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home / 世界杯决赛2022

vaughn palmer: 'seismic shift' makes b.c. family doctors the best paid in canada

opinion: government left out, probably deliberately, any specific targets and thresholds for retaining family doctors or attracting new ones

by vaughn palmer

nov 1 2022
read time 4 minute read
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victoria — health minister adrian dix held back a bit in announcing a new deal for family doctors monday.
he called the terms “historic,” the change “fundamental.”
he also acknowledged b.c. needs to do more to increase the ranks of family physicians, from expanding medical training to eliminating barriers to trained practitioners from other countries.
“this is one step, but i would say it is a pretty big step,” said the health minister.
dix was upstaged in rhetorical terms by the president of doctors of b.c., dr. ramneek dosanjh, who joined him for the announcement and did not hold back her enthusiasm.
she referred to a “seismic shift” and a “new dawn” in the government relationship with doctors.
a new model for compensating family doctors was in addition to a tentative fee agreement between the province and doctors of b.c. for all b.c. physicians that was also announced monday.
dosanjh called the proposed terms for family doctors the best in canada and suggested it was the best ever in b.c.
the key is a head-turning increase in compensation for family doctors.
under the old fee for service model family doctors were paid $250,000 a year on average.
the new model provides $385,000, which works out to an increase of 54 per cent. that includes $85,000 to cover the estimated cost of overhead and administration of doctors’ clinics, which up to now family doctors have had to cover out of their base fees.
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nor is the $385,000 capped. the amount is based on the model of a full-time family physician with a caseload of 1,250 patients, spending 1,680 hours a year working with patients over 5,000 visits or encounters.
some family doctors have more patients, some put in longer hours and they will be compensated above the base, according to dix.
the new model also includes a rostering provision for patients who do not have a family doctor. as i understand it, the province will maintain a roster of family doctors with the capacity and willingness to take on additional patients.
people lacking a family doctor will be able to find one on the roster, rather than having to phone around to all the doctors in their region.
will it be first come, first served? or will patients be provided access on the basis of age and the seriousness of their medical needs? dix couldn’t say.
nor were dix or dosanjh willing to predict how many family doctors will be added as a result of the new model, nor how many patients without a family doctor would be in line to get one.
both expect there will be a lot of interest among family doctors when the sign up for the new model begins in january.
dix noted the favourable response from this year’s medical graduates to the government offer of financial incentives — including a signing bonus and loan forgiveness — to go into family practice. so far there have been more than 60 takers, with others in negotiations.
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dosanjh said the immediate impact will be in persuading existing family doctors to maintain their practice in b.c. as many have been threatening to retire or relocate.
still, the lack of specific targets and thresholds will make it harder to judge the success of this deal, which is probably what the government intended.
monday’s announcement also included news of an overall fee agreement for all physicians. details to come pending ratification.
reporters were told that agreement also runs for three years. the fee increases are in the same range as the percentages in other public sector contracts — about 14 per cent over the three years, including leeway for cost-of-living adjustments.
by announcing the deal monday, the new democrats ensured it would be credited as one of the last acts of the john horgan government as opposed to happening on the watch of incoming premier david eby.
why not hold off and let the new guy preside over the good news?
perhaps because eby’s spouse, cailey lynch, is a family doctor. it might be better if one of his first acts was not to announce an increase in compensation for his wife.
adding to the progress on the bargaining front monday was a tentative deal with the b.c. teachers’ federation.

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not often does the bctf come to terms this smoothly with any b.c. government. but the talks went well, even if a few new democrats are pinching themselves in disbelief.
heading the list of remaining challenges is the b.c. nurses’ union.
but just last week nurses president aman grewal joined health minister dix on a public platform as he announced the hiring of 320 protection officers and 14 violence prevention managers for health care facilities.
safety in the workplace is a prime concern for nurses. by pre-empting the issue, the government may have eased the burden at the bargaining table.
dozens of public service union agreements remain to be settled and the full costing is still to come. but extrapolating from the terms announced to date, i expect the government will end up committing most of the $10 billion it set aside for public sector settlements over the next three years.
vpalmer@postmedia.com
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