'A triumphant thing': B.C. family doctor says new payment model helping to retain, attract physicians

A B.C. family doctor who once considered closing her family practice says the province's new payment model is making a significant difference to those in her profession.

Dr. Tahmeena Ali, president of B.C. Family Doctors, spoke with CTV Morning Live Tuesday saying the transition from a fee-for-service system is helping to keep existing doctors and attract new ones.

"It's had beyond impacts that I think we ever imagined," she said, adding it's "a triumphant thing" that more than 4,000 family doctors have converted to the new payment structure since it was introduced a year ago.

"Family doctors tend to be conservative and so for them switching and having faith that this is going to be a better model speaks to the simplicity and the efficacy of this new model."

Ali explained the fee-for-service system pays doctors a flat fee for taking care of a patient, regardless of how much time is spent with them. Ali said that led to complaints from patients feeling like their family doctor didn't spend enough time with them.

She also said a lot of the work doctors do isn't with patients, like administration or reviewing charts.

"I think the other (thing) people forget is that we're also businessmen. We also have to pay our staff, we have to pay our leases, our rent, just like everybody else," she said.

"All that other work that previously was unpaid and now we're paid for and we can spend more time with patients and take more complex patients because we can do the admin work around it."

Even so, there are about 220,000 people in the province who have requested a family doctor and don't have one. Ali said it'll take some time for that number to come down, adding things have begun to stabilize.

"A couple of years ago I was on the brink of closing my family practice. I could not continue to pay my bills and give the care I wanted with the previous model so we avoided the exodus of many family doctors leaving practice, but it is going to take time," she said.

"It's been many years where primary care has been underfunded, undervalued so it's going to take many years for us to kind of dig ourselves out of the hole."

The new payment model was developed in partnership with Doctors of B.C. and is being delivered through a three-year tentative physician master agreement, which comes with a total incremental cost increase of $708 million by the end of the third year.

Unlike the fee-for-service model, the new Longitudinal Family Physician billing system pays doctors based on the time they spend with patients, the number of patient visits, the number of patients in their practice and the medical complexity of those patients.

About 1,000 B.C. doctors are still choosing to be paid under the previous model.