Doctors' earnings won't be made public yet again this year

It will be at least another year before physicians' earnings are publicly reported in New Brunswick, despite pressure from the auditor general, according to the health minister.

Legislative changes made in May 2015 allow the Department of Health to publish how much individual doctors receive in Medicare payments.

"It however does not make it mandatory," Victor Boudreau said in an emailed statement.

Boudreau said the plan is to have physician earnings disclosed as part of the "unaudited supplementary employee lists," commonly known as the blue book or sunshine list.

"As this year's unaudited supplementary employee lists are already being prepped for publication, they will not be in the upcoming edition," expected later this month, he said.

"Government is continuing to work on this recommendation from the auditor general and intends to comply within the next year," he said.

Boudreau was responding to comments made by Auditor General Kim MacPherson earlier this week, when she released her latest report.

Auditor general disappointed

MacPherson said she is disappointed that remuneration paid to doctors by Medicare is still not publicly reported, four years after she first made the recommendation.

"None of our three recommendations to health re. medicare payments to doctors have been fully implemented, although progress has been made," a summary of her update on prior years' performance-audit recommendations states.

In 2012, MacPherson found some doctors were overbilling Medicare, while some doctors double billed, charging both Medicare and the province's WorkSafeNB for the same service.

​"Only some types of payments to doctors were audited and the audit function had several weaknesses."

There were no deterrents to wrongful billing, she said.

MacPherson had recommended the Health Department:

• Develop an action plan, with specific steps and timelines, to address the deficiencies identified.
• Publicly report total remuneration for each doctor, regardless of whether the doctor is paid via fee-for-service, salary, sessional or alternative payment arrangements.
• Publicly report summary-level information annually on doctor remuneration, such as total payments for each remuneration method (fee-for-service, salary, sessional, other), doctor remuneration by dollar range, doctor remuneration by specialty, etc.

"Medicare has a huge impact on the lives of all New Brunswickers," her latest report states, noting it is one of the government's highest cost programs.

In 2010-11, Medicare expenditures were $553.3 million. Roughly 1,873 doctors were paid under the program.

Earnings don't reflect overhead

The New Brunswick Medical Society "recognize[s] the issues raised in the auditor general's report and support[s] the goals of transparency and accountability," president Dr. Lynn Murphy-Kaulbeck said in an emailed statement.

But she contends publishing physician billings is not the same as publishing a government employee's salary. Billings do not reflect overhead expenses, such as rent, medical equipment and staff salaries, said Murphy-Kaulbeck.

In addition, many new fee-for-service doctors enter practice with hundreds of thousands of dollars in debt, and almost all doctors do not get a pension, sick leave or other common benefits, she said.

"How the government presents the data is very important — being transparent must mean being accurate."

The professional association representing all physicians in New Brunswick has been working with the provincial government "to ensure the information, if disclosed, is presented accurately," said Murphy-Kaulbeck.

"We have not been advised to date when the government will go forward with this," she said. "We await further direction, if any, from the province on this subject."