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, meaning they are not getting the medical care they need or deserve. It also means they are relying on walk-in clinics and emergency rooms for their primary medical care, putting additional burdens on already strained avenues of care. 

Retaining family doctors and recruiting new ones is critical. Family doctors can’t continue working in an overburdened system and patients can’t continue to rely on the episodic care they receive at walk-ins and emergency rooms. Patients need family doctors –someone who knows them and their health history, and who can give them the longitudinal care that is linked to better health outcomes.

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. Please keep an eye on this page, as it will be continually updated with additional information and updates.

Engagement with members

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Starting June 20, 2022, we are launching a province-wide member consultation to seek your input and ideas for solutions to address the primary care crisis. The significant challenges we are facing impact everyone – family doctors, specialists, and patients. Your feedback will help form the foundation for tangible, concrete actions that we will bring forward in our discussions with government. 

Here’s how you can participate:

  1. Virtual engagement sessions: we will be hosting a series of Zoom sessions in June and July, organized by health region. Details about the questions and discussion topics will be provided to participants ahead of time. Register here for your region’s session. If you cannot attend any sessions scheduled for your region, feel free to join a meeting being held in a different health region.
  2. Online engagement forum: in addition to the virtual sessions, you can also submit your comments, ideas, and input using our Have your Say online community engagement platform, which will be open from June 20 – July 15. Please note, a one-time registration is required to access the platform. Join the dialogue now. 

Doctors of BC is committed to listening to our members, understanding your needs, and ensuring your input shapes the development of short-, medium- and long-term solutions. We hope you will join us on this pivotal journey.

More information on this engagement can be found in our President’s Letter (login required) and our Future of Primary Care news story.

Background documents:

Political advocacy 

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In our discussions with the Ministry, we have been pressing government about the need to commit to an immediate action plan that addresses the challenges across the province. We want government to work with us on solutions – quickly, with urgency, and with the understanding that significant investment is needed. 

Doctors of BC is advocating for:

  • Compensation to address the rising cost of running a business and the extra time and energy required to do longitudinal care.
  • Development of new practice models that address compensation and are easily accessible. 
  • 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.

Meeting with Premier and Health Minister

In a joint statement, President Dr Ramneek Dosanjh and Board Chair Dr Adam Thompson shared an update on their meeting with the Premier and the Health Minister in May, 2022. The Premier and Minister acknowledged the significant challenges in primary care, and committed to:

  • Immediate action to develop solutions with Doctors of BC that will be implemented in a timely way.
  • Address compensation issues for family doctors providing longitudinal care and develop new payment/practice models.
  • Consider options for alternate governance models for Primary Care Networks and Urgent and Primary Care Centres in communities where it is needed.
  • Develop a firm timeline with tangible outcomes.

Meetings between Doctors of BC and government are currently underway, and we will keep members informed about our progress. We are also engaging with members to ensure their voices are heard in the development of actions and solutions that will be proposed in our meetings with government.

Further information can be found in the joint President and Board Chair’s Letter (login required). 

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.

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. 

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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 and Statements

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Doctors of BC is committed to open and transparent communications with members about our advocacy work on behalf of patients and the profession.

  • In this President’s Letter, Dr Ramneek Dosanjh shares detailed information on the large and wide-ranging member engagement Doctors of BC is launching in regards to the primary care challenges. She breaks down the goals of the engagement, as well as the ways in which members can participate.
  • In a joint President and Board Chair Letter (login required), President Dr Ramneek Dosanjh and Board Chair Dr Adam Thompson shared an update on their meeting with the Premier and the Health Minister, and the commitments made by government. (May 18, 2022)
  • In response to Health Minister Adrian Dix’s comments about Nurse Practitioners (NPs), Doctors of BC released a statement in support of family doctors stating that NPs cannot replace doctors and they do not provide better care. (May 11, 2022) 
  • Dr Ramneek Dosanjh and Board Chair Dr Adam Thompson sent a joint President and Board Chair Letter (login required) letting members know that Doctors of BC’s board committed to greater transparency about how we are advocating for primary care, and to increase our public profile with a stronger tone and stance. (May 10, 2022)
  • In a President’s Letter (login required), Dr Ramneek Dosanjh shared an update on primary care, including what Doctors of BC has and will continue to advocate for with government. (April 8, 2022)

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.


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