FAMILY MDS RECEIVE INCENTIVE
Doctors can net $16K each
REGINA — A new $9.83-million provincial program aims to reward family doctors who provide cradle-to-grave care.
Announced Tuesday, the program encourages family physicians to provide service in six areas — hospitalized care, nursing home care, complete physical assessments, collaboration with other health care providers, chronic disease management and pre- and post-natal care, including deliveries and infant care.
“This is a measure to provide some compensation to doctors who are doing the kind of practice that their patients like best and also allows less variability in service over time and therefore better quality of care for the patient and the patient’s family,” said Dr. Clare Kozroski, vice-president of the Saskatchewan Medical Association and Gull Lake’s sole family doctor.
She believes the program will allow medical practices to “survive as full-service practices” and argues it is not a cash grab for doctors.
On average, each qualifying family doctor will receive $16,000 for 2011-12. If physicians meet five of the six criteria, they will receive 4.5 per cent of their base earnings. Doctors who achieve six out of six will get a five per cent increase.
“THIS IS NOT SOMETHING (DOCTORS) ASKED THE MINISTRY FOR.”
DR. CLARE KOZROSKI
“This is not something that the physicians or the SMA asked the ministry for,” Kozroski said. “This is their initiative. They came to us and said, ‘We want to go forward with family doctors who do this old-fashioned kind of care because that’s what patients want and because there are studies that show that that works.’”
Based on physicians’ billing for 2011-12, 58 per cent of family doctors currently provide care in all six areas.
“What we’re trying to do is to encourage those physicians that limit their practice to be incented to start opening their services to a broader scope of patient,” said Shaylene Salazar, executive director of the Health Ministry’s medical services branch.
As some physicians near retirement, they may choose not to deliver babies anymore, but they’ll ensure someone in their clinic is providing that service, Salazar said.
“Fewer and fewer family doctors are delivering babies, and that’s not necessarily a good thing because we don’t have enough specialists to cover uncomplicated deliveries,” said Kozroski, who expects the new program could provide an incentive to reverse that trend.
“It’s also ensuring that physi- cians will be available to take calls for their own patients because that’s been a big bone of contention,” she said.
If more physicians manage their patients’ chronic diseases — such as diabetes or chronic obstructive pulmonary disease, Kozroski believes that would decrease the after-hours demand on hospital emergency departments.
However, setting up a long-term treatment plan for patients with chronic conditions is time-consuming and requires physicians’ offices to do a lot of administrative work.
The ministry is sending letters to all family doctors to notify them if they qualify for the financial incentive. Qualifying doctors will receive retroactive payments in August. Those who didn’t qualify will be told what areas need improvement if they wish to receive the incentive next year.
In general, rural physicians have provided more comprehensive care, Kozroski said.
“City physicians certainly haven’t been rewarded for that and part of the reason they’ve moved away to more fragmented doctoring is because of the way they’re paid,” Kozroski said. “We’re not all money-motivated, but it’s an expensive practice to carry on.”
She expects better quality and more affordable health care will result from encouraging doctors to expand their practice.
“A small group of physicians can meet the criteria to be called a fullservice practice even though not every single physician within that practice would do all of the components needed,” Kozroski said. “If I was in partnership with two other doctors and one liked looking after the elderly and one liked to deliver babies, they would do those components.”