New physicians in BC are keen to work in team environments where ‘someone has their backs’ – where they will benefit from collegial relationships in which experienced physician mentors can help them navigate those early practice years.
That was the key theme at a panel discussion of new doctors and family residents at the recent General Practice Services Committee Spring Summit. The panel members shared their hopes, aspirations, and concerns for their future careers, and what can be done to build the types of practices that will ensure new doctors want to come and practice in our province. Physician recruitment and retention is a key priority of Doctors of BC as we work with our partners at the Ministry of Health and health authorities so that all British Columbians can access the care they need.
A major concern expressed by panel participants related to physician burnout. With rates of burnout rising, it’s easy to see why new doctors are focused on ensuring they can leave their patients in good hands when they need a break. One resident commented “We see ourselves in practice where there’s good team support—where work-life balance can be achieved.” According to the resident, this means a practice environment incorporating nurses, nurse practitioners, and allied health providers, in addition to a team of physician colleagues.
The group of new doctors pointed out that med school training prepares physicians to work in a collegial environment in which trainees rely on and consult colleagues regularly. Few of them can contemplate caring for patients in a solo practice—a concept they perceive as lonely and isolating.
Mentoring plays an important role for new doctors as well. Rather than practising alone in a new community where they’re unfamiliar with local processes and resources, new doctors value an environment where colleagues and allied health practitioners can help them learn the ropes. This applies to operational aspects of family practice as well. Almost all panel participants described the MSP billing system as “intimidating,” and—in the case of one international medical grad accustomed to a salaried environment—“incomprehensible.”
All participants expressed valuing the support of physician mentors and knowledgeable MOAs to help them navigate the billing process, but at the same time, they would prefer not to manage or be involved in the business side of clinics at all. It would be great, said one participant, to “start working in a clinic that’s ready to go—where everything is sitting waiting for doctors to just come in and treat patients.”
As they discussed billing and administration challenges, participants shared their thoughts on compensation and payment models as well. While compensation is fundamental to lifestyle and job satisfaction, participants said, they are open to considering new pay models.
“Offering longitudinal patient-centred care and not fee-centered care allows FPs to work in a way that benefits their patients,” explained one resident. She also feels strongly that payment per day for GPs should match compensation for competing hospitalist and ER jobs, which, she says “arguably have a much better team-based model, and are therefore intrinsically more attractive to new grads.”
Overall, it appears that new doctors and residents welcome a move toward practices that include health care teams to support doctors in providing patients with continuous, comprehensive, and coordinated care.
These changes are already underway. The General Practice Services Committee (a partnership of Doctors of BC and the BC Ministry of Health) is supporting doctors around the province to transform their practices into patient medical homes—family practices in which care is provided by teams that include doctors, nurses, and allied care providers.
Patient medical homes then link to primary care networks, which seamlessly connect patients with specialist care and community services. These changes will ensure patients get the care they need, when they need it, and provide the type of working environment that will ensure new doctors feel confident in setting up practice in BC and providing care for communities in the future.