LFP Payment Model invigorates family medicine in BC

Becoming a family doctor was a tough sell during Dr Matthew Lum’s first six years of medical school. 

He was told it was demanding work, the days long. Doctors were burned out, feeling unappreciated.

Starting his own family practice didn’t seem to be in the cards. 

“My preceptors said it’s not a bad idea to do other stuff because it’s not well compensated for the hours you put in,” says Dr Lum, who graduated this year from the University of BC Family Practice’s medical residency. 

He considered his options, which didn’t include a family practice. But the goal posts suddenly changed with the introduction of the Longitudinal Family Physician (LFP) Payment Model. 

Dr Lum was in his final year at the University of BC Family Practice residency program when the LFP came into effect in February 2023. Developed by the Ministry of Health with Doctors of BC and BC Family Doctors, the model was in response to an urgent need to retain and attract family physicians in community longitudinal practice by compensating them appropriately for the work they do. 

“On paper, it looked like a great change,” Dr Lum says. “I thought ‘I’m excited about this.’ I wondered if other people are too and if it’s going to change their attitudes and practice plans.” 

He and four other residents decided to put the model to the test. They surveyed 83 residents and found what they had expected – 65% of respondents were more likely to start their own family practice due to LFP. 

The respondents included Dr Lum’s family medicine resident colleagues who worked with him, as part of their final year project. Of the five residents involved in the study, three will be practicing family medicine in Williams Lake, Merritt, and Kelowna. A fourth is doing a mix of family practice and hospitalist work in Cranbrook. 

Dr Lum, a former clinical pharmacist, is working mostly as a hospitalist and “doing a little bit of everything to get my feet wet” in Kelowna. But within five years, he expects he, too, will have his own family practice. 

“For some of my friends, they’re going to be doing family practice because of these changes,” he says. 

Dr Josh Greggain, who oversees the UBC Family Practice residency program, says the research study results underscore a desire by doctors and residents to feel valued for their time. The flexibility allows them to work within their own schedules, which often includes evenings outside the office, and still receive compensation. 

The LFP also values the time physicians spend with patients, especially those with complex issues, Dr Greggain says. And more complete primary care when patients need it means fewer visits to the emergency department. 

 “(LFP) was really built on the idea that people want time,” Dr Greggain says. “Patients don’t want one visit one problem, they want the time to build relationships, build connections and the LFP helps foster that. This gives future family physicians the idea this a really appealing, sustainable and valued profession.” 

Dr Lum says he is excited about the future of medicine. To him, the LFP will bring more family physicians into BC, resulting in increased hours, availability, and access for patients. Family physicians will also be less stressed out, he says. 

 Although his heart is in acute care, Dr Lum says the comprehensive approach to family medicine appeals to him. 

“I do want to have a family practice eventually,” he says. “I like the idea of building relationships longitudinally as well, seeing people early in life and late in life. That’s the most rewarding part of family medicine.” 

Dr Greggain says the research study results have shown the LFP can help recruit and retain family physicians. 

“These residents have been on the forefront of what family practice was like in 2022 and witnessing what it will be like in 2024,” he says of Dr Lum and the other graduates. “This is a demonstration in storytelling from residents and the research that LFP has made a difference in their appeal to do longitudinal practice.” 

The model is already drawing more physicians to BC, Dr Greggain added, while it has also invigorated the idea of family medicine among his colleagues, who had considered leaving the profession. 

“The whole campaign was initially that everyone deserves a family doctor and that’s true. We need more family doctors to make that happen and we need those doctors to feel hopeful and inspired and I think LFP has been a critical part of that,” Dr Greggain says.

“Never has there been a better time to be a family doctor.”