Commentary: Relationships with family physicians are essential


A commentary from the president of the BC College of Family Physicians.

On February 4, the Times Colonist published the first in a series of editorials addressing the family physician crisis in British Columbia

The editorial raises many valuable points, including the importance for patients to have an ongoing relationship with a family physician and the risks we face of traditional family medicine disappearing.

There are, however, some points that we would like to clarify.

The editorial states that family physicians are paid $31.62 per visit and average between $250,000 and $300,000 per year. This suggests that these numbers do not add up and that there must be other ways to remunerate family physicians.

Due to the high demand for their services, family physicians often see 30 to 40 patients a day with little time off during the year. Multiply the visit fee by the number of visits in a week, month or year – it quickly adds up to the estimated billing.

The article rightly points out that overhead and administration should be removed from a physician’s billing. What it doesn’t say is that the average family doctor pays 30% to 35%. 100 overhead.

This means that a family doctor billing $300,000 (which is the highest amount that family doctors charge) brings in less than $200,000 – before taxes, no vacation, sick leave, maternity leave , disability, extended benefits or retirement savings.

Yes, it is higher than the Canadian average. But that doesn’t equate to a highly trained specialist, with over 11 years of post-secondary training, caring for his patients from cradle to grave and technically available 24/7. nor does it compare to what other medical specialists earn.

Physicians working in family medicine clinics have no other lucrative sources of remuneration. In fact, they cannot charge for many aspects of the patient care they provide, such as reviewing test results or consultation reports, coordinating follow-up care with other medical specialists, or writing sick notes.

They often have to do this “pro bono” work (very) early in the morning or in the evening, which further increases the risk of stress and burnout.

Regarding virtual care:

The editorial also warns of the risks of remote medicine and suggests that, all else being equal, family doctors will flock to telehealth companies that offer remote and on-time care.

Like its national counterpart, the College of Family Physicians of Canada, the BC College of Family Physicians believes that virtual care has a role to play as one of many tools in relationship-based longitudinal care offered by physicians in family.

This, however, is completely different from the “episodic care” model offered by large corporations getting into primary health care.

Numerous studies have shown that an ongoing relationship with a family physician leads to better overall health outcomes, greater patient satisfaction, and reduced costs to the health care system.

The doctor-patient relationship is the basis of good health. Maintaining options for in-person care and supporting the provision of comprehensive longitudinal care are essential to preserving family medicine.

As family physicians, we want to build relationships with our patients and support them throughout their life stages. However, the conditions in which we currently work prevent all British Columbians from having access to an ongoing relationship with a family doctor.

The BCCFP calls on the government to build on what works – an ongoing, long-term relationship with a family doctor as a positive indicator of improved health outcomes – and find ways to further support and improve this. relationship.

The health of British Columbians depends on it.

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