Health Minister Dix willing to consider alternate payment to encourage doctors to work in ER

British Columbia’s Health Minister said he’s willing to look at a new method for paying South Okanagan physicians working in the Emergency Room at South Okanagan General Hospital (SOGH) in Oliver.

Adrian Dix, the former leader of the provincial New Democratic Party, visited SOGH on Friday to hear from local physicians, nurses, administrators and local residents to listen to their input and concerns over staffing at the hospital’s ER.

A working group of physicians from Oliver, Osoyoos and other parts of the South Okanagan are expected to present a formal application to Dix and his ministry within the next month detailing their request for better payment options they believe will correct staffing problems at SOGH’s ER.

Earlier in the day, Dix participated in a special ceremonial beam raising ceremony at Penticton Regional Hospital as stakeholders celebrated construction moving past the halfway mark in the $312-million project to build a new patient tower.

Dix said he decided to come to SOGH after hearing and reading about a number of potential and temporary closures of the ER over the past several months as senior administrators were unable to attract physicians to work weekend shifts.

Dr. Peter Entwistle, the longtime Chief of Staff at SOGH, stepped down from his position several months ago citing his deep concerns about staffing levels and the method used to attract and pay physicians to work at the Oliver hospital, particularly in the ER.

“I think Interior Health is doing a good job of addressing concerns and fortunately, for example, there are more doctors in the region, now, and in Oliver, than there were a year ago,” said Dix. “That said, there are ongoing concerns, so rather than hear about them from a distance, I’m going and meeting with health care workers, with nurses, with doctors, with people who are providing care at the South Okanagan hospital.”

Dix pointed out one full-time general practitioner has opened an office in Oliver and another in Osoyoos in the past few months.

Dix said he had wanted to visit the South Okanagan before last week, but has been unable to because he’s needed in the provincial legislature, as are all elected NDP MLAs, as his government, with the assistance of three Green Party MLAs, narrowly hold the balance of power.

There have been calls by several physicians in this area calling for the government to approve an “alternate payment plan (APP)” to attract more physicians to the South Okanagan and the ER at SOGH, said Dix.

This could replace the fee-for-service mode of pay currently in place.

The APP would provide a more stable form of funding and he’s willing to consider applications for APP funding for physicians working at SOGH, said Dix.

“They’re developing some proposals and I think they’re supposed to be ready to move forward, so we’re going to take a look as well,” said Dix.

Boundary-Similkameen MLA Linda Larson joined Dix during his tour of the SOGH on Friday.

Dix announced his visit in response to a question from Larson on Oct. 17 during discussion in the provincial legislature relating to Ministry of Health estimates.

Larson was following up on recent discussions with Dix at the Union of B.C. Municipalities (UBCM) when Oliver Mayor Ron Hovanes and Osoyoos Mayor Sue McKortoff raised concerns about doctor staffing of SOGH’s emergency department.

Larson said she accompanied the mayors on their meeting with Dix in September.

Larson had pointed out to Dix that SOGH emergency normally serves about 10,000 regular residents, but in the summer and tourist season, that number is up to about 30,000.

Larson said she was impressed that Dix was prepared for the meeting with doctors on Friday.

“He obviously had a good understanding of the file and he assured everyone he would give it his full attention,” said Larson. “I think the doctors in attendance were very pleased with his response to their concerns.”

Larson is confident once the physicians officially apply to the ministry for a new funding model that Dix will have a prompt response in a timely manner.

The meeting on Friday last approximately one hour and two-thirds of the time was spent discussing payment options, said Larson.

The ER at SOGH is badly in need of an upgrade and potential renovations for this area were also discussed, she said.

Larson reminded Dix that doctors working in emergency are just local general practitioners who also run their own practices.

Larson said she has talked to numerous physicians who are supportive of the APP for working at SOGH.

“They’re looking for an APP (alternate payment plan) for the hospital so that we can pay differently and have permanent or full-time emergency doctors,” Larson told Dix. “I’d like to know whether you have been able to move forward on that at all. It has been discussed with Interior Health now for the last three to six months.”

An APP is how emergency doctors are paid in larger centres such as Penticton or Kelowna, Larson said.

But in smaller communities such as Oliver and Osoyoos, doctors are paid by the number of people who come through the door under the MSP (Medical Services Plan), the same as in their regular practices.

She notes that in their regular practices, doctors can schedule patients.

In emergency, however, they may be extraordinarily busy at some times, while at other times it is quiet and they aren’t compensated.

Dix noted the issue of changing the payment method for rural physicians came up during the election and has been discussed for a number of years before that.

Larson said she would ultimately like to see doctors who only work in emergency and work on salary.

“That would be the ultimate goal,” she said. “I don’t know if there’s an intermediate plan.”

She notes that doctors working in emergency in Penticton don’t run private practices.

KEITH LACEY

Osoyoos Times