91原创

B.C. has for years experienced family doctor shortages with people left behind in the province. To address this, B.C. decided to tackle unpaid administrative work head on.

It has been just over a year since B.C. implemented its new payment model for family physicians as an alternative to the traditional fee-for-service model where doctors are paid by the volume of services provided. was developed by the B.C. Ministry of Health in February 2023, and includes compensation for:聽

• Number of patients physicians see in a day
• Size and complexity of physician’s patient panel
• Time spent providing direct clinical care
• Time spent on indirect patient care such as reviewing labs and co-ordinating specialist referrals
• Time spent on clinical administrative tasks such as maintaining an accurate and up-to-date list of patients on an electronic medical record.聽

Since the introduction of this new payment model, B.C. saw more than a 20 per cent increase in family doctors starting practices,

We spoke to recent family medicine graduates in B.C. about how the new LFP model has impacted their practice of full-scope family medicine.聽

Dr. Brian Or, a recent graduate of the family medicine residency program at t丑别听University of British Columbia said, “I really appreciated the process on how the LFP was built. The ministry received input from family doctors through , and we were also consulted as family medicine residents. The product of the LFP model not only means an income boost for most doctors, but more importantly it streamlines the administrative tasks and reduces the billing burden, allowing doctors to focus on clinical care.”

We spoke to another new-to-practice family doctor who said, “wages from fee-for-service visits haven鈥檛 really gone up but health care has become more complex, people are living longer with complex diseases and many comorbid conditions, tons of unpaid (administrative work), and rising costs of operation.鈥�

In Ontario, its most recent change in compensation was a This was well below the . For family doctors whose work demands are increasing while more patients find themselves without care, this isn鈥檛 enough.聽

Recognizing the drawbacks of the fee-for-service model, Ontario also has a model called capitation, which provides a fixed lump sum payment per patient in a physician鈥檚 roster. Although it presents an alternative to the fee-for-service model, it continues to neglect the compensation of indirect patient care services and administrative tasks. These tasks, such as reviewing new blood work results, filling out important patient forms and sick notes, are all unpaid, and are often done in the evening after clinic or on the weekend.聽

The novel LFP model is clearly effective in addressing the family doctor shortage. Ontario must act fast to replicate this success. The need to attract and retain family doctors is urgent, and B.C. has demonstrated that compensating for unpaid labour is a key step toward ensuring patients receive the care they need.