The government of Nova Scotia is introducing a pilot program to test a new way of paying family doctors, but opposition politicians are worried that it is not coming fast enough.
The government will use the mixed per capita accrual model at least until March 2023 to pay 19 doctors working in three primary care clinics in Cheticamp, New Minas and Upper Tantallon. Three other clinics, which include an additional 30 doctors, could be added to the pilot project.
“We hope that this new model will encourage a more team-based approach and make it easier for patients to receive the care they need, when and where they need it,” Health Minister Michelle Thompson told reporters at a press conference in Halifax on Thursday. .
Mixed capital is a model in which doctors are paid through a formula that takes into account how many patients are on their list, the number of services they provide, and may include a bonus if it can be shown that access to care is improving.
WATCH Amy Smith’s interview with Dr. Leisha Hawker, president of Doctors Nova Scotia:
President of Doctors Nova Scotia on the new payment program for family doctors
Dr Leisha Hawker says most new family doctors want to work together.
Currently, doctors in Nova Scotia are paid either by contract or by a service fee. But Dr Leisha Hawker, president of Doctors Nova Scotia, said most new family doctors are looking for models that promote collaborative medicine.
“They really want to do team health care,” she told reporters.
Hawker and Thompson said the mixed captain should lead to more meetings for the same and the next day for patients and services on evenings and weekends, because if one doctor is not available, another doctor or a related specialist at the clinic may intervene.
Hawker said the payment model also refers to the fact that many patients are sicker and need more time with a doctor than the current billing codes cover.
“The way patients are provided has changed and volume is no longer a good measure of good care,” she said.
The pilot was agreed as part of a major agreement signed by Nova Scotia doctors with the province in 2019, but Thompson said implementation was delayed due to the COVID-19 pandemic. $ 7.3 million has been set aside for its funding, and the minister said a third-party assessment would determine what works and what needs to be improved.
“We have to make a huge change,” said the NDP health critic
Opposition MPs welcomed anything that could improve patients’ access to services, but said it did not go far enough.
Although mixed capitation is only being attempted here now, it has been in effect in other provinces, such as New Brunswick, for years.
NDP health critic Susan LeBlanc said she was pleased that the program encouraged more joint care, but said there was no reason for so few clinics to be included as part of the initial deployment.
“We already know it works elsewhere, so let’s just implement it,” she told reporters.
“We don’t have time to sit and try things in small pieces. We have to make a huge change.”
Liberal MLA Kelly Regan said the Tories had promised during the election that they had a plan to adjust health care, and Thursday’s announcement was not enough to deliver on that promise. She said various health indicators have deteriorated since the Tories came to power last summer.
Waiting list of doctors up to 95,000
Prime Minister Tim Houston said during the election campaign that his plan to improve healthcare would take time and money, and things are likely to get worse before they improve.
Although the intention is to expand the use of a mixed captain after the pilot program, Thompson said doctors who prefer the service charge model will still be able to use it.
There are currently about 95,000 people registered in the provincial list to receive primary care.
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