B.C. government offering incentives to push new doctors into general practice

The province is opening the purse strings to lure new doctors into family practice in an attempt to make a dent in the shortage.

A new contract comes with a $25,000 signing bonus, significant loan forgiveness and a substantial starting pay cheque.

The starting salary will be nearly $300,000 — which is the current second-year rate. And over five years, the new practice program will offer up to $150,000 in loan forgiven.

B.C.’s Health Minister Adrian Dix says this is a temporary or interim step people want to see to know the province is taking action.

“This is a temporary step in a sense, because we want a broader deal that makes it better for everybody,” he said. “In the interim, as we work together on those things. I think people want us to take action and this is this in action. It’s not a step to solve every problem. But it’s a step to help encourage young doctors to become part of full family practice medicine.”

However, Dr. Jennifer Lush, a family physician in Victoria, says doctors with the same education starting in a hospital or in urgent care can make twice as much.

“At least $85,000 is going to come off that for overhead. It does not include any sick time or benefits that people often expect. Many employees as a condition of their employment, they have benefits packages and they have pensions — we have none of that.”

Dix argues it is a start.

“That’s why we’re doing it. We want more people, young doctors to join full-service family practice to become family doctors. So this is one effort to do this. It’s not a resolution of all the problems but it shows our determination to address these issues and to act quickly where necessary,” he said.

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Doctors like Lush are expressing concern about this approach since it may end up with new doctors in positions that are a poor fit, so they won’t stay and would like to see a locum model with shorter stints in a variety of situations.

“The signing bonus is a concerning feature in that it’s only there until September. So it’s going to pressure people perhaps into signing when they are just immediately out of school,” Dr. Jennifer Lush, a family physician in Victoria, told CityNews.

“The trouble with having them sign a contract in a hurried fashion like this, is that there’s nothing that’s going to keep them in community Family Medicine, when their term of their contract is up until we fix the problems with family medicine.”

Lush criticizes the contract, adding it does not address the drivers, causing family doctors to leave the practice.

For example: “burgeoning overhead, very heavy workloads with increasingly complex patients, inequitable compensation, and things like not having locum coverage to take time off, when somebody wants to start a family or to take holiday time.”

However Dix admits, that this is not a long-term solution.

“I think there’s a lot of uncertainty about family practice right now. So we wanted to say — with a very significant offer particularly about the repayment of debt, which is a significant issue for new doctors, and to address some of their immediate costs — this is our commitment. We are determined to take action here, that’s going to involve a bigger deal, and a bigger effort and a bigger work with the Doctors of B.C., which won’t be ready as people emerge, and new doctors come forward.”

Doctors like Lush are finding it harder and harder to justify staying in family practice, she says. So they are looking to the government to act quickly, but in a way that works for them. For some, she says, it is this kind of contract, but for many it’s an updated fee-for-service model, she’s worried as being left on the table.

“Stop dictating to physicians what the solution should look like, and start really listening to what’s going to be workable and what’s going to get them the greatest number of British Columbians taken care of by a family physician, because that’s what everyone deserves,” she said.

A few hundred grads from this year and last are eligible, but only a portion who are interested in family practice won’t stay after the contract ends.