Whereas rural and remote communities face significant challenges in recruiting and retaining primary care physicians, leading to chronic understaffing and healthcare access issues; And whereas the expansion of the Practice Ready Assessment British Columbia PRA-BC programs eligible communities and the implementation of the Longitudinal Family Physician LFP Payment Model has contributed to increased physician shortages, excessive workloads, and frequent emergency room diversions in rural areas: Therefore be it resolved that UBCM lobby the provincial government to reassess the recent changes to the Practice Ready Assessment British Columbia program and Longitudinal Family Physician Payment Model, ensuring that these initiatives prioritize the recruitment and retention of physicians in rural and remote communities to address ongoing healthcare disparities.
Ministry of Health Thank you for your resolution requesting the Province of BC reassess the recent changes to the Practice Ready Assessment-BC PRA-BC program and the Longitudinal Family Physician payment model to ensure these initiatives prioritize recruitment and retention of physicians in rural and remote communities. Physician Return of Service ROS programs, such as PRA-BC as well as the International Medical Graduate-BC Program, are an important part of the Provinces recruitment strategies to ensure the distribution of physician services and enable patient access in designated communities of need. The PRA-BC program provides a pathway to licensure for internationally trained family physicians FPs in exchange for a 3-year return of service ROS practice commitment in a community of designated need identified by a BC health authority. As you are aware, through BCs Health Human Resources Strategy, the PRA-BC program was tripled in size in 2024 from 32 to 96 funded seats annually, that included a ROS commitment in a rural, semi-urban or urban community. While this expansion requires the significant contributions of the physicians within Northern Health to support the Program, the outcome to this investment will greatly benefit the communities across the region, including Dawson Creek. The PRA-BC program, through its funded agencies the Ministry of Health and the Joint Standing Committee on Rural Issues, a collaborative committee between the Ministry and Doctors of BC, attributes its success to the Programs strong partnership among BCs Health Authorities, UBC Continuing Professional Development Program, Doctors of BC, Ministry of Health, College of Physicians and Surgeons of BC, and Health Match BC. Through this partnership since 2015, the PRA-BC has successfully assessed 363 FPs for ROS placement into 78 communities across BC to December 2025. Of these 363 placements, 76 percent were in designated rural communities. During a physicians ROS commitment, they contribute greatly to their communities by attaching a patient panel and providing priority primary care services as determined by their Health Authority such as emergency department shifts, in-hospital care, and long-term care coverage. Retention beyond the ROS term is influenced by many personal, professional and community factors. Should longer term retention not be achieved, the value of the ROS term should not be discounted. There is a choice of compensation models available to physicians in BC, including the Longitudinal Family Physician LFP Payment Model. For many new physicians or new to BC physicians, the New to Practice compensation contract model is often the option selected. The LFP Payment Model was developed by the BC Ministry of Health in consultation with BC Family Doctors and Doctors of BC. In support of longitudinal physicians working and being retained in rural communities, the LFP Payment Model: - Allows rural physicians to receive Rural Retention Program fee premiums on LFP Payment Model payments. - Provides exceptions to key eligibility criteria for the Model for physicians in rural communities receiving Northern Isolation Allowance premiums, including that the 30 limit on Clinic Non-Panel Services and any daily maximums for interactions do not apply. - Was expanded in June 2024 to allow physicians providing LFP clinic care to also enroll and bill under the Model for long-term care and palliative, inpatient, and pregnancy and newborn care in facility settings. - Allows physicians to bill as a locum under the LFP Payment Model in any setting under the Model on behalf of a broad range of longitudinal host physicians. The Ministry continues to work closely with BC Family Doctors and Doctors of BC to review and improve the model, including contemplation of the complex needs and challenges facing rural physicians and communities.