The B.C. government is going back to the drawing board on its plan to attract new doctors to communities amid concerning shortages, after numerous resident doctors criticized one proposed solution for not properly addressing the true financial and mental costs health-care workers face.
The plan, which was presented to resident doctors during an online information session June 15, offered new graduates and those who completed their residency in the last 12 months with an incentive-filled full-time contract.
It included starting new doctors at a second-year salary of $295,457, as well as a one-time $25,000-bonus on contracts signed before Sept. 30, and a five-year loan forgiveness program for up to $130,000.
Sabrina Trigo and Edward Fang, both residents at the University of British Columbia’s family medicine program, say they know it may sound like a good deal to someone outside of health care, but in reality it falls short.
“You don’t actually make what they’re stating. You make less than half of that,” Trigo said.
The contracts stipulate that doctors are independent contractors. This means they don’t get benefits or pension plans, aren’t eligible for practice insurance reimbursement – which can be $10,000 to $35,000, according to Trigo – and have to cover their own overhead costs, estimated at between 25 to 40 per cent of income.
Add in yearly licensing fees and take away taxes, and Trigo says family doctors are left making far less than other health-care professionals who have far fewer years of study under their belts.
On top of that, Fang says they are expected to do the work of three doctors. They get paid for their eight hours seeing patients, but aren’t compensated for all the administrative work they have to do behind the scenes. Plus, Fang says, they are expected to work evenings and weekends and be on-call at anytime in between.
“They’re taking us for fools essentially and making us do more for less,” he said.
He and Trigo agree that the contracts are preying on new family doctors who haven’t had an income for about 10 years, are in hundreds of thousands of dollars of debt, and need some money to start coming in.
The problem the province is failing to address is the work environment itself, according to Fang. Without a far greater reform, the profession will continue to be a revolving door, he says.
Dr. Devon Mitchell, the president of Resident Doctors of BC, says he’s heard mixed reactions from family medicine residents over the proposed contracts, but that the overarching issue is that residents were never consulted on them. He said their association has made it clear to the government that going forward residents – “the future of medical care,” as Mitchell calls them – must be involved.
Both he and Doctors of BC, a voluntary organization representing B.C. physicians and medical residents and students, confirmed the province is reconsidering its original proposal.
“The government is currently incorporating the feedback into an updated proposal which they will share with residents soon,” Doctors of BC said in an emailed statement, adding that they also were not consulted on the original incentive contract proposal.
“We have advised government that getting physician input on proposals to address challenges in the system is critical.”
The association is in separate discussions with the ministry of health to address the larger issues surrounding doctor retention, they confirmed, while also engaging with doctors this week.
The ministry didn’t agree to an interview with minister Adrian Dix, but provided a brief statement saying it is working to both act quickly to end B.C.’s doctor shortage and to engage with doctors for meaningful solutions.
“This is only the early stages of consultation, and the plan is continuing to consult with residents to meet their needs as this process unfolds,” it said.
According to Doctors of BC, close to one million British Columbians are currently without a family doctor.