The organization that represents B.C. doctors says it’s pleased at the uptake to B.C.’s new family doctor payment model, but many physicians appear to still be taking a wait-and-see approach.
Doctors of BC says more than 2,000 physicians have signed up for the Longitudinal Family Practice pay scheme in the five weeks since it took effect, representing about 45 per cent of longitudinal family doctors.
“That gives me great hope, and I think our entire negotiating team and the Ministry of Health some real optimism that we got the model right, because people are joining,” Doctors of BC president Dr. Josh Greggain told Global News on Monday.
The numbers include about 145 doctors who weren’t currently practicing family medicine, something Greggain also suggests is a good sign for B.C.’s system.
About one million British Columbians currently don’t have a family doctor.
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The new model is meant to help reduce burnout and help recruit and retain doctors who feel burdened by additional administrative work under the current fee-for-service model.
“The feedback is that this has been a game-changer for many physicians. They have been able to now bill for the time they take to look at labs and provide consults and team-based care alongside some of their nurses,” Greggain said.
“Not only have we stabilized things for the short term, we’ve started to recruit some new physicians in. And the biggest shift we hope is creating some optimism and some hope for the future of family practice, which only then brings in newer physicians, the young graduates.”
While the professional association for B.C. doctors is bullish about the new model, thousands of family doctors have yet to sign on.
Among them is Vancouver family physician Dr. Anna Wolak, who said she and many colleagues feel there are still too many unknown details and unanswered questions about the new model.
“What a lot of people are really waiting for is the addressing of how we deal with complex patients, because when a patient comes in it’s more than just ‘OK you need a refill of your medications, we’ll write it all out.’ There’s no clarity as to the compensation for that,” she said.
“We also are not necessarily sure how much better this pay is compared to fee for service. Some people are paid a lot better and that’s great, that’s part of what this model was designed for, but that’s a lot of the younger career physicians. Those who are mid-to-late career with more complex patients, it’s harder to see the advantage.”
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Wolak said there is still a lack of clarity about exactly how much and of what type of information needs to be submitted for billing.
She said she’s heard from colleagues who signed on and have had payments clawed back or billing submissions rejected without clear answers as to why.
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Greggain said Doctors of BC and the provincial government tried to make the model as simple as possible.
He said that physicians who have signed up now only need to deal with 11 billing codes.
“For contrast, in the fee-for-service model there are several hundred billing codes,” he said.
“So we believe there’s a simplicity to this. You get paid for the time you spend, the number of encounters or interactions you have per day, and then the panel, or how many patients you look after.”
Wolak said she’s not condemning the new model, and said it was a step in the right direction.
But she said she’s not comfortable signing on until more of the unknowns are ironed out.
“A lot of it is one step forward two steps back with some of the payment,” she said.
“There’s just a lot of confusion when really all you want to do is practice medicine and take care of our patients.”
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