N.S. spends $39.6 million on doctors, including $150 new-patient bonus

HALIFAX – Nova Scotia’s family doctors are getting a pay boost — including a one-time, $150 bonus for every new patient they take on who was previously without a doctor.

Premier Stephen McNeil announced nearly $40 million in funding for family doctors Monday, including $13.9 million for hikes for physicians paid through fee-for-service or through a salary.

The Health Department estimates physicians could take home an extra $10,000 to $20,000 a year due to an increase in the office fee alone.

“We have a focused investment in family medicine, which is a first critical step in solving the challenges facing Nova Scotia’s primary health system,” said Dr. Tim Holland, president-elect of Doctors Nova Scotia.

Of the money announced Monday — one day ahead of Tuesday’s provincial budget — $18.2 million is part of the $240 million, end-of-year spending spree announced last week.

Under the plan, charges for visits by patients under age 65 will jump for the current rate of $31.72 to $36. The rate for seniors increases to $44.54 from $40.26.

Holland said the funding would help with doctor recruitment and retention efforts as well as encouraging better ways to practise family medicine.

“This isn’t just about putting more dollars in the pockets of family doctors. This allows family doctors to practice the way they want to … and it effectively leverages technology to increase capacity within our system.”

Holland said the changes would help address a pay gap with other physicians in the Atlantic region.

On average, the pay for Nova Scotia’s physicians is currently the lowest in the country.

According to the Canadian Institute for Health Information “the average gross clinical payment per physician (family doctors and specialists) ranged from $262,000 in Nova Scotia to $380,000 in Alberta,” in 2015-16. Doctors Nova Scotia provided provincial MSI data indicating gross family physician compensation is approximately $254,000.

“It will bring us much closer to our regional colleagues in New Brunswick and P.E.I.,” Holland said. “It won’t bring us right up to them but it’s going to really close that gap and that will allow us to push forward on a lot of the other things that will attract physicians to Nova Scotia.”

The announcement also includes $6.6 million to encourage family doctors to develop an up-to-date patient list, a $4.2 million e-health pilot project incentive, and $8.5 million to support doctors using electronic medical records.

It also includes $6.4 million to encourage doctors to accept patients from the provincial wait list, which currently stands at 44,000.

The plan will see a $150 bonus “for each patient a family doctor takes off the list, or who is referred from an emergency department, or without a family doctor due to doctor retirements or relocation,” the province said.

Dr. Heather Johnson, a family physician in a group collaborative practice with three other physicians in Bridgewater, said the money will make a difference in patient care and access.

Johnson said the use of more telephone and electronic health services will mean less of a need to see patients in person who have travel problems, who are managing chronic conditions, or who are frail and elderly.

“I will be able to allow technology to facilitate their care more easily. It will be easier for my patients and then hopefully free up some time that will allow other patients who need to see me face-to-face, easier access.”

McNeil said the patient incentive, the enrolment incentive, and part of the electronic medical records initiative ($5.2 million) are one-time incentives set out in a trust announced last week.

“This will give us a chance to assess these (incentives),” he said. “The issues around the investments we are making in terms of the fee-for-service changes or the issues in terms of some of the other direct investments, they are ongoing and part of our fiscal plan.”

As part of that ongoing commitment, McNeil said, an additional $1.5 million is earmarked for medical records in 2018-19 and $1.8 million in 2019-20.

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