How compensation models shape how newer family physicians choose to practice: study

A study of early career family physicians shows they prefer alternative compensation models over fee-for-service. The results suggest that a lack of alternative compensation models pushes new family physicians away from practicing longitudinal primary care. Researchers interviewed 63 family physicians in their first decade of practice, from British Columbia, Ontario and Nova Scotia. Of those interviewed, 41% practiced comprehensive family medicine, while the remainder worked full-time or part-time in a focused area of practice. Half practiced in urban or suburban settings. Many of those interviewed said they would prefer to work as part of a team of healthcare professionals, Dr. Goldis Mitra told CBC News. Dr. Mitra is a family physician and assistant professor in the department of family practice at the University of British Columbia and lead author of the paper. In some cases, the early career physicians interviewed had completed their residency in interprofessional team settings under alternative compensation models and were concerned that these models were not available to them when they entered practice. "Many of the doctors we spoke to said they wanted to go into [an] office-based practice—so, they wanted to be what we think of as the traditional family doctor—but they avoided going into this type of practice because fee-for-service, in some ways, prevented them from providing the care they felt their patients needed and deserved," Dr. Mitra told CBC News. In areas where fee-for-service was the only option, many of the physicians interviewed opted for locums or focused areas of practice over longitudinal family medicine. The physicians said that the fee-for-service system did not allow them to provide the type of patient care that aligns with their values. Read: Fee-for-service fights on The authors note that payment model reform alone can’t reinvigorate comprehensive family medicine, but it can promote team-based care and help reduce administrative burden. They acknowledge that there have been recent developments in remuneration model reforms, particularly in Nova Scotia and British Columbia, where governments have committed to developing alternative compensation models. In May 2020, the College of Family Physicians of Canada called on policy-makers to shift from fee-for-service to alternative funding models, a plea sparked by how the COVID-19 pandemic exposed problems with the fee-for-service payment model. The college endorses the Patient’s Medical Home model of care, which is best supported by alternative funding models. The researchers plan to reveal more results from the study at a later date. Their paper was published in the November 2021 issue of Canadian Family Physician. Read: Negation driving many Ontario family doctors to distraction

How compensation models shape how newer family physicians choose to practice: study

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