Posted 2017/12/15 & filed under Updates.

ANDI, MANDI, CANDI – what does it all mean?

In order to fairly compare incomes of doctors in different specialties, several formulas have been developed around Average Net Daily Income (ANDI), Modified Average Net Daily Income (MANDI) and so on. In the last arbitration, when Dr Toope applied the MANDI formula, some fairly big inequities resulted. Our Disparity Data and Overhead Working Group (DDOWG) is working with the Doctors of BC Economics department. Using data from the overhead study, and perhaps considering annual incomes, we hope to come up with an improved model. As we progress, we will be coming back to each specialty group for input and suggestions. Stay tuned…

Second same specialty consultations

After much negotiation between the Specialists of BC and the Tariff committee/MSP, the issue of second same specialty consults has been settled. When referring a patient to a colleague from the same specialty within two weeks of the first consultation, you must indicate that your colleague has some skill beyond your own, such as a general neurologist referring to an epilepsy neurologist or a retinal ophthalmologist referring to a cornea expert, in order to be paid in full for your consult. In the Note field of the billing claim, include something like “I am referring Mr. X to my same specialist colleague Y, because Y has a special skill beyond my own.” Tariff will also be developing a new mirror billing code for each specialty, for when you are seeing a patient on referral from a same specialist, which will be at the same consultation rate.

Doctors of BC Overhead Study 2016/2017

During the arbitration submissions to Dr Toope early this year, it became
apparent that the last overhead study by House in 2005 needed a full update
and an improved methodology. Working with the Doctors of BC Overhead
Committee, the Specialists of BC formed a working group that has been carefully considering income cutoffs, sample sizes, and methodological details.

We believe that enough progress has been made for us to wholeheartedly endorse the Doctors of BC proposed new overhead study. MNP will be conducting the survey, and the results will be exceedingly useful for all as we plan benefits, examine future disparity monies, and get ready for the next round of negotiations. We will be working with all sections to enable a clean study that provides the best data so far.

Transitioning young patients to adult specialists

The Section of Pediatrics has a Specialist Services Committee-funded grant for transitioning usually complex young patients from community pediatricians to adult care (including adult specialists in about 25 percent of the cases).

The section has interviewed community pediatricians and family physicians. Many said they had difficulty locating suitable adult specialists, because of full practices, lack of familiarity with disorders that pediatric patients grow up and enter adulthood with, and concerns over patient expectations that the specialist would do primary care.

The Section of Pediatrics would like to work with other specialty groups to enhance access to appropriate care, perhaps through a roster of specialists willing to take on these complex patients, or through further conversation before we even start to think about solutions.

If this topic interests you, please contact Stephanie Stevenson, the Executive Director of the section via email sstevenson@cw.bc.ca or phone (604) 875-3101. Thank you for your feedback and interest.

Facility Engagement

The new Facility Physician Engagement program and funding is fully underway. Most hospitals are establishing functioning Medical Staff Associations and Facility Engagement Working Groups to discuss interesting ideas. At my hospital in Kelowna, we’re talking about a formal program for fecal transplants. I will let you know how that turns out, but in the meantime, I will try to stay clear of the fan.