N.L. arranges financial relief for doctors signing up to fight COVID-19
Doctors who agree to do COVID-19 work will get up to 100% of what they normally bill MCP
A new Newfoundland and Labrador policy will provide financial relief for doctors losing income because they can't see their usual patients during the COVID-19 pandemic.
To reduce the spread of the virus, hospitals have stopped providing elective services, physicians with offices in the community are seeing fewer patients, and some patients are postponing doctor visits.
"All of those together are having a direct impact on physicians who bill the Medical Care Plan on a service-by-service basis," said Newfoundland and Labrador Medical Association executive director Robert Thompson.
More than 60 per cent of the province's 1,300 practising doctors are fee-for-service doctors who bill MCP for each service they provide to a patient. The rest are salaried physicians whose pay is not affected by the pandemic.
Doctors want to step up but they need to know that there still is a revenue flow.- Robert Thompson
To ensure fee-for-service doctors continue to have a stable income and pay their overhead costs, such as the salaries of their office employees and rent for their offices, the NLMA has negotiated a work-disruption policy with the provincial government.
Thompson says it makes sense for two reasons. First, the health-care system depends on the infrastructure doctors have built in the community.
"When the volume of work for physicians was reduced it became clear that a lot of doctors have put in place a substantial amount of the infrastructure of the health-care system in their community offices — that's clinics, technology, additional staff, that are paid for with fee-for-service revenue," said Thompson.
"So all that is outside the regional health authority but still needs to be maintained and paid for during the pandemic period."
Second, the health-care system needs physicians to do different work during a pandemic than they normally would, said Thompson.
"Doctors want to step up to that but they need to know that there still is a revenue flow to replace the revenue from the things they used to bill for," said Thompson.
Stage set by 2009 H1N1 influenza preparations
Thompson says the new policy is based on a similar one developed in response to the H1N1 influenza outbreak in 2009.
Under the new policy, fee-for-service physicians are paid 80 per cent of what they would normally have billed MCP if they agree to be available to help regional health authorities, such as Eastern Health, fight COVID-19.
"They need to commit to make themselves available for the work a regional health authority may have for them in response to a pandemic," said Thompson.
That might mean working in one of the various COVID-19 units that are being established in hospitals around the province, an assessment centre where suspected COVID-19 patients are tested, or helping to provide other services that continue to be offered despite the pandemic, such as chemotherapy for cancer patients.
Physicians who sign up will receive 100 per cent of what they normally bill MCP once they are called on to provide COVID-19-related services.
The policy also applies to doctors who contract the virus during the pandemic.
"If a physician becomes ill with COVID-19 … or requires mandatory self-isolation based on guidance from the chief medical officer of health during the pandemic emergency, and has been providing services as agreed, or in the course of performing their normal duties, he/she will be entitled to 80 per cent compensation under the policy," says the NLMA's website.
Doctors waiting to apply
As of Tuesday, the provincial government was still designing the application form and agreement for the policy, but Thompson says many physicians have already stepped up to help with the COVID-19 response.
"We expect those forms will be available within a day or two and that physicians will rapidly sign up," he said.
"But that hasn't delayed anything because the request for physicians to take a role in the pandemic response is occurring all the time anyway, and lots of physicians are already taking on roles in these units and assessment centres. The payment policy will catch up with that once it's put in place."
Thompson said physicians who are still seeing many patients or those who are more vulnerable to COVID-19 because they have compromised immune systems themselves may choose not to sign up.