November 2022

Dear Specialist Colleagues:

The tentative 2022 Physician Master Agreement (PMA) was announced on October 31. Voting to determine whether this PMA will be ratified opens November 14 and closes December 5. This communication provides the Consultant Specialists of BC perspective to help inform your voting decisions. We encourage all Specialists to vote and ensure their voices are heard.

This settlement offers balanced funding between Family Practice and Specialists, increases for physician services that are greater than what has been achieved in other provinces, and cost-of-living provisions. The gender pay gap within Family Practice and Specialty sections has also been acknowledged.

Consultant Specialists of BC has vigorously advocated on behalf of Specialists to ensure that Specialist concerns were heard and addressed: 

Benefits to Specialists in this PMA:

• Business Cost Premium – expansion to all fees to benefit all Specialists maintaining outpatient offices
• MOCAP – first raise since April 2002 inception
• Tray fees – long overdue raise of 25% and a new mechanism for Sections to apply for tray fees to allow innovation and expansion of office-based Specialist services
• Specialist income disparity – $70 million fund
• cSBC New Fee Fund – $15 million fund to create new fees benefiting Specialists at large, including Specialist physician communication codes.
• AP physician funding – $129 million to create new FTE positions to alleviate workload concerns, $31.2 million to address income disparity and rising business costs, and $29.3 million for afterhours premiums.

Shortfalls of PMA for Specialists:

• Business Cost Premium – cSBC endorsed raising the BCP daily cap by 150% to ensure that Specialists had their overhead fully supported by this program. The negotiated funding is estimated to raise the cap by only 12% which will not cover Specialist costs.
• MOCAP – cSBC recommended a MOCAP increase of at least 30%; this PMA would deliver only 10%.
• Remuneration for indirect patient care – The new Family Practice payment model will pay Family Physicians for charting, forms, lab review and so on. There is no provision within the proposed PMA to fund similar time-based indirect patient care for Specialists. NOTE: The recent Family Physician Payment model was separately funded outside the PMA. PMA funding was not affected by this deal and the ratification vote is solely to determine whether physicians wish to accept the proposed PMA.

There are important steps forward for Specialists in this PMA, even though some of the gains aren’t as significant as what cSBC called for.

As a result of our recent advocacy, we are now in talks with the Deputy Minister of Health to address the remaining shortfalls for Specialists and our patients outside the PMA. We will also continue our work protecting Telehealth (in combination with in-person care) and updating the re-referral system to recognize and support Longitudinal Specialist Care.

We leave it to you to vote according to your interpretation of the PMA. You will receive voting instructions from Doctors of BC in the coming days. Make sure your voice is heard and cast your vote.

Kind regards,

Dr Chris Hoag