‘There’s inequities with the pay structure’: Kamloops doctors hoping for overhaul in compensation model

KAMLOOPS — The Doctors of B.C. says the funding announced on Wednesday is a first step in addressing overhead costs faced by family doctors.

Closer to home, the Thompson Division of Family Practice says the $118 million — with individual physicians getting about $25,000 each — will help some keep their doors open.

“This is really about retention rather than recruitment right now,” said executive director of the Thompson Division of Family Practice Tim Shoults. “It provides a bridge to a new fee arrangement the doctors are negotiating with the province of B.C. right now. This funding gets family physicians, who would otherwise just have to give up, before then to stay the course until we get that new model into place.”

The four-month program will begin in October and be available to nearly 3,500 family doctors in B.C. and walk-in clinics that face high overhead costs — about $75,000 a year.

Health Minister Adrian Dix says it’s a way to close the gap between family doctors and hospitalists, the latter of which do not face overhead costs.

However, some doctors say there are already huge pay disparities between established family doctors and graduating doctors just starting their practice. They are being paid more — as much as $295,000 compared to $200,000 — having their overhead covered by the province, and also getting their student debt forgiven. Doctors at rural clinics also get paid a lot more as an incentive to work in smaller communities.

“There’s inequities with the pay structure right across the board. Depending on where a family physician works, the compensation models are different,” noted executive director of the STEPS clinic in Valleyview Dr. Christine Matuschewski. “Lots of family physicians are feeling undervalued, so I think the efforts by the government right now are very much needed.”

The province could not provide specific numbers to CFJC Today on Kamloops residents without a doctor, but it’s in the tens of thousands. One of five people in B.C. are in the same predicament.

The Thompson Division of Family Practice, like most areas of B.C., is still having difficulty recruiting new family doctors. Shoults notes it’s tough to compete against the incentives for physicians to practice in rural communities.

The new model, which is expected to be in place early next year, would pay doctors for their time, not simply how many patients they see.

“Most doctors are on a fee-for-service arrangement, whether they see the patient for five minutes or two hours. They get the same amount of money for that service,” said Shoults. “That really doesn’t account for the time the doctor has to spend with their patient, especially all the other time spending doing charting, asking for tests. That’s what really contributes to the lack of work of work-life balance and potential burnout we’re seeing with family physicians.”

Dr. Matuschewski believes the new model will not only help recruit and retain doctors here, but also benefit patients.

“In some care models, yes. So for marginalized and people who are vulnerable and have hard time accessing the fee-for-service system the way it is, absolutely, this will enable people who have challenges accessing care to access care.”

Meanwhile, Kamloops-South Thompson MLA Todd Stone says this funding is a stop-gap and may not be enough to prevent more doctors’ offices from closing.

“In and of itself, it’s going to do absolutely nothing for the one million British Columbians today who do not have a family doctor,” said Stone. “And if you talk with heathcare professionals since the announcement earlier this week, they’ll tell you they’re not convinced it’s going to do much to prevent more doctors from coming to the same conclusion to close their practices and throw even more British Columbians out of having a family doctor.”