Health Human Resources

Health Human Resources

Health human resources and physician compensation are primary areas of focus for Doctors of BC. This is reflected in two of the strategic goals of the organization which state that we strive to achieve fair economic reward and a favourable social, political, and economic environment for physicians in BC. One of the ways we achieve these goals is through the development of policy to effectively articulate the position of Doctors of BC on key issues pertaining to these strategic areas. Our policy in this area is outlined in more detail below.

Physician Workforce Planning

Physician workforce planning is key to meeting the evolving health needs of the BC population. However, this process is challenging as accurately predicting future need and forecasting physician supply is difficult which often leads to cycles of surplus and shortage. A level of uncertainty in physician workforce planning is inevitable, however there are steps that can be taken to reduce this uncertainty and develop more effective workforce plans. As such, Doctors of BC has developed policy to advocate for key improvements in physician workforce planning.

Summary of Relevant Policy

  • Physician workforce planning in BC can be improved by establishing a multi-stakeholder committee including Doctors of BC, the Ministry of Health, and health authorities to better coordinate the development of physician resource plans and identify short and long term physician resource priorities.
  • Workforce planning needs to be supported by a provincial framework for needs-based physician resource planning and a physician workforce database to provide a baseline for future planning.

Doctors of BC Publications

Policy Papers:

Doctors Today and Tomorrow: Planning BC’s Physician Workforce

 

Working with Allied Health Professionals

Providing health care in BC involves an intricate network of relationships, and positive professional relationship within this network ensure that each stakeholder, including physicians, is able to focus on their part in ensuring the highest standard of health care. In light of the importance of relationships and networks within the health system, Doctors of BC has developed a number of policies to speak to professionalism, the role of allied healthcare providers, and multi-disciplinary primary care.   

Summary of Relevant Policy

  • Professionalism and effective relationships in healthcare can be enhanced healthcare provider organizations clearly defining scope of practice and expected roles, and by health authorities and government working to promote and support collaborative relationships with physicians and other healthcare providers.
  • To enhance multidisciplinary primary care in BC, standards must be set to guarantee patient safety and quality of care, funding should be provided to incorporate allied health providers, and physicians should have the option to operate in these teams as the clinical team leader.
  • Maximizing the role of allied health professionals, including nurse practitioners, in the health system requires clear evidence-based processes for scope of practice changes that allows for stakeholder input and that respects well-defined titles such as “physician” or “doctor”.
  • Scope of practice changes for allied health professionals should be substantiated by evidence of training and demonstrated expertise, ethical and appropriate, consistent with the best available scientific evidence, and should protect patient safety and quality of care.

Doctors of BC Publications

Policy Papers:

Working Together: Enhancing Multidisciplinary Primary Care in BC (paper)

Medical Professionalism – Working Together: An Exploration of Professional Relationships in Medicine

 

Policy Statements:

Scope of Practice for Allied Health Professionals

Multidisciplinary Primary Care

Nurse Practitioners

Physician Assistants

 

Physician Autonomy

Professional autonomy of physicians is integral to the provision of patient care and to a well-functioning health care system. Professional autonomy enables physicians to exercise their judgement to make care decisions that meet the needs of their patients and enables them to engage openly in issues of quality improvement, patient safety, and health system improvement. Professional autonomy is also integral to forming strong partnerships between physicians and other key stakeholders such as health authorities and the Ministry of Health. As such, Doctors of BC has developed policy to outline fundamental principles of professional autonomy and partnering with physicians.

Summary of Relevant Policy

  • Principles of professional autonomy for physicians include the ability of physicians to engage in self regulation, the ability to utilize professional judgement in clinical decision making, and the ability for physicians to advocate on issues of quality, patient safety, and health system planning/improvement.
  • To create effective partnerships with physicians, health organizations should provide physicians with meaningful opportunities for physicians to participate in health service and system planning, they should support physicians’ ability to advocate about quality concerns, and their medical leadership should be valued and adequately resourced.

Doctors of BC Publications

Policy Papers:

Partnering with Physicians

Policy Statements:

Physician Autonomy

 

Workplace Safety

Psychological and physical safety are important in developing safe and happy workplaces with high performing teams. However, both physical violence and psychological challenges continue to be prevalent for physicians and other healthcare providers. This is partially due to gaps in training for physicians, but also a lack in adequate policies and protocols to protect the physical and psychological safety of physicians. As such, Doctors of BC has developed policy to address these gaps.

