A new payment model and pay bump for hospitalists in Nova Scotia has family doctors crying foul.
Hospitalists are similar to family doctors but take care of patients in hospitals rather than in the community.
The new payment model was announced by Doctors Nova Scotia in a memo to doctors on Monday. The memo, obtained by Global News, says hospitalists will be paid $1,300 per day.
And it acknowledges that the changes “result in a more pronounced funding disparity between hospitalists and community-based family physicians.”
On Tuesday, the doctors’ group said after accounting for the overhead that many family doctors pay for their practice’s the difference in pay will be in the tens of thousands.
On average, a hospitalist will now make $239,000 compared to $175,000 for family physicians, according to Doctors Nova Scotia. The changes are retroactive to Sept. 1, 2017.
The news was slammed by family doctors in Halifax.
Citing the gaps in access to primary care and the challenges the province faces recruiting more physicians, two doctors said the changes were a step in the wrong direction.
“It’s completely asinine,” Dr. Howard Conter said.
The physician of more than 32 years said it is yet another disincentive to new graduates who are deciding what type of medicine to specialize in.
The health authority currently has postings for 71 full-time family doctor positions across the province. And the latest numbers from Statistics Canada peg the number of Nova Scotians (above the age of 12) without at regular health-care provider at more 91,800.
“This absolutely flies in the face of any new graduate coming out and wanting to be a family doctor,” he said.
He placed the blame squarely on the health department and Doctors Nova Scotia.
The association’s president-elect, Dr. Tim Holland, defended the move saying the changes for hospitalists were crucial.
“It’s a necessary band-aid solution to deal with a crisis in the health-care system,” Holland, a family doctor said. “But the true crisis causing all these other crises is a lack of appropriate primary care in the province.”
He said the association is working on fixing that as part of the next round of contract talks.
Health Minister Randy Delorey wasn’t made available for an interview.
In a statement sent late on Tuesday, health department spokesperson Tracy Barron said the department was unaware the changes would create a discrepancy in pay between the two groups of physicians.
“This is the first time we are hearing these concerns about this arrangement that (Doctors Nova Scotia) executive endorsed,” she said in an emailed statement.
But Holland rejects that.
“The issue of the discrepancy was raised and discussed at all levels of development,” he said. “We went into this with eyes wide open.”
Still, another family doctor says the move “devastated” her.
Dr. Ajantha Jayabarathan said she can barely bill $700 per day even if she works longer hours than those set out for hospitalists, and from that she still has to deduct overhead costs.
“Many colleagues have reached out to me and stated they feel like they have been punched in the gut, knifed in the back and sold down the river,” she said in an email.
The government says the new formula “standardizes hospitalist work across the province ensuring better care for in patients.”