Dear members and prospective members:
Over the winter, cSBC has continued to be vigorously active advocating for Specialists, our practice environment, the challenges we face, and for our patients. Please read on for updates on the multiple issues we’ve been tracking and working on.
- New Longitudinal Family Practice (LFP) payment model – In February, longitudinal family practice physicians were offered a new blended payment model. More than half the province’s longitudinal family physicians enrolled in the first two months. This model combines payment of $130 an hour for direct/indirect patient care and clinical administration with an element of fee-for-service (FFS) whereby physicians are still remunerated per patient for services provided. In addition, LFP physicians receive annual per capita remuneration for the number of patients in their patient panel with consideration for patient complexity. The expected gross income for the average full time family physician on the LFP model is $385,000 per year.
- Direct patient care – includes services for which there was previously no FFS billing code such as clinical teaching.
- Indirect care – includes investigation review, documentation/charting, chart review, preparing referrals and requisitions, care coordination, travel time for home visits, clinical teaching without the patient, research directly related to the needs of a particular patient, completion of clinically required forms and reports.
- Clinical administration – includes EMR management, clinical data review, and clinical administration to maintain practice compliance with College and provincial regulations.
- Specialist Care Crisis and Negotiations with Government – cSBC knows that the work-types encompassed by the LFP payment model are the same burdensome work types for which Specialists continue to be unpaid. This lack of recognition of our work contributes to Specialist burnout and a growing sense of being undervalued for the services we provide. We know that Specialist Care is also in crisis with Specialists grappling with overwhelming waitlists and pervasive moral distress as we struggle to provide care within a system that cannot keep up with demand. Specialist Care needs the same type of attention and resuscitation that Longitudinal Family Practice is receiving. We can’t treat only half of the broken healthcare system.
Since cSBC highlighted the Specialist waitlist crisis in the media in September, we have been in regular meetings with the Deputy Minister of Health to find a path forward to address these significant Specialist Care challenges and inequities. These talks are ongoing, led jointly by cSBC and Doctors of BC. Progress has been slow thus far but is being made. Our last meeting saw increasing commitment from government to work collaboratively to address our overwhelming waitlists, acknowledgement of the Specialist burden of administration and indirect patient care, and interest in improved efficiencies of care delivery that may be achieved through integration of physician extenders into Specialist Care. We continue to meet regularly and will provide updates as we progress.
- Re-referral Process – The Consultation and Referral Working Group (CRWG) has now concluded its work. I am pleased to say that agreement has been reached on how the re-referral process will be modernized to support longitudinal Specialist care while removing the significant burden of the former process. he details of this new process will be communicated to physicians in the coming weeks. I am confident that members will agree that the new process represents a significant improvement over the status quo and recognizes the collaborative care that Specialists and referring practitioners undertake together for our patients.
- Future of Virtual Care – The Physician Master Agreement (PMA) mandated that the ongoing role of and remuneration for virtual care be clarified and confirmed. After receiving the report from the Virtual Care Clinical Reference Group (VCCRG) on the principles of hybrid care going forward, Tariff convened the Virtual Care Working Group (VCWG). The VCWG and the Ministry of Health must reach consensus on the future of virtual care, including necessary revisions to the preamble and relevant fee codes, within 60 days of receiving the VCCRG report. The overarching principles with which cSBC is approaching these discussions include: simplifying solutions and fee codes, ensuring maintenance of access to Specialty care for patients, protecting continuity of timely Specialist care, and minimizing unintended consequences of solutions. Further updates will follow once the VCWG completes its work.
- Disparity Adjudication – Meetings between the sections and adjudicator Robert Brick started on April 1 with a second meeting scheduled for April 29. These meetings will be followed by written sectional submissions to Mr. Brick and one to two subsequent rebuttal submissions; timelines for submissions and final decision are still being established.
- Advocacy and Parting Thoughts – It has been my great honour and privilege to lead Consultant Specialists of BC and advocate on your behalf over the last two years. During this time we have restructured our organization to help ensure balanced representation of Specialists in our medico-political process; we have advocated for Specialists and our patients during a time of enormous upheaval in the healthcare system; we have highlighted the unique and significant challenges in the Specialist care system, both to the public and to government; and we have negotiated vigorously to see improvements for Specialists in the PMA, with further negotiations now being held outside the PMA to address the ongoing Specialist Care Crisis.
This collective advocacy, on behalf of all Specialist sections and individual Specialists, is critical to addressing the many shared challenges faced in Specialty Care. It is imperative that cSBC continue to grow and thrive, supported by everyone who benefits from the work that this organization does. Without strong collective advocacy, Specialists will fall behind and we and our patients will suffer. To members, thank you for your membership and financial support of the organization working for you. Please forward this letter to your colleagues and encourage them to join cSBC if they have not already. And if you’re receiving this update and are not a member, please join:
Go to https://doctorsofbc.ca/account/sections Scroll down to Consultant Specialists of BC, click on the + sign, check the box for regular $450; first-year practice/disabled/parental leave $225; OR student/resident/retired free. Click the JOIN SELECTED SECTIONS AND SOCIETIES button to pay. Thank you!
Not sure if you’ve joined this year? Drop our Executive Director a line to check.
On April 27, I will be handing over the leadership of cSBC to Dr Dana Wong. Dr Wong is an Otolaryngologist in Nanaimo. I have worked with her on multiple cSBC committees over the last three years and can attest that the organization is in excellent hands. Many thanks to all of you for your trust and support over the last two years.
Thank you for your interest and engagement,
Dr Chris Hoag
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Dr Chris Hoag, President
phone: (604) 739-1334
[email protected]