A woman in a graduation robe holds a stethoscope in front of her that's been bent to resemble a heart.

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The Good, the Bad, and the Money

Docs can sign up for the program as of January 2023

New doctors have said BC’s fee-for-service model keeps them from becoming family docs

On Monday, the provincial government announced a new payment model for family doctors in the province. In BC, doctors are paid in a fee-for-service model. That means a doctor gets $30 for every patient they see. And it doesn’t matter if that patient has the sniffles or cancer.

They are also basically small business people. They are considered independent contractors, so they have to pay for things like office rental and administrative staff.

Lots of doctors have said this model makes it really difficult to keep a family practice going. And they’re burnt out from COVID. So they’re retiring early. They’re packing up and moving away. They’re leaving medicine.

And almost a million people in BC have no family doctor. It’s a crisis.

It’s hoped that the provincial government’s new payment model will fix some of the biggest problems doctors face. And if we can fix those problems, we’ll have more doctors to care for folks.

The Good

The new model is built more like having a full-time job instead of getting a commission for every patient.

So a full-service family doctor would work roughly 1,680 hours in a year and see about 1,250 patients. Overall, the target would be 5,000 visits.

That should mean doctors can take more time with complicated health problems. They won’t have to rush through an appointment so they can make enough money to run their office.

The Bad

Shirley Bond used to be the BC Liberal health minister. Now she’s the opposition health critic. She says she’s happy to see some movement on the doctors problem. But she’s right, this is just an announcement.

So far there aren’t any ways to measure whether the plan is successful. There aren’t any benchmarks or timelines.

All we know is that family docs can sign up for this new payment model as of January 2023. That’s it.

The Money

Under the new payment model, family doctors will be paid about $385,000 a year. For those of us struggling to make rent, that number might make your eyes water.

But that’s about the same amount that doctors in hospitals make. And they don’t have to pay for their own clinic.

Throwing money at doctors doesn’t solve every problem. It doesn’t address things like the steep cost of medical school or the desire for team-based care. It also doesn’t fix the administrative hoops docs need to jump through to work here.

But hopefully it’s a start.