In an effort to improve patient access to family physicians, the province and the Saskatchewan Medical Association have come to an agreement in principle. Additional funding will be available to after-hours urgent care clinics that provide regular extended hours access to all patients with an enhanced suite of services such as lab, casting and suturing. As well, all community-based, full-service, fee-for-service family physicians will be eligible for a top-up to their after-hours funding. The goal is to support clinics and doctors to extend their hours if they are able.
Health Minister Paul Merriman says the changes are expected to help reduce the number of people going to emergency departments for less severe needs, and therefore decreasing wait times. However, he understands this is just a stop gap measure until a full reform to primary health care takes place. SMA president, Dr. John Gjevre, says they are also working with the Health Ministry on other changes, including physician-led care teams, which will help address pressures on family physicians.
A Saskatoon family doctor, Adam Ogieglo says it’s a positive step, but more work needs to be done, because fee-for-service doesn’t work for everyone. For example, “A patient comes into our urgent care clinic and they are having chest pain or they are having stroke symptoms. I’ll spend an hour with that patient, and I’ll earn $44 if it’s after hours. If it’s during business hours I’ll get $40, so currently the bonus is $4 to work after 7 p.m.” He would like to see a system similar to what British Columbia has introduced which is part fee-for-service and part compensation for extra work done, like all the administrative work that comes along with being a family physician.
Family physician, Dr. Carla Holinaty, who is also an SMA board member, explains that one of the reasons doctors don’t want the fee-for-service model is it doesn’t take into consideration all of the paperwork that also has to be done. “Like the 20-page insurance forms that we get more and more of, so you know, this time of year, especially as people are doing things like claiming their disability tax credits. If we have 2,000 patients you can imagine how many of those forms pile up on their desks, and that’s free work for family doctors right now, and that’s part of what is really burning them out, is that unpaid labour.” She considers this agreement in principle a good first step to transforming primary health care, to bring more access to those who need to see a family doctor and to entice doctors to practice family medicine.
