New Charlottetown and Summerside family doctors now fee-for-service
'To ensure we are getting the maximum out of what we are paying, and encouraging physicians to do more'
Health PEI has changed the way it pays new family doctors in Charlottetown and Summerside. All doctors hired to work in the two major cities are now being paid on a fee-for-service basis — getting a salary is no longer an option.
Two-thirds of the Island's family doctors are currently salaried, according to Health PEI. They get paid a flat rate regardless of the number of patients they see. Under a fee-for-service model, doctors are paid based on the number of patients they see.
Health PEI's executive director of medical affairs, Dr. Nadeem Dada, believes this change will mean more Islanders will get a family doctor. He said currently about 8,000 people are on the patient registry.
"A number of our doctors do a great job and work really hard. It's trying to look at setting the foundation and the rules that make it easier for them to achieve the same objective as we are setting out to do. I believe that's the objective too, to provide better access and care."
After consulting doctors, Dada said Health PEI has set a target of 1,300 to 1,500 patients per doctor.
"To ensure we are getting the maximum out of what we are paying, and encouraging physicians to do more," said Dada.
He wouldn't say how many of the Island's 94 family doctors are not meeting that target, but said he hoped switching new family doctors to a fee-for-service model will help.
"It's more about giving ownership to the physician. It's their enterprise, in a sense right, and whenever we know we give the ownership to someone, they have an added stake in making it work," he explained.
Dada doesn't know if the move will save Health PEI money, but he said he believes it will ensure the money is better spent.
"I think over time when recruitment was difficult the salary model was more attractive. And it is, to be frank, for certain types of physicians, especially newer, younger physicians who want a different work-life balance, can be attractive," said Dada.
Better accountability needed
"As things have changed, as we move towards ensuring better accountability, moving towards providing better access that we're required to provide and looking at newer ways of thinking and the availability now through our own family medicine residency program and other changes in availability of physicians across the country, I think we're moving in that direction now."
New family doctors hired outside Charlottetown and Summerside will still have a choice in the way they're paid, Dada said, because recruitment continues to be more difficult in rural areas.
The Medical Society of PEI declined to comment because it's currently negotiating a new payment contract for doctors with Health PEI. The Prince Edward Island College of Family Physicians said it wanted to go over the details first.
Dada admits reaction has been mixed.
"There are mixed reviews on it, to be frank, and part of it I believe is due to the change. Change is always a little harder."