College of Family Physicians thinks fee-for-service switch will hurt recruiting

The group that represents family doctors on P.E.I. worries not giving new doctors hired in Charlottetown and Summerside, P.E.I., a choice in how they are paid will ultimately hurt recruitment.

"We at the College feel that a one-size fits all approach is not an ideal way to recruit or retain physicians, and that there
needs to be options for physicians and how they're able to provide patient care," said Dr. Shannon Curtis, president of the Prince Edward Island College of Family Physicians.

The collegerepresents most of thefamily doctors on the Island, including the thirdHealth PEI says are already paid through afee-for-service model.

Health PEI told CBC News on Friday that all new family doctors hired in Charlottetown and Summerside, P.E.I. will now be paid fee-for-service taking a salary is no longer an option.

Health officials say recruitment in the major centres is not as difficult as it once was, and sothe focus is now on gettingmore people access to a family doctor.

No consultationwith group on changes

Curtis said CBC's reportwas the first she'dheardabout the change.

While sheagrees Health PEI's Family Medicine Program has made recruitment moresuccessful in the last few years, she believes allowing graduates to take a salary rather than fee-for-service is a major reason for that success.

"Most of those residents have chosen salary as the way that they wantto practice when they are first starting out. And so that may lead to less retention of those traineephysicians," said Curtis.

"Physicians like anyone else like choice in how they work and they want to feel comfortable in the workplace, and if they'vebeen trained in a salary-type setting for them to suddenly change to a fee-for-service setting they might not find that attractive."

Health PEI hopesthe switch to fee-for-service in the two major centreswill help eventually clearthe patient registry. Currently, Health PEI estimates about 8,000 Islanders are on that list waiting for a family doctor.

Higher earning potential under fee-for-service

"If we look at a fee-for-service models versus salary models, certainly physicians that carry a fee-for-service load tend to have alarger amount of patients," explained Curtis.

Under fee-for-service a doctor is paid based on the number ofpatients theysee versus salary which is an hourly wage.

Curtis said fee-for-service doeshaveadvantages, including a higher earning potential for doctors, but she said new graduates need time to get up to speed, something she believes is easier in a salaried position.

"As you advance alongand get to know your patients you can increase your speed at an appropriate time for you, which willimprove the patient care," said Curtis.

Dr. Nadeem Dada, executive director of medical affairs forHealth PEI, told CBC Newsthat the new policy will be reassessed if recruitment drops.