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Essential information

Essential information for family physicians and nurse practitioners who want to practice in Richmond, British Columbia, Canada.

Essential information for Family Physicians (FPs)

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What is HealthMatch BC?

HealthMatch BC is a recruitment service for health care professionals funded by the province of British Columbia. If you see a position that interests you, email support@rdfp.ca so that our team can help you through the application process.

What payment models are available?

As of November 2022, new-to-practice family physicians can choose between practicing under a Primary Care Network (PCN) contract or practicing under the Fee-for-Service (FFS) payment model. On Monday, Oct. 31 st 2022 the British Columbia Ministry of Health announced plans for a new payment model that is designed to further strengthen the health care system and is set to roll out in 2023.

PRIMARY CARE NETWORK (PCN) CONTRACT PAYMENT MODEL
Primary Care Network (PCN) contracts are based on hours worked for longitudinal family practice services provided in the clinic. The contract requires full-time family physicians (FPs) to provide a minimum of 1680 hours of service (to a maximum of 2100 hours) per year. Part-time agreements are also available. Year-end bonuses are available for FPs who complete ongoing QI activities. This payment model is ideal for individual FPs who are interested in income security while establishing their full-service family practice and building their own patient panel within a community group clinic that has integrated team-based care.  

FEE-FOR-SERVICE (FFS) PAYMENT MODEL
Under the Fee-for-Service compensation model, FPs are reimbursed for each patient visit or for service rendered to a patient, based on standard reimbursement rates defined under the Physician Master Agreement. This model can provide opportunities to achieve a higher income by increasing the number of services rendered. FFS care is characterized by more hours of direct patient care, increased patient visits, and the provision of more services such as diagnostic tests. While FFS may indicate better patient access, it may facilitate service overuse, overtreatment, and a one-issue-per-visit approach. Other potential downsides to the FFS model are limits to the fee schedule, which traditionally do not allow for complex case management, collaboration with other health care providers, and non-face-to-face encounters. Studies also suggest a correlation between increased FP income and decreased professional satisfaction.

 

Primary Care Network Contract Information

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What type of PCN contract is available for FPs?

New-to-practice contracts for family physicians are available.

New-to-Practice hours-based contracts are available for individual family physicians who do not have a patient panel, and who wish to join an existing group practice to build a panel of attached patients for longitudinal care. The duration of this contract is two years. For more information, visit the Doctors of BC , or email support@rdfp.ca.

Once this contract is nearing completion, FPs can either apply for a PCN contract extension, join a group contract with at least two other full-service family physicians who have established patient panels, or transition into a fee-for-service (FFS) payment model.

Are part-time positions available for Family Physicians?

Yes, part-time opportunities working a minimum 50 per cent (0.5 FTE) are available. Payments for service contracts 100 per cent (1.0 FTE) are pro-rated.

Does the PCN contract allow me to see other patients, i.e., walk-in, long-term care, etc.?

You may commit to other opportunities provided that you meet all obligations under both the PCN service contract and your group Practice Agreement, including extended/after hours and on-call requirements. These other types of opportunities are outside the scope of both the contract and contracted panel commitments.

In this case, you may bill separately as fee-for-service (FFS) for services outside the scope of the contract, including:

  • Services provided outside of the clinic.
  • Services provided to third parties.
  • Specialized services provided to referred patients who are not attached to the practice.
  • GPSC networking fees and fees for the Long Term Care Initiative (LTCI).

Time spent for services outside the scope of the contract and billed under FFS cannot contribute to the PCN contract hours requirement.

Will I need to start right away?

Discuss your start date with your host clinic, leaving sufficient time for contract execution and licensure. Once you confirm that you are joining a clinic, the Vancouver Coastal Health (VCH) Contracts Team needs approximately four to six weeks to execute the contract and practice agreement. For new graduates, it takes additional time to obtain licensure and complete registration with the College of Physicians and Surgeons of BC. 

How is payment made to physicians?

Payments are made to the physician group. It is the responsibility of the physician group to determine how to allocate the payments among themselves. Physicians and Vancouver Coastal Health (VCH, which is the local health authority) will determine whether payment will be made on a biweekly or monthly basis. Payments are made in equal installments throughout the year.

How does the funding for overhead work?

As a physician under the PCN contract, you are required to contribute to the overhead costs of your clinic at the rate set out in the Practice Agreement.

What will be my employment status for tax purposes?

You will be an independent contractor and will not receive a T4 Statement of Remuneration for your salary under the PCN contract.

I have been working at a walk-in clinic and have a small patient panel. Can I transition into a New-to-Practice Family Physician (NTP FP) contract at a different group family practice to build the remainder of my longitudinal care panel?

Yes, if you have been working at a walk-in clinic and billing as fee-for-service (FFS), you may sign a NTP FP contract with a different clinic.

How will I fill my patient panel?

Family Physicians practicing under the PCN contract are provided with support through the Richmond Primary Care Networks for patient attachment. The Richmond Health Connect Registry allows patients to request a family physician, and the Richmond Attachment Program connects patients who are especially vulnerable and have urgent needs for longitudinal care.

