LFP Payment Model ‘tailor made’ for physicians providing longitudinal care 

Dr Lucy Nee built her practice from the ground up. 

As a new physician in Vancouver, she literally walked the pavement to tell people she could take on patients. That was in 2000 when she had a service contract with Vancouver Coastal Health’s Evergreen Health Centre.

Fast forward to today. Dr Nee has her own family practice within the Pacific Medical Group and has 1,800 patients — many of whom have been with her over the past two decades. Although times have changed, Dr Nee knows many of her patients can’t always afford the time for multiple visits for complex issues. As a result, she spends at least 15 minutes, or longer, to care for them if needed. A standard doctor’s appointment is 10 minutes.

This has meant long days at the office, and extra hours at home doing paperwork. The days were so long that as a present to herself when she turned 50, Dr Nee gave herself Mondays off — something she credits to keeping burnout at bay.

Now, thanks in part to the Longitudinal Family Physician (LFP) Payment Model, Dr Nee expects she will continue caring for patients for another eight to 10 years — partly because she can bring in UBC Family Practice residents training in her office who later become her locums to share the work.

“I can honestly say I have always tried to practice in a way that makes me enjoy family medicine,” Dr Nee says. “LFP billing feels like this is tailor made for someone with a [longitudinal family] practice like mine because it encourages me to keep on doing what I’m doing in a way that I’ve always done it.”

The Ministry of Health with Doctors of BC and BC Family Doctors developed the LFP Payment Model 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.

Dr Nee, who trains UBC Family Practice residents, says she was so excited when the model was introduced that she volunteered to share its benefits with a group of 50 medical residents.

She expects the LFP model will not only draw more locums to practices like hers — with high intensity-low volume bookings — but also keep them in BC. and in family practice because they can have a better work-life balance. Many of her previous medical residents returned to Ontario, she says, because they had family there or couldn’t afford to live and practice in BC.

Recruiting and retaining more providers will not only give more access to patients but help reduce physician burnout and keep doctors working longer, she says.

“The days are long. I don’t blame the next generation for wanting to tailor a practice where they’ve got time for work, time for families and time to dedicate to their own mental health,” she says.

Dr Nee usually sees about 30-35 patients per day in her blended practice at Pacific Medical Group. On her Monday away from the office, she completes forms and other paperwork at home, while being available for her medical residents. Thanks to Urgent and Primary Care Centre, she can keep tabs on those patients, who may need to see someone else if they can’t get an appointment with her right away.

“I was excited to tell future doctors you could practice like me and still make a decent living,” she says.