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New funding model a ‘morale boost’: Nelson doctor

A Nelson family physician expects a new funding model that took effect this month in B.C. will go a long way toward retaining doctors and attracting new ones.

“For me, and a lot of physicians around the area and province, it’s a morale boost,” said Dr. Dharma McBride, who started working under the new model on Feb. 1, the first day it became available.

“It makes the job a lot more attractive, just the way we approach how we clock in and clock out. We’re now paid for doing everything from patient care to paperwork to clinic administrative services. Everything that before we did pro bono.”

Previously physicians were paid on a fee-for-service model that focused solely on the number of patients they saw.

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McBride, who also chairs the board of the Kootenay Boundary Division of Practice, said the new system is much more flexible and allows them to spend longer with patients with more complex cases.

While he had no exact numbers, he believed the “vast majority” of his colleagues have switched to the new payment model, although there may be some who structured their practice in a way that relies on fee-for-service.

“Getting people seen quicker has its advantages, but I think most of us would rather work under a model that allows us to get paid for everything we do, not just seeing patients, but also the administrative tasks,” he said.

The new model makes family medicine more appealing to residents and other trainees, who don’t want to “churn through a lot of patients to make it profitable and sustainable,” he added.

While he doesn’t see the new system helping patients without family doctors find them in the short-term, he is optimistic it will eventually happen.

“We’re seeing this as a long-term strategy to make sure the exodus of family physicians is stopped and make sure we can maintain and sustain primary care. I think in the long term a lot more physicians will choose family practice.”

Family doctors are responsible for paying staff fees and other clinic overhead, he noted.

McBride, who has practiced for a little over a decade in Nelson and also worked in the hospital emergency room, said the new payment model will also help with a broader reform of primary care.

He said local physicians are interested in community health centres where allied health staff such as social workers and physiotherapists are not just located in the same building but offer seamlessly integrated services.

“A lot of work is being done above and beyond the way physicians are being paid that is hopefully going to make a big difference in primary care and make it a much stronger, more robust system.”

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