Summary of Relevant Policy

  • To better prevent violence against physicians, they should be included in workplace violence prevention planning and evaluation, and they should have access to violence prevention training/education.
  • To improve psychological safety, physician advocacy should be supported, physicians should have access to leadership training activities, provider experience should be considered a key performance metric of the health system, and health authorities should develop fair dispute resolution systems for physicians to access.

Doctors of BC Publications

Policy Statements

Preventing Violence in Healthcare

Promoting Psychological Safety for Physicians

 

Health System Funding, Performance, and Sustainability

As the health needs of the population continue to evolve, new ideas and debates emerge on how the system should be designed and funded to meet these needs in a sustainable way while delivering quality care. Central to many of these debates are the role of public and private care, models for how funding is delivered, and questions about expanding the services that are covered. Physicians play an integral role in the system and have a strong voice in these ongoing debates and Doctors of BC has developed a number of policy documents to lend the physician voice to these discussions.

Summary of Relevant Policy

  • There is a role for public-private partnerships in healthcare – where privately delivered services and facilities are publicly funded – so long as they increase efficiency and meet high quality care standards.
  • To be successful, patient-focused funding models should be developed collaboratively with physicians, models should be monitored and evaluated, and they should be delivered with flexibility to respond to provider performance and evolving program goals.  
  • Activity-based funding should prioritize quality of care, should be developed collaboratively with stakeholders and healthcare providers, should be evidence based,  and should be flexible in order to support innovation. .
  • Improving BC’s health system requires commitment to a common vision, leadership by key stakeholders, alignment of performance measures, investment in required technology and human resources, and enhanced support for innovation and expansion of successful quality improvement initiatives.

Doctors of BC Publications

Policy Papers:

Patient-Focused Funding in British Columbia

Improving BC’s Health System Performance

Policy Statements:

Public & Private Health Care

Activity-based Funding

Public-Private Partnerships (P3s) in Health Care

Doctors of BC Response to Ministry of Health Papers

 

Physician Compensation

Physician compensation is the most significant component of the healthcare budget in BC. Physician compensation is used not only to pay physicians for the vital services they provide, but is also used as a tool to shape healthcare delivery in order to achieve health related goals and policy. The association’s position on physician compensation is most strongly articulated in Doctors of BC strategic framework where fair economic reward has been identified as a key pillar of our Vision. Key principles around fair economic reward and physician compensation are outlined below. 

Summary of Relevant Policy

  • Physician compensation should be fair between members of the profession both locally and extra-provincially, fair relative to other healthcare professions, and should recognize the cost to physicians of providing care to patients, including any costs imposed by the system.
  • Physicians should be able to exercise choice related to their compensation including how they are paid, the ability to meaningfully influence their practice environment or organize the business aspect of their work, and they should have leadership and influence in how fees or services are set.
  • Physicians should have access to fair negotiations for all physician compensation, the role of Doctors of BC should be recognized in all negotiations, and physicians should have access to fair dispute resolution processes at all levels.
  • To address the diverse healthcare needs and delivery mechanisms in BC, a pluralistic system of publicly funded physician compensation models is needed. [HJ2] 
  • Physician compensation should utilize models that are evidence-based and enhance patient care to ensure that they address the needs of physicians, patients, and the healthcare system.

Doctors of BC Publications

Doctors of BC Strategic Framework

 

Medical Student and Resident Debt Relief

Becoming a physician in BC requires between 9 to 15 years of post-secondary education. To fund their extensive education and training, most medical students and residents must take out considerable student loans both from government and private lenders. The average debt load for medical students is upwards of $158,000 and continues to increase. The burden of debt can prevent many low-income students from entering medical school and can act as a significant source of financial stress for residents and new physicians. Doctors of BC has developed policy to speak to this issue with recommendations to reduce the burden and impact of debt on medical students and residents.

Summary of Relevant Policy:

  • Key steps to help reduce the impact of medical student debt include raising annual student loan limits to adequately cover expenses and tuition, defer loan payments and interest accrual until residency training is completed, and offer debt relief incentives for new physicians who commit to practice in BC.

Doctors of BC Publications

Policy Statements:

Medical Student and Resident Debt Relief