The Future of Primary Care

Advocating for BC family doctors and patients

Physicians who provide longitudinal patient care are the foundation of our primary care system, yet nearly one million British Columbians do not have access to a family doctor. Doctors of BC is strongly advocating on behalf of the profession and patients to address the significant challenges that have created the shortage of family physicians. This webpage includes up-to-date information on the changing primary care environment.  

Step 1: Interim stabilization funding

Doctors of BC has been meeting with provincial government representatives regularly to advocate for tangible, concrete solutions to the primary care crisis. As a first step to address significant financial challenges family doctors are facing, interim funding of $118 M has been introduced to help stabilize family practices until a new payment model is developed. This funding provides a bridge for practices and clinics to meet their expenses and keep their doors open for patients for the four month period between October 1 and January 31, 2022. Further information can be found in our news article and President’s Letter (login required).

Funding breakdown

The stabilization funding has two components: $75M in new funding provided by government and $43M from the General Practice Services Committee (GPSC), a collaboration of Doctors of BC and the BC government. The total from both components of the funding will be on average $27,000 per physician over the four months, with some of the funding going directly to clinics to help cover overhead costs.

Application Process

On Tuesday, September 6, family doctors would have received emails detailing the funding application process for the $75M Clinic Stabilization Payment and the $43M Community Longitudinal Family Physician (CLFP) top up payment from the GPSC. 

  1. Clinic Stabilization Funding: The Clinic Stabilization Payment has been introduced to support family physicians who provide longitudinal family practice services and/or episodic primary care services (e.g. walk-in clinic services) in clinics that provide in-person patient visits and where family doctors are responsible for contributing to the overhead costs of the clinic. The time family doctors spend delivering virtual care services to patients from home offices can also be included, provided that the family doctors also deliver services while physically located in the clinic.
     
    • Application forms are to be submitted by Clinic Medical Directors only, detailed information can be found in this FAQ document (login required).
    • The deadline to submit this application form is September 30, 2022, with Clinical Stabilization Payments expected to be distributed in October 2022.
    • Questions? Email .
       
  2. Community Longitudinal Family Physician (CLFP) Payment: Since 2019, the CLFP payment has been provided to recognize family physicians who work under fee-for-service and provide long-term, relationship-based care for a panel of patients. While the CLFP Payment is an ongoing annual payment, the upcoming payment includes the new interim funding that supports an additional top up made available by GPSC for 2022 to further enhance financial supports for community longitudinal family physicians at this challenging time.   
     
    • Please see the GPSC website for more information about the 2022 CLFP Payment, detailed information can be found in this FAQ document (login required).
    • The deadline to submit the claim form is September 30, 2022, with payments to be delivered to eligible physicians in October.
    • Questions? Email .

Discussions with government

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Since our initial meeting with the Premier and the Health Minister in May, 2022, we have continued to meet twice weekly to advocate for an immediate action plan as well as long-term solutions to the primary care crisis. Doctors of BC has proposed a new payment model that would contain the best of Fee-for-Service and contract models, and would still see funding administered through MSP. The new model would account for time spent providing clinical services, the number of patient encounters, and the size/complexity of the patient panel. More information can be found in our President’s Letter. Discussions are still ongoing and we hope to announce the new model this fall.

In our discussions with government we have also been advocating for:

  • Significant improvements in relieving the burdens of after-hours care through additional supports.
  • Extra support for locum coverage so that doctors can take necessary breaks or time away from the office.
  • Reducing the burden of paperwork and administrative tasks so that family doctors can get back to doing what they do best – caring for patients. 
  • Development of alternative governance models for Primary Care Networks and Urgent and Primary Care Centres.
  • Continued support for the expansion of team-based care.

Member engagement 

Engaging%20with%20Members

Between June 20 – July 20, 2022, we held extensive province-wide member engagement to seek input into short, medium, and long-term solutions to address the primary care challenges. This engagement included eleven virtual discussion sessions, organized by health region and attended by family doctors, specialists, and residents / new to practice physicians. At the same time we also collected feedback through our online platform “Have Your Say” where members provided written input and partook in open dialogue with each other. The feedback we received is providing a foundation for our discussions with government and will continue to be utilized as we move forward to more long-term solutions. Key summaries of what we heard in these sessions can be found below. A full report will be posted in the coming weeks.

Background documents:

Negotiations

Doctors of BC is currently pursuing a two track strategy with regards to negotiations:

  1. On the first track, negotiations with government for a new Physician Master Agreement (PMA) are ongoing. During this time the provisions in the current PMA remain in place – and will do so until a new PMA is ratified by members. Any changes will be applied retroactively.
  2. While PMA discussions continue, Doctors of BC is also in talks with government on a secondary track, outside of the PMA, to develop new and/or improved compensation models to address the rising cost of business and to provide family doctors with the option to practice in a different way than fee-for-service.

Information on the negotiations process is available here or read our 5 things to know about PMA/negotiations.

The value of family doctors

Family doctors are the foundation of our health care system. They bring in-depth knowledge through extensive training and experience, and are experts in both diagnosing and treating the whole person. They know their patients’ health history which enables them to play a vital role in the prevention and early identification of disease. They manage a variety of biological, psychological, and social complexities, and bring a vast breadth of knowledge that expands the entire lifespan. Family doctors care for patients through their lives, and work in a range of settings from community care to long-term care, emergency rooms to home visits. They reduce the need for acute care visits, cost the health care system less, and contribute to reduced mortality, keeping patients living healthier and longer lives. Family doctors are innovators and powerful advocates for patients.

Please share our The Value of Family Doctors video and our We Value Family Doctors poster on your social media channels. Help us share the message that doctors are critical to the delivery of quality care and cannot be replaced.

How doctors are paid

Compensation

Most doctors are paid fee-for-service (FFS) – a fee is paid by MSP for each service a doctor provides. However, MSP only pays one fee of $31.62 per patient visit. Up to 40% of what physicians earn goes toward the cost of overhead – or the costs associated with running a business – including office rent/lease, staff salaries, purchasing and maintaining medical equipment, etc. Doctors do not get paid for vacation, taking mandatory medical education courses, or when they are off sick, but they do have to continue to pay overhead in these situations. But the fees are not keeping up with the soaring costs of running a business as they don’t take into consideration that a doctors’ remuneration is fixed even in the midst of skyrocketing costs.

How%20Doctors%20are%20Paid

Some doctors are compensated through other payment/practice models. This will be updated to include information on those models and how they work.

President’s Letters 

President's%20Letters%20and%20Statements

Doctors of BC is committed to open and transparent communications with members about our advocacy work on behalf of patients and the profession. Read previous President’s Letters and stay informed (login required).

Doctors of BC in the media

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Doctors of BC is active in the media, getting our message out on the challenges doctors are facing and the changes that need to happen. For a summary of appearances featuring Doctors of BC and our spokespeople, please visit our Doctors of BC in the Media webpage.


Questions or comments? Email