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B.C. doctors ratify new $708-million, three-year deal

The deal includes a new payment model that the government hopes will help attract and retain family physicians; it was approved by 94 per cent of doctors who voted.
The new agreement includes pay increases for all physicians, with additional money for overhead costs. THE CANADIAN PRESS/AP/Thomas Kienzle

B.C. doctors have ratified a $708-million, three-year deal with the province that includes a new payment model that the government hopes will help attract and retain family physicians.

The new Physician Master Agreement was unveiled by Health Minister Adrian Dix and Doctors of B.C. president ­Ramneek Dosanjh in October. The ratification vote concluded at midnight Monday with 94 per cent approval from ­doctors.

“I think the size of the vote today from all doctors, not just family doctors but all doctors, shows we’re together on the same path with a determination to make the system better for patients,” Dix said at the B.C. legislature on Tuesday. “[It’s] an excellent step and now we get on and do the work.”

The new agreement includes pay increases for all physicians, with additional money for overhead costs. There’s also more money for specialist recruitment and retention, rural programs, after-hours on-call programs and team-based care.

Dix said the new agreement marks a “fundamental transformation” of primary care and brings significant improvements across the board for doctors. The province hopes the agreement makes it more attractive for people to become family ­doctors.

The deal includes a provincial roster system starting in mid-2023 for all B.C. residents seeking a full-service family doctor, so they don’t have to search on their own.

About a million people in B.C. are without a family doctor — more than double the 437,000 people without a family physician in B.C. in 2003.

The new payment model, co-developed with the Doctors of B.C., would allow full-service family practice physicians who opt in starting Feb. 1 to earn $385,000 gross a year. That amount is based on working about 1,680 hours a year, with about 1,250 patients of average complexity — about 5,000 annual visits.

A family doctor must work at least one day a week to qualify for the new fee structure, but there’s no longer a cap on the number of patients a physician can see in a day, allowing physicians to earn more if they take on more patients.

The new payment model also ensures that family doctors with full-service practices are paid the same as family physicians working in hospitals, who earn about $300,000 a year without having to pay overhead costs in the range of $80,000.

Saanich family physician Dr. Jennifer Lush, who voted in favour of the deal, has advocated for years for a better deal for doctors as family practices closed and patients complained of not having a doctor.

“It shows that physician and patient joint advocacy has led to the most successful negotiation in recent years,” Lush said Tuesday.

Lush said much work remains to be done, including recruiting new physicians and eliminating unnecessary administrative tasks, but she is hopeful the province and doctors can continue to work together.

The new agreement takes effect Jan. 31, with an interim agreement in place since August, when the province announced $118 million for family physicians — about $25,000 each — to offset operational costs until the deal was signed.

In June, the Health Ministry also offered a lucrative new deal to new-to practice-doctors, including a signing bonus, loan forgiveness and overhead costs.

The new doctors were offered nearly $300,000 in the first year — $295,457 — plus a $25,000 signing bonus and debt forgiveness for medical training of up to $50,000 in the initial year and up to $20,000 a year over the next four years. Plus the new physicians will receive a $75,000 payment as a contribution toward overhead costs for their host clinic.

So far, 88 of about 175 family resident doctors have signed contracts to work in B.C. “That’s a very significant influx of new-to-practice family doctors into the B.C. primary-care system,” Dix said.

Dosanjh has called the deal a “seismic shift” in the way doctors practise in B.C. and said it was “by far the best agreement negotiated for physicians in Canada this year” and the best ever negotiated in B.C.

On Tuesday, Doctors of B.C. president-elect Ahmer Karimuddin called the vote result a “strong endorsement of the path we are on.”

The $708 million over three years represents two to 5.5 per cent increases each year to the total base budget. The base cost of the physician master agreement was $4.8 billion in 2018, but is now $5.3 billion.

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