Original Published on Sep 01, 2022 at 11:47

By Moira Wyton, Local Journalism Initiative Reporter

British Columbia will send $118 million in relief funding directly to primary care doctors this fall in an effort to quell the growing  shortage of family doctors and stabilize patient care in the province.

All family doctors working  in longitudinal care or walk-in clinics, over 4,500 physicians, will be  eligible for an average of $25,000 between Oct. 1 and Jan. 31.

The Ministry of Health is contributing $75  million of the funding, announced in partnership with Doctors of BC, and  $43 million is coming from the General Practice Services Committee,  which was established in concert with Doctors of BC.

Health Minister Adrian Dix said doctors can  use the funding to cover overhead costs like staffing, clinic supplies  and rent, and to supplement their own salary at their own discretion.

“This interim funding will  provide the support and stability our family doctors and their patients  count on,” said Dix on Wednesday.

Approximately one million  British Columbians do not have a family doctor, and waitlists for  specialist care and surgery remain long.

“We have a lot of work ahead of us to  achieve long-term solutions to the primary care crisis in this  province,” said Dr. Ramneek Dosanjh, president of Doctors of BC. “But I  do believe we are one step closer today.”

The announcement is a stop-gap measure for  the floundering primary care system, which has been hemorrhaging  physicians to telehealth practice and having difficulty attracting new  doctors to replace those retiring. 

It comes amid negotiations between the  government and Doctors of BC for a new master agreement governing  physician compensation. The new agreement, to be announced this fall and  take effect early next year, will usher in the transformational changes  needed to keep and attract family doctors, Dix said.

“This is an important announcement that  stabilizes the system,” said Dix. “It also demonstrates our commitment  to a new funding model for primary care.”

Currently, primary care doctors are  contractors who are paid through a fee-for-service model, meaning they  bill the Medical Services Plan, or MSP, for each service provided to a  patient. 

That fee stays the same no matter how long  or complex their appointment with a patient is. A doctor’s pay is their  billings minus the overhead costs of running a clinic, like office and  medical supplies, staff salaries and soaring rents.

The fee-for-service model also does not  compensate doctors for the administrative work of running a clinic, or  cover sick or parental leave time.

Doctors have said the model makes caring  for patients with complex medical needs and conditions difficult, and  impedes the development of the strong relationships that are essential  to good care. 

And in recent months, some have sought controversial alternative solutions to keep their clinics open and patients attached.

A Capital Regional District doctor recently withdrew a proposed $125 monthly retainer fee after an investigation by the Medical Services Commission, and instead announced she would unenrol from MSP and bill patients directly for her services.

Many are also leaving to telemedicine  platforms like Telus Health MyCare, which offer the ability to practice  with far reduced overhead costs and administrative work. But the paid  LifePlus plan for longer appointments and fast access to your primary  care provider forces existing patients to pay for memberships to stay  attached to their physician. 

The Medical Services  Commission is currently reviewing Telus Health MyCare LifePlus plan to  see if it is giving priority to paying members and equates to a two-tire  health-care system, which would violate the Canada Health Act. The MSC  will release its findings and any actions taken “in due course,” Dix  said.

The BC Greens say Wednesday’s funding is an important step that should have been taken sooner.

“Why today and not months ago? Many clinics  have closed their doors while the government did nothing to address the  increasing cost of overhead,” said Adam Olsen, MLA for Saanich North  and the Islands, in a news release.

The Greens have called for a modernized  fee-for-service model to compensate doctors for time spent with patients  and unpaid administrative tasks, as well as the expansion of community  health centres run by non-profits.

“I am still waiting for Minister Adrian Dix to show British Columbians a coherent plan,” said Olsen.

Dix said the work is not stopping with Wednesday’s announcement, but “it’s an important step, and it’s an important start.”

This item reprinted with permission from   The Tyee   Vancouver, British Columbia
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