Negotiating the Physician Master Agreement

Well in advance of sitting down with government to start discussions, much prep work has already taken place. PMA negotiations are driven by members’ priorities on key issues such as funding for programs, fees, and benefits that we gather through extensive member consultation via a number of different avenues: our comprehensive negotiations survey; virtual webinars and Q and A sessions with members; and meetings with all sections and both societies, physician members of the FPSC, SSC, SCC, JSC, and the Joint Benefits Committee, and the Representative Assembly.

Once all the feedback is collected, it is then carefully analyzed to identify recurring themes and priority areas. Important issues raised by members for the 2022 PMA include funding to address growing business costs and ongoing support for virtual services to patients.

While member consultation is underway, Doctors of BC staff undertake an environmental review, taking into consideration factors that can impact negotiations, such as economic indicators, other provincial settlements, government and Ministry priorities, and the Doctors of BC Strategic plan.

Once all member input is gathered and sorted into themes and the negotiations environment is assessed, Doctors of BC’s Negotiations team develops a draft negotiating plan, which is then reviewed by two physician committees. Each of these committees offers a different perspective that provides expertise and input into the following elements of the draft negotiating plan: the strategic approach we will take with government, the core objectives that need to be achieved within the agreement, and the opening proposals.

• Negotiations Coordinating Group (NCG): comprised of the nine physicians who will play an active role in the PMA negotiations, this committee is the first to receive and review the draft negotiating plan. The NCG considers the plan through the lens of physicians with the most negotiating experience, and they focus on how we can achieve our member priorities in the context of the negotiating environment. The NCG has completed this work and made its recommendations to the Negotiations Forum.
• Negotiations Forum (NF): comprised of 16 physician members who represent the broad cross section of physician practices in BC, the NF ensures that the amended PMA negotiations plan appropriately balances the collective interests of the entire membership and is representative of them. The NF is responsible for making a recommendation on the draft negotiating plan to the Board.

Once the draft negotiating plan is endorsed by the Negotiations Forum, it is presented to the Doctors of BC Board of Directors for final approval. Approval by the Board constitutes direction to the Statutory Negotiating Committee to formally begin negotiations with the BC government.

When negotiations between Doctors of BC and the BC government formally begin, they are carried out by the Statutory Negotiating Committee (SNC). Comprised of experienced physicians from the NCG and supported by staff from the Doctors of BC’s Economics, Advocacy and Negotiations Department, the SNC’s primary responsibility is to conduct PMA negotiations in accordance with the negotiating plan approved by the Board of Directors. Doctors of BC’s Chief Negotiator is the chief advisor to the SNC and is the committee’s official spokesperson in the negotiations.

Both government and Doctors of BC typically agree to a communications/media blackout during the period of face-to-face negotiations so that each party can explore the broadest range of options to find a deal that represents both parties’ best interests. This is a common practice in negotiations of this nature.

Once a tentative agreement has been reached by both parties, the following steps are taken:

• Board of Directors: Reviews and must approve the tentative agreement. Board approval constitutes direction that the tentative agreement be distributed to the general membership for ratification.
• Membership referendum: A summary of the tentative agreement and the detailed changes to the PMA are distributed to the general membership for consideration in the ratification vote.
• Ratification vote: Members are given three to five weeks to review the material and vote on whether to accept or reject the changes.
• If a majority of the voting membership supports the deal, it is ratified, and the agreement is signed by all parties.
• If a majority of the voting membership rejects the deal, we return to the bargaining table with government.
• If we are unable to come to an agreement with government, the PMA states that a Conciliation Panel—a dispute resolution body— shall be appointed to help resolve outstanding compensation issues. The Chair of the Conciliation Panel will initially attempt to mediate an agreement between the parties. However, if that is not achieved, then the Conciliation Panel will release a report with its recommended settlement terms for the outstanding issues. There are two types of recommendations:
  • Central Recommendations contain the recommended settlement terms for physician compensation (fees, service, salary, and sessional contract rates), on-call issues, and benefits issues. These are binding on the parties unless government rejects them within 10 days.
  • Other recommendations contain the recommended settlement terms for all other issues and are not binding on either party.

Between February 2024 and the end of June 2024, member input and feedback was gathered through the following avenues:

• Negotiations survey of all members to identify overall member priorities.
• Briefings with each Section and Society, as well as meetings with Doctors of BC members on each Joint Collaborative Committee and the Alternative Issues Payment Committee, to outline the PMA negotiations context and discuss priorities (each group then provided a written submission).
• Two virtual member consultation webinars and Q and A sessions to provide negotiations context as a background for written submissions identifying individual member priorities.
• Representative Assembly briefing and workshop to determine overarching negotiations principles.

In June of 2024, Doctors of BC’s Negotiations team developed the draft negotiating plan. The plan is currently being reviewed by the Negotiations Coordinating Group and the Negotiations Forum. This review period began in early July 2024 and will continue until the end of October 2024. In December 2024, the Board will review the negotiating plan and consider it for approval.

Doctors of BC and the BC government agreed to delay the beginning of negotiations until after the newly elected government establishes its first budget. Negotiations are not expected to begin before March 2025.