N.S. doctors ratify new contract with focus on easing physician shortage

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Dr. Don PugsleyHALIFAX — Nova Scotia’s 2,300 doctors have ratified a new fee agreement with the province that is aimed at easing physician shortages, particularly in rural areas.

The $616-million, five-year agreement will introduce financial incentives to attract and retain specialists such as pediatricians and surgeons in rural areas.

A specialist who sets up a rural practice this year will be eligible for a bonus after three years. That doctor will then receive a total of $40,000 to be paid out over five years, and $12,000 for each year after.

Rural general practitioners will also receive bonuses depending on how often they provide services such as nursing home care, obstetrical delivery, infant care and prenatal visits.

Full details of the contract are expected to be made public in June.

Dr. Don Pugsley, president of Doctors Nova Scotia, said Wednesday the agreement supports changes in the system rather than simply offering across-the-board fee increases.

“There’s better matching of patient need and payment,” Pugsley said.

Previously, all doctors received a $28 flat fee for each patient visit, no matter if they spent five minutes or half an hour with the patient.

Under the new agreement, doctors will receive more money if they spend more time with patients who need extra care.

Dr. Jane Brooks, a general practitioner in Middleton, says physicians are seeing an increasing number of patients with chronic illnesses who require more of doctors’ time.

“We used to think that complex patients were only over 65, but there’s now many patients with chronic diseases at 45,” Brooks said, pointing to diabetes and other illnesses caused by obesity as the prime causes.

Brooks said the agreement will encourage doctors to “spend a little bit more time with patients, and address more than one problem in one visit.”

The agreement is retroactive to April 1 and represents a $108.2-million increase over the previous agreement.

About half of the province’s doctors voted on the deal, which was ratified with 71 per cent in favour.

Among doctors who are expected to benefit from the agreement are physicians who work in emergency rooms.

Urban emergency room doctors will see their pay increase from $134.81 per hour to $156.10, effective immediately.

More specific plans are still in the works to address problems with doctor shortages at rural ERs. The government has set aside $300,000 this year to keep rural ERs staffed. A new locum program is planned to ensure ERs stay open when the regular doctor isn’t available.

Pugsley said that while the province has had success in recruiting more doctors to the province, the challenge remains how to match where physicians choose to practise with where demand for service exists.

“We feel that with this kind of contract it will be a good recruitment tool, that people will like the way it is laid out and they’ll like the dollars they’ll be able to make in Nova Scotia and they’ll come and set up here,” Health Minister Chris d’Entremont said.

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