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Physicians who provide longitudinal patient care are the foundation of our primary care system, yet nearly one million British Columbians do not have access to a family doctor. Doctors of BC is strongly advocating on behalf of the profession and patients to address the significant challenges that have created the shortage of family physicians. This webpage includes up-to-date information on the changing primary care environment.
Development of a new payment model option
After months of planning, Doctors of BC, BC Family Doctors, and the provincial government have co-developed a new Longitudinal Family Physician (LFP) Payment Model, which launched in February 2023. This model is the result of what you told us you needed to stabilize and strengthen longitudinal family practice, and combines the best aspects of each of the current payment modalities. It provides:
Additional compensation to address rising business costs, equitable funding that encompasses all your work, and recognition of the value of physicians who provide longitudinal care.
Compensation for the significant time you spend on clinical administrative tasks and indirect patient care, including clinical teaching.
Compensation for time spent with patients, number of patient encounters, panel size, and complexity of attached patients.
Continued business autonomy, giving you the flexibility to create the kind of practice that works best for you and your patients.
More information can be found in our President’s Letter (login required). Please visit our dedicated webpage (login required) to learn who is eligible for the new model, how it works, a compensation calculator, extensive FAQs, latest LFP Payment Model news, our latest newsletters, and more.
What you told us
During our extensive province-wide member engagement that sought input into short, medium, and long-term solutions to address the primary care challenges, you identified the following priorities:
Have choice in the way you practice and are compensated.
Address rising business costs, and ensure pay equity across family medicine.
Recognize the time it takes for administrative work and indirect patient care.
Recognize complexity of care and the size of patient panels.
Develop a simpler fee structure with easier billing mechanisms.
Maintain clinical and business autonomy.
Ease the ever-increasing burdens on physicians, including paperwork, referrals etc.
Provide ways for physicians to take breaks by making locums more easily available.
Detailed information can be found in the Future of Primary Care Member Engagement Report that summarizes in all the feedback we received from BC’s doctors. A one-page document summarizes the recurring themes from the discussion on proposed solutions.
Negotiating the Physician Master Agreement
BC doctors have ratified the 2022 Physician Master Agreement that was negotiated by the provincial government and Doctors of BC. With this, BC doctors will see ongoing increases to their fees, MOCAP (the Medical On-Call Availability Program), and the Business Cost Premium, along with deliverables on many other areas BC doctors identified as priority issues. More information can be found in our President’s Letter (login required) or on our information webpage (login required) which includes an overview, detailed summary, link to the full tentative agreement, quick overview outlining the benefits for specialists and for family physicians, and more.
Currently, many doctors are paid fee-for-service (FFS) – doctors bill a fee to the Medical Services Plan for the service they provide a patient. Out of those fees, doctors must pay up to 40% toward the cost of running their business, what is called overhead. When doctors go on vacation, take mandatory medical education courses, or are off sick, not only do they not get paid for this time off, but these overhead costs continue. On top of that, physicians’ fees have remained woefully behind the skyrocketing costs of running a business – they remained stagnant as staff salaries, lease payments, utility costs, etc. continue to rise. As well, BC doctors have not been compensated for the time they spend with patients, the number of patient visits, nor for the complexity of their patients’ health (except in some instances) in their practice.
Addressing and finding solutions to these complex issues is the basis for the new Longitudinal Family Physician (LFP) Payment Model for family doctors who provide longitudinal care, which launched in February 2023. More information can be found in our news article.