President’s Bulletin, October 2020

Your priorities in the pandemic

Like so many things since the beginning of the pandemic, this president’s bulletin is going to be a little different. I’ll be directly asking for feedback on several issues, topics and questions. We can’t help specialists if we don’t know what is happening to you! Please feel free to answer any questions you can in any form that is convenient (call 604-739-1334; email [email protected])

• Covid
  • Day to day practice
    • On call and backup on call planning (isolation). Asymptomatic doctors (with positive contact) told to isolate for 14 days should be allowed testing if providing essential call services. Though we understand the BCCDC is going to revise for critical service areas which would be applicable to specialists (no symptoms, negative COVID test), we need to hear from you to make a strong case about the impact of these requirements!
    • Is COVID-19 slowing down your practice? Tell us how.
    • Can you get PPE? How are you managing to pay for it if it’s not free from your HA? PPE is six months behind but community physicians will become part of the supply chain soon, we hear.
  • Rise of virtual care
    • How are your patients responding to virtual care? Do they want to see you or are they happy to talk to you through a computer screen or phone line?
    • Many of the telemedicine discussions, including policy and proposed regulations, have thus far been focused on the primary care experience but each specialist group has local, national, and international guidance available for appropriate use. Are you comfortable with the access to and use of specialist virtual care currently?
  • Fee codes/payments If your specialty group is applying for a fee, please let us know. Also please be advised that MOH has signalled strongly that any fee change proposals are to go back to the Tariff process and the temporary COVID-19 fee codes and pre-amble changes will need to be entrenched in a PMA package but are unlikely to be withdrawn or capped in the medium term.
  • New contracts for those affected/interested: We’ve been advised a temporary COVID service contract will be available by the end of 2020 in the form of bridge funding, not a transfer to contract from FFS with the stabilization of income as the goal, not the replacement of incomes to pre-COVID levels. Would such a contract interest you?
  • Planning for second, third and beyond waves – especially ICU, ER, Anaesthesia

Are you aware of future plans? Happy with them? Should specialties support/promote new public COVID-19 strategies?

• Next PMA negotiations are underway. What are your priorities?
  • Disparities
  • Change or continue negotiation style and strategies: To sustain the physician office the Business Cost Premium (BCP) is one potential model. BCP is a percentage of daily billings (to a daily max) that is added onto your daily fee-for-service depending on the city of practice. Have you noticed a benefit from the BCP? Should the values be increased? Should the cities covered by expanded/changed?Rather than introducing Urgent and Primary Care Centres (UPCCs) that often have not had consultations with local doctors as they go up, government money would be better spent on grants for physician community infrastructure.  It is important to hold space for specialists in the community so we can continue to provide good patient care in conjunction with full-service family practitioners. To that end, we will continue to work as closely as possible with the BC Family Doctors (formerly SGP)

Specialists of BC changes: renewal and support

We’ve been through a lot (including a name change) and it is time to look at whether the Specialists of BC is still relevant. We are forming a Renewal Working Group and would be pleased if you’d care to take part. There will be a modest honorarium, evening meetings and a short-term commitment. Please let us know if you are interested.

Also if you haven’t joined SBC for 2020, there’s still a small window to do so. Log in to doctorsofbc.ca and go to https://www.doctorsofbc.ca/account/sections where you can scroll down alphabetically to find us. Thank you.