Can B.C. agreement be applied to Ontario doctors?

Some colleagues believe that Family Health Organization (FHO) doctors do not see enough patients or that they are not present in their clinics for enough hours during the day or enough days during the week. They base this belief on a very small percentage of doctors who work far less than their peers. They believe that FHO doctors take advantage of the model—I personally see it the way around. In light of the B.C. agreement, a colleague sent an email to the Ontario College of Family Physicians (OCFP) president inviting him to look at family doctors payment and try to do something for it. He cc’d me on his email. He definitely didn’t address the right person and that probably is because there is no right person to fix all of this. My colleague’s email has a few facts where there is no written evidence to support them but these facts seem logical to me and match my sense of things: Read: Dr. Jabir Jassam: Has respect between doctors gone with the wind? Here are what he asked the OCFP president (with some modifications): Do you know that having 1,000 patients in the FHO model (which is supposed to be an optimal model) corresponds with at least 1,500 to 2,000 hours of yearly work in very efficient and capable hands? Do you know that taking care of 1,000 patients in the FHO model will not generate more than $160,000 annual take home income (after the regular overhead and administrative costs)? That’s basically what we make per year before our personal expenses—and please keep in mind that we have no benefits. Do you know that a government employee (who has benefits up to their neck) makes the same money or more with much less effort, challenges, qualifications, risk and competition? They even complain when asked to go back to work and want to work from home only! Interestingly, some of them happen to be the policymakers tightening the bottleneck of the primary care physicians. I did not read the entire B.C. agreement but I stopped at an important paragraph which is, in my opinion, crucial and vital and should be reproduced in all provinces because it respects patients, doctors and the entire profession: “The new payment model will take into account factors that include how much time a doctor spends with a patient, the complexity of their needs, the number of patients a doctor sees daily, their administrative costs and the total number of patients a doctor supports through their office.” I am not sure exactly about the best way to make this work but I believe this is the way that our payment should be considered. Generally, I think this could work in multiple ways such as adding $10 per patient per visit as administrative costs plus increase the visit payment based on the time the physician spends with each patient by creating a special code to use if the visit exceeds the reasonable allocated time which is 15 to 20 minutes. As well, add more incentives for more complicated patients. I know it will not happen due to the absence of an active negotiating union but I believe that this should happen in order to restore our profession and attract more doctors instead of pushing them away. I am not sure if there is a conscious ear that will hear this and implement this to our payments. But I am sure that if they implement it, we will magically find ourselves having enough doctors. Dr. Jabir Jassam is a family physician in Ottawa.

Can B.C. agreement be applied to Ontario doctors?

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