Whereas healthcare staffing shortages in rural communities across British Columbia have led to primary care providers assuming broader scopes of responsibilities, often performing multiple roles to ensure comprehensive patient care; And whereas existing monetary incentives for primary care providers in British Columbia do not adequately reflect the expanded scope of responsibilities required in rural settings, contributing to recruitment and retention challenges: Therefore be it resolved that UBCM advocate for the provincial government to implement a pay structure and incentive model that directly aligns with the scope of responsibilities undertaken by primary care providers in rural areas.
Ministry of Health Physician Compensation response: The Ministry of Health is responsible for ensuring access to the health care in rural and remote areas of the province. Stabilizing and enhancing healthcare in rural communities is a key priority under BCs Health Human Resources HHR Strategy which articulates actions that focus on the retention, redesign, recruitment and training initiatives for primary care providers. Physician compensation is determined through the Physician Master Agreement PMA, a negotiated agreement between the Ministry of Health and the Doctors of BC. Regional Health Authorities are responsible for the planning and delivery of health care services, implementing physician services in accordance with the compensation rates agreed to in the PMA. The Ministry has been working with Health Authorities to ensure alignment with PMA physician compensation rate structures that reflect the unique, full scope nature of primary care in rural communities. Physicians may be compensated through Fee-For-Service FFS, the Longitudinal Family Physician LFP Payment Model, or through clinical service contracts. The Ministry recognizes the unique role that PMA-compliant General Practice Full Scope service contracts play in rural locations in ensuring family physician presence in all required care settings. It is recognized that concerns regarding service contract rates are most appropriately and sustainably addressed through the 2025 Physician Master Agreement PMA. The Rural Stabilization Stipend was introduced as an interim bridge measure to support family physicians in remoterural communities who perceived a rate inequity between their contract payments and the LFP Payment Model. The Rural Stabilization Stipend is a temporary measure and will conclude March 31, 2026. Rural Programs response: The Ministry of Health and the Joint Standing Committee on Rural Issues JSC leverage funding negotiated through the Physician Master Agreement to support and enhance the delivery of physician services in rural and remote areas of BC. Current incentive programs, which are formally called the Rural Practice Programs, broadly focus on recruitment, retention, travel time and expenses, locum coverage and continuing medical education. Physician payments are intended to augment the base level of clinical compensation and are defined by community rurality and remoteness, in recognition of the unique circumstances of providing services in rural and remote communities. Physicians in Port Alberni may be eligible for the following supports, over and above their base clinical compensation: - Rural Retention Fee Premium of 7.98 on all clinical payments - Rural Retention Flat Fee annual retention payment of 12,366.72 - Rural Continuing Medical Education annual stipend of up to 6,000 - Recruitment Incentive Fund of up to 10,000 for the FTE commitment one-time - Recruitment Contingency Fund of up to 15,000 for relocation costs one-time, depending on origin - Rural Emergency Enhancement Fund annual stipend of up to 200,000 per physician group up to 65,000 per individual physician None of the Rural Practice Programs set out in the PMA are exclusively targeted to full scope rural physicians. With that said, the following limitations apply: - Eligibility for the Rural Retention Flat Fee is limited to physicians who both reside and practice rurally. In primary care, these are more likely to be full scope family physicians. - The Recruitment Incentive Fund and Recruitment Contingency Fund are limited to FTEs which are part of regional health authority physician supply planning. In the context of primary care services, these are more likely to be full scope family physician roles. - The Rural Emergency Enhancement Fund is limited to physicians providing Emergency Department ED support. In communities eligible for the program, participation in ED call is undertaken primarily by full scope family physicians.