New payment model to support B.C.’s family doctors

A tentative new deal has been developed between doctors and the B.C. government that is aimed at protecting, supporting and strengthening B.C.’s health care system and patient care.

The new three-year model, called a physician master agreement, was developed by the government, Doctors of B.C. and B.C. Family Doctors.

It will see payment to doctors based on time with patients; number of patient visits; number of patients in their practice; and medical complexity of patients.

The current model sees payments to family doctors based solely on number of services provided.

“We know how important family doctors are in B.C.,” Premier John Horgan said.

“Rising costs, pandemic-related pressures and staffing shortages required action for doctors on several fronts. Working with the Doctors of B.C., I am pleased that we have come up with a new payment model that makes B.C. a province that attracts, retains and supports family doctors, and ensures they can focus on what matters most — providing care to patients when they need it.”

Under the changes, a full-time family doctor could earn $385,000 per year, up from the current average of $250,000.

The new system is scheduled to start in February.

“This payment model for family doctors will help protect and strengthen B.C.’s health care system by helping to attract new family doctors and retain existing doctors,” Health Minister Adrian Dix said. “By supporting our health care workers, including doctors, we are helping patients get better access to the health care that they need. And that’s what matters most, making sure patients get access to that care.”

The province said the terms of the new agreement provide a more equitable payment for working family doctors and recognizing their value in providing full-service primary care to patients, which in turn is intended to help maintain their business autonomy and create the kind of practice that works best for them and their patients.

The model also includes measures to continue the collaboration between the Ministry of Health, physicians, Doctors of B.C. and regional health authorities to improve health care in key areas, including gender equity, Indigenous reconciliation and workplace safety. It will also address work completed after regular operating hours and improve existing alternative physician payment contracts and increases.

“Over the last months, the provincial government has listened to the voices of physicians who passionately care about our patients,” said Dr. Ramneek Dosanjh, president of Doctors of B.C.

“The new physician master agreement, which must be ratified by B.C.’s doctors, recognizes the value of the work doctors do every day. The new payment model option for family doctors is unique in Canada, bringing together the best of a range of payment methods. The goal is to not only stabilize longitudinal family practice, but to also make it sustainable and rewarding. Everyone deserves a family doctor, and this new option is a major step toward making that goal a reality.”

Family doctors in B.C. will be able to opt-in to the new payment model.

It’s estimated the total cost increase of the new funding model will be $708 million by the end of the third year.

The model includes funding for payment increases for all physicians; expansion of the business cost premium; adjustments to alternate payment rates to address income disparity issues while also implementing new premiums for after-hours services; funding to support family practice, inpatient care and primary care refresh through the Family Practice Services Committee; additional funding new and adjusted family physician fees; increased funding for rural programs; funding for recruitment and retention of specialists; maintaining and enhancing physician benefits; funding to support additional full-time equivalents (FTEs) to meet increased demand for services; and an increase for annual medical on-call availability program (MOCAP) rates.