B.C. residents having difficulty finding a family doctor stand to benefit from a new program for primary care announced Friday in Vancouver.
The $132.4 million GP and Me program will match patients with doctors and offer financial incentives for general practitioners provincewide to take on more patients, especially those with complex medical conditions, such as cancer and heart disease. The goal of the program, which starts April 1, is to ensure every B.C. resident will have a family doctor by 2015.
GP and Me will encourage doctors to consult with patients over the phone and will pay them for offering that service, making it easier for patients who have difficulty travelling to a doctor's office to access medical advice.
The program will also provide financial support to local physician groups like the Blue Pine Primary Health Care Clinic in downtown Prince George, to work in collaboration with health authorities to create better access to primary care.
The program is based on the findings of three pilot projects launched in 2010 in Prince George, White Rock-South Surrey, and Cowichan Valley. Those three projects have already matched 9,000 unattached patients with family doctors, including more than 3,800 in Prince George.
The province will provide $40 million over the next three years to Divisions of Family Practice for developing and providing primary care services geared to vulnerable patients. An additional $22 million will pay for doctor-patients telephone consultations. Family doctors will receive $15 for each phone call from the Medical Services Plan and are allowed to bill the health care system for up to 500 calls per year.
A total of $20 million has been allotted for doctors who take on frail or vulnerable patients who have been in cancer care, residential care, have severe disabilities, substance dependencies, mental health conditions or who are pregnant. Doctors who agree to become the primary care provider of those patients will receive $200 for each new patient.
A further $18.5 million will support doctors who develop long-term care plans for patients with complex conditions and those identified as high-needs patients. For each patient, doctors will receive $315 per calendar year. The fund will also enable doctors to co-ordinate patient care with other doctors and health care providers and will pay $40 for each 15-minute patient conference to a maximum of three hours per patient per year.
The province will also create a separate program to help connect hospitalized patients with the care of family physicians. Targeted funding of $31.9 million will support family doctors to provide care to patients in hospitals, including patients admitted without a family doctor or whose doctor does not have hospital privileges or those patients who are from out of town. There are also increased incentives for doctors to provide care at hospice terminal-care facilities.
For many of its patients, the Blue Pine clinic is a one-stop health facility, offering the equivalent of 1 1/2 full time family doctors, two nurse practitioners, nursing staff, mental health workers and other allied health professionals. Garry Knoll, a family doctor at Blue Pine, is part of the Prince George Division of Family Practice, which began in March 2009 as a means to train family practice resident doctors from the Northern Medical Program at UNBC and provide doctors for the hospital after-hours clinic. The clinic at 102-1302 Seventh Ave., started out as an unattached patient clinic at UHNBC. While Blue Pine is geared to patients most in need of medical help, it also includes the mainstream population.
"It's really a team-based approach and the clinic has the capacity to see people who don't generally do well in traditional family practices, people who may be living on the street or close to the street and they might have major health issues that have been barriers to accessing the system," said Knoll.
"We've been focusing on trying to accommodate those people who are in most feed of medical care first and there's a staged plan of increasing that capacity over the next year [largely dependent on whether the clinic can recruit more doctors]."
The clinic, owned and operated jointly by Northern Health and the Division of Family Practice opened in July. Doctors are paid on a sessional basis, rather than the conventional fee-for-service model. Knoll said it takes a different skill set to work as part of a team and doctors have to be prepared when some clients show their preference to work with other members of the medical team.
"The clients who initially settled in that clinic were the ones in very difficult situations and they were basically getting all their health care needs met at the emergency department, which just doesn't work," said Knoll. "Sometimes, just travelling downtown to the after-hours clinic [at UHNBC] was a huge barrier to them."