Nova Scotia’s health minister said Thursday a new pilot project that will permit some family doctors to be paid for the number of patients on their roster, not just for services provided, will help reduce the province’s nearly 95,000-person primary care wait list.
The funding model, which will be implemented immediately in three family doctor clinics, is a “lever in a suite of things we need to do” to see more patients matched with primary care, Michelle Thompson told a news conference.
“This has been a long time coming,” Thompson said.
Currently, family physicians in Nova Scotia are paid only for the services they provide, and most doctors in the province limit patient visits to one issue per appointment.
Called “blended capitation,” the new funding model is expected to incentivize doctors to take on more patients and will allow physicians working in the same clinic to care for each other’s patients. New Brunswick uses a similar model.
“We hope this new model will encourage a more team-based approach and make it easier for patients to get the care they need when and where they need it,” Thompson added.
The list of Nova Scotians on the wait list for a family doctor or nurse practitioner continues to rise, and is up another three per cent as of June 1. The record-high 94,855 people on the wait list represents 9.5 per cent of residents in the province.
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Doctors Nova Scotia, the professional association that represents physicians in the province, has been pushing for a blended capitation model for years. The province agreed to put $7.3 million toward a blended capitation pilot in the province’s 2019 funding agreement with physicians, but it was not implemented.
Thompson said the government will wait to see results of the pilot before expanding it. The pilot will run until March 2023 and will start with 19 doctors at three clinics. It is expected to expand in the coming weeks to include about 30 more doctors working at three additional clinics.
Nova Scotia NDP and Liberal opposition members say the pilot doesn’t do enough to respond to the growing need for primary care. NDP health critic Susan Leblanc says it doesn’t make sense that this model is being piloted instead of being made available to all family doctors.
“It’s a strange choice,” Leblanc told reporters following the announcement.
“We already know it works in other places, so let’s just implement it,” she said. “We don’t have time to sit around and try things in little bits and pieces.”
Liberal member Kelly Regan said, “by every measure, this is not enough.”
Dr. Leisha Hawker, president of Doctors Nova Scotia, said the province’s “aging, sicker population” means that patient care is much more complex than it used to be. “And billing codes haven’t evolved accurately to reflect the work physicians do,” she said in a statement.
Hawker said Thursday she hopes the new model will allow physicians to spend more time with patients to address complicated health needs.
The model also encourages physicians to work with health professionals like nurses and social workers, who can provide a range of care to a clinic’s patients, Hawker said.
It’s not yet clear, however, whether the new model will lead to doctors being paid more for care they provide, Hawker said.
This report by The Canadian Press was first published June 9, 2022.
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