The crisis in family medicine cannot be resolved with piecemeal solutions like those we’ve seen so far. Urgent care clinics? Perhaps, but where are the physicians to staff them? Training more doctors and nurses? Yes, but this takes years and we have a problem right now. Attracting more foreign trained physicians? Again yes, but a large percentage of these physicians either fail entry exams, or require significant retraining.
Viewed against the huge structural problems confronting family medicine, we need a more fundamental rethink.
The main obstacle to family practice reform is an outdated fee system.
On the current model, known as fee for service (FFS), physicians bill the Medical Services Plan for each patient they treat. FFS was intended to reward efficiency; the more patients you saw, the more you could bill.
This might have been fine when the population was young and treatments were simpler.
But times have changed. Patients are older with more chronic diseases that need team-based care, and treatments are more complex.
Read more at: The Times Colonist
