A room full of medical school students claps for a colleague on a stage that sits out of frame.

Photo Credit: Province of British Columbia | Flickr

What Do New BC Doctors Actually Want?

Our old healthcare system doesn't attract modern graduates

Hint: it’s not a signing bonus

We need more family doctors. Nearly 1 in 5 folks in BC have no family doctor. But the province’s attempts to fill this gap aren’t working. Or at least they aren’t working yet.

Take the new contract offer, for example. The province offered two-year contracts to 175 freshly graduated medical students from the University of British Columbia. The “value deal” would be worth about $300,000 and include a $25,000 signing bonus and $130,000 toward student loans.

The catch? These new grads had to sign on as a family doctor in BC.

None of those 175 grads took the contract. Not a single one.

So why is extra cash not wooing students with piles of debt?

First of all, $25,000 doesn’t cover the overhead costs of actually running a medical clinic. Like, not even close.

New clinics need rent, supplies, utilities, licensing fees, staff, malpractice insurance, software for charting, and locum doctors to cover vacations. These all add up quickly. They usually cost $80,000–$100,000 each year.

There’s also the fee-for-service payment method. 

The Canadian Family Physician Journal published a report last fall. They found that new doctors are choosing hospital-based work and specialized practice rather than family medicine.

New docs are worried about how fee-for-service would affect their income (particularly in low population areas like the NorthIsle) and their work-life-balance. 

Under the fee-for-service model, which is generally about $32 per patient, doctors don’t get paid for hours of paperwork they have to do. That eats into their earnings.

“Now if the govt would pay the doctor for all work done, after hours included, it would be one step to attracting docs back into family medicine,” said Dr. Jennifer Lush on Twitter.

Dr. Lush is a VanIsle family physician. She’s been fully covering her own costs and practising about 70 hours per week for over 20 years.

That sounds a lot like Port McNeill’s Dr. Prean Armogam. He’s been calling for changes to NorthIsle’s healthcare system for years. It almost got him driven out of the area by Vancouver Island Health Authority.

Now, most new physicians want to work on contracts and salary. This gives far better work-life balance and can include overhead costs.

Dr. Ana Boskovic is one of the new grads the province hoped to woo with their deal. She told Vancouver is Awesome that she sees family doctors who’ve been practising for decades who are drowning trying to keep their practice afloat

“I would say we’re definitely feeling the weight of the need. I think there needs to be [more] options for new graduates,” she said.

Giving doctors a steady salary may attract more of them to small town family practices. But new docs are calling for bigger changes.

They want family doctors to work with coordinated teams of nurse practitioners, midwives, and other professionals to lighten Island physicians’ loads.

Dr. Kathleen Ross is the president of Doctors of BC. She talked to the Capital Daily back in 2020.

“Unfortunately, you can’t take a tired horse and whip it harder to make it work,” said Ross.

“We can’t look at our beleaguered primary care system in the community and continue to push harder for it to work in a way that’s not working.”

She said that almost all doctors want team-based care where physicians and healthcare professionals work together to get patients the help they need.

Considering how COVID has emptied our healthcare system, it sounds like now is a good time to try that model.