Province adds $18.6M for some family physicians to expand their practice
New billing options introduced for family doctors to work with nurses, maintain patient registry
The province is spending $18.6 million on billing changesto encourage solo-practicephysicians to work with nurses and take on more patients.
The money will result in an update to the wayphysicians working under the fee-for-service model in privatepractice are compensated, Health Minister Bruce Fitch saidat a news conference Thursday.
Fitch said more thanhalfof the province's family doctors now operate their own practices.
"[That] number that is much higher than in other provinces, when we do the inter-jurisdictional scan," Fitch said.
"We're working with various stakeholders, like the regional health authorities and the medical society, to encourage a shift to the collaborative-care clinics."
To that end, Fitch saidphysicians will see"expanded codes" to bill for nursing servicesstarting on Sept. 16.
The province will also introduce a patient and provider registry that physicians will be compensated for maintaining, with payments to begin this fiscal year.
Fitch saidthe pay scale attached to the registry will give doctors an incentive to add more patients to their rosters.
Dr. Paula Keating, president of the New Brunswick Medical Society, said the funding will help bridge the gap untilnegotiationswith the province begin on a new physician-services master agreement, expectedin 2025.
"Many physicians are small-business owners," she said."With extraordinary inflation affecting rent, staff, salaries, equipment, supplies, not to mention mounting administrative burdens, the pressures on family physicians have become unsustainable."
While Keating said the funding is a step in the right direction, she added that it will not be enough to establish the required number of collaborative-care clinics.
The medical societyand the New Brunswick NursesUnionsaidin a budget submission this year that a $70-million commitment would be necessary to establish 50 of those clinics, much more than what the province announced on Thursday.
If the Progressive Conservatives are re-elected, the 2025-26 fiscal year would see a $20-million spend, Fitch said, with potential increases in years after based on uptake.
Paula Doucet, president of the New Brunswick NursesUnion, is not convinced the updated compensation model will help fill the province's primary care gaps.
"This government's choice to incentivize physicians to expand their private practices is not the solution ... It will weaken the public health-care system by drawing more health-care resources out of the public system," she said in anemail.
It also promotes "structural inequity" among health care professionals, Doucet said, and won't be effective"considering the magnitude of New Brunswick's nurse shortage."
Doucetsaid the government should focus on "multidisciplinary, nurse-practitioner led, primary care clinics," managed by theregional health authorities.
The provincial government defines a collaborative-care clinic as a practice with family physicians and "allied health-care professionals," spokesperson Bruce Macfarlane said in anemail.
"There are a total of54collaborative health-care clinics across New Brunswick," he said.
That total includes community health centresoperated by theregional health authorities,nurse-practitioner clinics,family-medicine practices, N.B. Health Link clinics,Vitalit family-health teams,Macfarlane said.