Doctors in the province and the provincial government are rowing in the same direction when it comes to the future of primary health care, Health Minister Dr. John Haggie says.
Haggie was the focus of questions Thursday in the House of Assembly, given both an ongoing series of health care stories from the CBC, and the release earlier this week of a new 10-year vision for family medicine from the Newfoundland and Labrador Medical Association (NLMA), the College of Family Physicians and the family medicine discipline at Memorial University.
“Essentially, those items in (the report), they line up perfectly with not only what we plan to do, but what we actually started to do,” Haggie said.
He noted the province has the highest number of doctors it has ever had, and has the second-highest number of doctors per capita of any jurisdiction in Canada, but there’s room for many improvements in the health system.
He met Wednesday evening with the creators of the 10-year vision for family medicine.
N.L. doctors release 10-year plan for family medicine
As part of their vision, the province’s family doctors are seeking a new payment model to allow them to spend more time with patients who have complex conditions and to offer more collaborative response to patient health needs.
Family doctors are currently paid per patient visit, which goes against spending more time with patients who have complicated needs.
The new model proposed by the three organizations suggests pay for family doctors would be a blend — a base salary and some fee for service. That would allow doctors to slow down their patient interactions, the organizations say.
While collaborative primary health teams exist in the province — one area being Bonavista — the plan for integrating physicians in those teams hasn’t been spelled out or negotiated, the three organizations said Tuesday.
Haggie said the government wants to see more teams in place, and there’s room to discuss the approach to payments.
“I think we’re quite open to explore other avenues rather than kind of traditional fee-for-service versus salaried approach,” he said, adding it is a part of ongoing, formal negotiations around physician compensation packages.
The doctors said they also want a better relationship with the provincial government.
The document outlining the doctors’ vision says family doctors feel undervalued by the government, and income and benefits have been cut “without warning or justification.”
Haggie said he hadn’t been aware of an issue in the relationship. While there hadn’t always been agreement on decisions, he said, he ultimately found there were cordial interactions. At this point, he said, he doesn’t see major obstacles.
The vision for the province included a demand for a human resources strategy for health care, as currently it’s not known how many family doctors the province needs.
There are at least 50,000 people in the province without a family doctor. Asked about that during question period, the minister said he hopes retention will be helped through ongoing changes in the system, including the addition of more primary health care teams.
The NLMA also wants to see a formal review and report from the government about the province’s future health care labour needs.