B.C.’s roster of family physicians has grown by 160 since the province’s new payment model took effect, a development that Health Minister Adrian Dix is calling a “breathtaking success.”
More than half of B.C.’s full-time family physicians have switched to the new fee structure, billed as a way to increase people’s access to a family doctor and stop those in family practice from fleeing a system that was burning them out. As of Friday, 2,142 family physicians have signed on to the new model, Dix said at a news conference in Vancouver. That’s more than half the 4,122 physicians working in full-service family practice, according to 2021-22 data.
Of the net new 160 family physicians on the new payment model, the Health Ministry said half billed to the Medical Services Plan in 2021-22, which indicates they were working outside primary care. This could include family physicians who work as hospitalists or in focused care such as addictions treatment, emergency care or palliative care.
Dix said that shows physicians who previously avoided family medicine are now seeing it as a lucrative option, which will benefit patients looking for a doctor. He expects to see more doctors sign onto the new payment model in the coming months.
“The reason it’s good for patients and the reason that we’ve seen so many doctors join already is because we worked on it together [with the Doctors of B.C.],” he said.
The other half of the 160 new doctors are either new to B.C. or previously provided private medical services not covered by MSP.
The new payment model took effect Feb. 1. It is an alternative to the fee-for-service model that pays physicians $30 to $40 per visit regardless of the severity of a patient’s health issues. Under the new system, which will cost taxpayers at least $708 million over three years, physicians will be paid based on the number of patients seen in a day, the number of patients attached to their practice, the complexity of the patients’ issues, and their office overhead costs.
That means a full-time family physician working 1,680 hours a year, who sees 1,250 patients with cases of average complexity, and has 5,000 visits from patients a year, will earn at least $385,000 — compared to $250,000 under the fee-for-service model that physicians had complained was outdated and not well-suited to dealing with patients with multiple health issues.
Another 120 doctors have been added to the health-care system through the province’s new-to-practice incentive program. The program aimed to lure family-practice resident graduates to full-time work in family practice through contracts valued at $295,457 for the first year, medical training loan forgiveness of up to $130,000 over five years, and a $25,000 signing bonus.
Of those new doctors, 38 are Canadian medical graduates (10 will work on Vancouver Island), and 82 are international medical graduates (16 will work on the Island).
Asked why thousands of family physicians still haven’t joined the new system, Dr. Josh Greggain, president of Doctors of B.C., said there are physicians working in more remote areas of the province who are on “alternate payment plans” or population-based funding, which are already outside the fee-for-service model. Other doctors might be taking a wait-and-see approach, he said.
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