinics open. Some of the burdens are the cost of business, operating clinics, and maintaining staff and human resources. 

While this new payment model is a way forward, she says the problems physicians face will not be solved overnight, and the new model is “one step towards creating a better future of healthcare equity.” 

With the new model, the province will move away from a system that is “highly diffused and difficult to understand for patients,” said Minister of Health Adrian Dix in a press conference.  

Almost one million British Columbians are without a family doctor. The new payment model aims to begin creating a system that focuses on patients, patient care, and providing family physicians the chance to build their practice. 

The new system is positive for family doctors. It will also allow patients to better connect with the system of family doctors without having to search around, Dix said. 

Full-time family physicians will earn $385,000 under the new payment model, which Dosanjh says is based on 1,680 hours and 1,250 patient panels. She says the salary increase will help doctors with overhead and business operational costs. 

The new salary will pay physicians for indirect care, like the patient charting that physicians take home with them. It also offers physicians flexibility by giving them a minimum full time equivalent (FTE) requirement and no maximum. With this, physicians can choose to commit only one day to longitudinal primary care, Dosanjh says.  

She says this new model is a redesign of the healthcare system and hopes more physicians can be retained in the process. But with almost one million residents without a family doctor, a health issue that has increased over the years, Dosanjh says the process of improving the system will take some time. 

“I can’t reiterate enough that it is an anchoring of support to prevent people from closing their doors and from walking away, because the working conditions have been so difficult over the years. Gaining the trust and bringing back people to medicine but also allowing them to retain their practices at this point,” she says.

“This does not fix everything. We’ve got countless problems in the healthcare system, including increased hospital wait times [and] delays in radiology. We also have to think about our community-based specialists,” she says. “This is a first start in really acknowledging the work that family doctors do and allowing them to be compensated for all the tasks.”