Doctors Nova Scotia is appealing a court decision that would allow the province to negotiate deals directly with physicians across the province.
The organization says that legislation states the Doctors Nova Scotia is the sole bargaining agent for compensation, but the province has been making deals directly with physicians without the consent of Doctors Nova Scotia.
“We want to make sure there’s equity between all physicians,” said lawyer Ron Pink, who represents Doctors Nova Scotia.
READ MORE: Doctors Nova Scotia takes province to court over contract issues
During the hearing at the Court of Appeal on Monday, Pink argued that compensation goes beyond pay.
“Compensation includes all the issues, all the matters that go into making a contract, and it’s the benefits provided in return for the services provided,” he told the judge.
All doctors in the province are required to be members of Doctors Nova Scotia and are paid by a fee-for-service model of through the Alternative Payment Plan (APP) model.
Fee for service is based on paying doctors for the work they do. The model is based on medical service units (MSUs). Each task a doctor performs is assigned a set number of MSUs as determined by the province and Doctors Nova Scotia. An MSU is then assigned one set tariff, and doctor’s pay is based on the number of MSU’s multipled by the set tariff.
But the model is often not well received in rural areas where the workload is different, so many rural physicians opt for the APP model where the province provides a sum of money and then doctors must chose a certain amount of services to offer including office hours, ER shifts, or nursing home visits.
Doctors Nova Scotia argues that the problems are with the APP model where the province is negotiating benefits differently with each individual doctor.
Previously, Doctors Nova Scotia worked with the province to negotiate a list of services that doctors could chose from as part of the APP model, but Doctors Nova Scotia alleges the province has expanded that list and is offering other benefits without their consent.
Lawyer Agnes MacNeil represented the province, and while she agreed that all negotiations in regards to compensation must be made through Doctors Nova Scotia, she disputed arguments that the province ever breached that.
She argued that Doctors Nova Scotia is not a union and that physicians still maintain some autonomy in deciding their contracts and how they work.
“One of the purposes of the health services insurance act is to preserve as much Independence as possible” said MacNeil, ” given that the compensation is determined by others.”
The judges have reserved their decision in the case.