Fee-for-Service (FFS) Information

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What is a normal billing split?

Physicians and host clinics negotiate their revenue sharing agreement and therefore arrangements will vary. One common billing split model is 70:30. Often, FFS family physicians retain 70 per cent of the payment and provide 30 per cent of the payment to the clinic owner toward overhead costs.

How can I arrange practice coverage?

Practice coverage arrangements may be a component of the agreement with your group practice, or you may be responsible for finding your own locum. The BC Family Doctors and Locums.ca provide online recruitment platforms to promote locum jobs. 

What arrangements are available for after-hours call coverage?

You may cover your own calls, you may participate in an after-hours call group arranged by your group practice, or you may join the Richmond Division After-Hours Call Group. For details contact support@rdfp.ca

Other Types of Practice Opportunities

Learn More about other types of family practice opportunities are available, including:

  • Roles within Richmond’s Long-Term Care Initiative (LTCI)
  • Walk-in-Clinic jobs related to Episodic Care
  • More

Essential information for Nurse Practitioners (NPs)

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What is HealthMatch BC?

HealthMatch BC is a recruitment service for health care professionals funded by the province of British Columbia. If you see a position that interests you, email support@rdfp.ca so that our team can help you through the application process.

What contract is available to Nurse Practitioners?

Independent PCN Contracts are available for nurse practitioners within a primary care network setting. These three-year contacts provide income security while you establish your practice an build your patient panel. More information is available through the General Practice Services Committee (GPSC), or email support@rdfp.ca

Are part-time positions available for Nurse Practitioners (NPs)?

Yes, part-time opportunities working a minimum 50 per cent (0.5 FTE) are available. Payments for service contracts 100 per cent (1.0 FTE) are pro-rated.

Should I become incorporated?

The Nurses and Nurse Practitioners of British Columbia (NNPBC) provides contract navigation for NPs and other related support.

How does funding for overhead work?

The overhead amount is paid directly to the contracted NP in monthly installments. The NP is responsible for paying their contribution to the group practice. Costs covered by NP overhead contribution to the practice vary depending on the arrangement with the clinic.

What will be my employment status for tax purposes?

You will be an independent contractor and will not receive a T4 Statement of Remuneration for your salary under the PCN contract.

If I go on maternity leave during my PCN contract, do I need to find an NP to cover for me?

You have two options: you can either find an NP to subcontract, or request that your contract be put on hold during your maternity leave provided the clinic has sufficient coverage for your patient panel. If your contract is put on hold, the term of your contract will be extended equivalent to the maternity leave period. Contact NNPBC regarding resources for additional coverage.

How will I fill my patient panel?

Nurse Practitioners practicing under the PCN contract are provided with support through the Richmond Primary Care Networks for patient attachment. The Richmond Health Connect Registry allows patients to request a nurse practitioner, and the Richmond Attachment Program connects patients who are especially vulnerable and have urgent needs for longitudinal care.

Essential Information for Host Clinics

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Is supervision required for practitioners working under provisional licence?

SUPERVISION OF FAMILY PHYSICIANS (FPs)
A physician on a provisional licence will require supervision. The level of supervision is at the discretion of the supervisor and depends on supervisee competency. Supervision is meant to be high-level; not all patient interactions require observation. Supervisors do not need to sign off on patient charts or medications, but should review them as a component of regular reporting. No legal liability applies to a supervisor for their supervisees; any complaints against a supervisee bears no consequence for their supervisor.
Supervisor reports are required at the three-month mark and annually until the physician sits for examinations and/or obtains Licentiate of the Medical Council of Canada (LMCC) and Certification in the College of Family Physicians (CCFP) designations to become fully licensed. A minimum of two reporting methods are required, such as chart reviews, chart discussions, direct patient–physician observation, 360-evaluation with other health professional colleagues, and other evaluation systems. Once the physician has met all other requirements and the first satisfactory report is received, the physician is eligible for full licensing. The maximum duration within the provisional class is five years.

The United States Medical Licensing Examination (USMLE) is equivalent to the LMCC, and that CCFP certification is granted without examination to physicians trained in the US, UK, Ireland, and Australia.

A supervisor is eligible to supervise a maximum of two provisional registrants and two clinical observers at one time. The College of Physicians and Surgeons of British Columbia must provide written approval for the supervision of additional registrants.

SUPERVISION OF NURSE PRACTITIONERS (NPs)
The supervision of nurse practitioners falls under the B.C. College of Nurses and Midwives. NP practice dos not require physician supervision. The NP is held to the same standards of care required of nursing, physician, and midwifery colleagues. 

What support is available to help me recruit practitioners who speak a language other than English?

We work closely with host clinics to help you recruit family physicians and nurse practitioners into your family practice. We promote specific needs wherever possible; given the shortage of practitioners in British Columbia we are unable to guarantee fluency in additional languages. Translation services are available.