New agreement with doctors supports team-based care

Adrian Dix

PHYSICIANS in British Columbia have ratified a new three-year agreement with government that will work to support the shift to team-based care and better access to health care for people.

The agreement meets government’s Sustainable Services Negotiating Mandate for bargaining and reflects the desires and commitment of all the parties to work within that mandate.

“New physicians have told us they want their focus to be on patients, while many retiring family doctors are unable to find new physicians to take over their practice and the administrative burden that comes with it,” said Adrian Dix, Minister of Health. “Through the Sustainable Services Negotiating Mandate and the give and take at the bargaining table, this agreement charts a new way forward by supporting doctors to work in partnership with other health professionals and gives patients the team-based care they need.”

The Physician Master Agreement supports team-based care through primary-care networks and a transition from fee-for-service compensation to new and other existing compensation models. This includes a 90-day consultation process for new non-fee-for-service physician compensation models, improvements made to existing alternative physician compensation contracts and salary increases to address work completed after regular operating hours.

It also covers enhanced rural primary-care programs and addresses the increasing costs physicians face in operating practices.

“We are pleased members have approved this agreement that provides a framework for physicians to continue working with government and health authorities to create a sustainable health-care system that best serves our patients and communities,” said Dr. Eric Cadesky, President, Doctors of BC.

The Ministry of Health, health authorities, Doctors of BC and physicians have been actively engaged in developing and implementing a range of programs and initiatives through a number of joint Ministry of Health and Doctors of BC collaborative committees established under the previous agreement. This agreement continues and builds upon this work.


Quick Facts

* Most physicians are independent contractors. Their services are paid for through fees, contractual arrangements and other incentive programs negotiated in the Physician Master Agreement.

* Unlike other public-sector employees, physicians are typically responsible for the overhead costs associated with operating their practices, which can include but are not limited to: information management and information technology infrastructure, medical equipment, clerical support and office space.

Physician Master Agreement financial terms

The financial terms of the agreement provide a total incremental cost increase of $331 million by the end of the third year (2021), which includes:

* $61.4 million to cover the annual general increase of .5% for physician service fees and alternative payment program rates;

* $63.6 million to support full-service family practices, primary care reform and other collaborative efforts. This includes:
* $56.1 million in new funding going to the General Practice Services Committee to support full-service family practices and to facilitate primary-care networks.

* $5.7 million going to the Specialist Services Committee, which supports the ongoing improvement of specialist services in B.C. through projects like the development of multidisciplinary clinics and identifying and filling gaps in various areas of specialty care.

* $1.8 million going to the Shared Care Committee (SCC), which works to improve patient outcomes by bridging patient transitions from primary care to specialty care. The SCC focuses on collaboration between doctors and patients to address barriers to care, fostering patient self-management, and reducing unnecessary burdens on patients and their families.

* $104.3 million for additional compensation increases including increases for rural programs and after-hours services;

* $66 million for physician benefit enhancements, including the Contributory Professional Retirement Savings Plan and the Physician Health Program; and

* $35.7 million to cover increasing physician business costs.

The Physician Master Agreement covers approximately 12,000 doctors in the province and is in effect from April 1, 2019 through March 31, 2022.