Patient Access and Measurement – a DIY approach

The Specialists of BC has often been focused on fee code issues and disparities. This year I would like to shift the lens to the patient. As specialists, we are acutely aware of our lack of capacity, which makes it harder for patients to access us. Our difficulty in capacity is worsened by challenges in accessing resources to help our patients. And if we do improve access, how will we know if we don’t identify where we started from?

Collaborating with Dr Kevin Wing, head of Orthopedics, we want to enable careful measurement of waitlists of all kinds for both surgeons and specialists. Kevin has already achieved this feat for many orthopedic surgeons, and now we want to extend the analysis to other surgeons and medical specialists too.

And what of improving access? We can’t just go to government with our hands out; more money isn’t there. We need to think of other ways to improve access. In Kelowna, the neurology department put all stroke patients on one ward and instituted bi- weekly multi-disciplinary rounds, which include nursing, physio, OT, speech, pharmacy, and most importantly patients and their families. This strategy has improved quality and reduced acute bed stay by 25%, saving 1000 bed-days last year alone.

Dr David Kendler wants to create an easy button for osteoporosis, where every time a fragility fracture patient is treated in hospital, an automatic assessment of osteoporosis risk and treatment will take place.

Who else has ideas? How can we at the Specialists of BC assist you in improving access without just asking for more money? Are there efficiencies that can be found in your practice, specialty, hospital or health authority? Even small ones might provide valuable gains.

Practice Tips: Taking calendar month holidays could mean CMPA savings

You’ve likely heard that CMPA fees are going up rapidly, and our former 1985-level rebates are being reduced to 55%. Many of you may be paying hundreds or even thousands of dollars more per month. Did you know that CMPA generally allows you to change classification or even suspend coverage for full calendar months? So if you are planning an extended holiday, consider notifying CMPA and asking them to waive your premiums while you are away. Keep in mind, you cannot do any medical work during this time. But if you are not practicing anyway, maybe you can save a chunk of cash!

Callback fees get special attention

The 1200m series of callback fee codes are not owned by any section, which means they only receive a bump if a fee increase is applied across the board. With the advent of targeted funding, these fees have lowered relatively by about 2% over the last decade or so. Recently the Society of General Practitioners and the Specialists of BC collaborated on a motion that was passed by the Doctors of BC board, asking that these fees be enhanced in the next negotiations. When any of us are called back in the evenings, weekends, or late at night, wouldn’t it be nice if the fee was at least treated equally to other fees?

Doctor Pharmacist?

The BC College of Pharmacy is floating the idea of increasing the scope and range of pharmacists’ activities to allow them to order class 1 prescriptions, begin/change treatment after examination, and request lab tests, all without a medical license. The details are here: Certified Pharmacist Prescriber Draft Framework

The Specialists of BC Council representatives have shared their thoughts with us, and feel that four weeks to get feedback from doctors is not reasonable. Training, responsibility, liability, collaboration, patient safety and costs are just a few of the many important issues that need time for discussion. Let me know what you think and also please take a moment to fill out this brief Doctors of BC survey. We will respond as best we can given the short notice.

Representation and governance

As you may know, the Doctors of BC is revisiting its governance structure. The most recent draft proposal would separate governance (the Board) from representation (the representative forum or RF). The proposed Board would be nine physician members, at least two of whom must be specialists. The proposed RF would have 50 physician members, with between 20 and 25 being specialists; one of these seats would go to the Specialists of BC. The RF is advisory to the Board.

Currently the Specialists of BC has a guaranteed voting seat on the Doctors of BC board which we would lose under the new proposal. Let me know how you feel about this governance idea.