Province adds $18.6M for some family physicians to expand their practice

The province is spending $18.6 million on billing changes to encourage solo-practice physicians to work with nurses and take on more patients.

The money will result in an update to the way physicians working under the fee-for-service model in private practice are compensated, Health Minister Bruce Fitch said at a news conference Thursday. 

Fitch said more than half of the province's family doctors now operate their own practices. 

"[That] number that is much higher than in other provinces, when we do the inter-jurisdictional scan," Fitch said. 

"We're working with various stakeholders, like the regional health authorities and the medical society, to encourage a shift to the collaborative-care clinics."

To that end, Fitch said physicians will see "expanded codes" to bill for nursing services starting on Sept. 16.

The province will also introduce a patient and provider registry that physicians will be compensated for maintaining, with payments to begin this fiscal year.

Fitch said the pay scale attached to the registry will give doctors an incentive to add more patients to their rosters. 

WATCH | 'It's a good start but no, it does not go far enough,' says Dr. Paula Keating:

Some N.B. docs can now bill for more nursing services, but is it enough?

3 months ago

Duration 0:50

Dr. Paula Keating, president of the N.B. Medical Society, says family physicians with a solo practice can bill for more nursing services as part of an updated compensation model.

Dr. Paula Keating, president of the New Brunswick Medical Society, said the funding will help bridge the gap until negotiations with the province begin on a new physician-services master agreement, expected in 2025. 

"Many physicians are small-business owners," she said. "With extraordinary inflation affecting rent, staff, salaries, equipment, supplies, not to mention mounting administrative burdens, the pressures on family physicians have become unsustainable."

While Keating said the funding is a step in the right direction, she added that it will not be enough to establish the required number of collaborative-care clinics. 

The medical society and the New Brunswick Nurses Union said in a budget submission this year that a $70-million commitment would be necessary to establish 50 of those clinics, much more than what the province announced on Thursday.

If the Progressive Conservatives are re-elected, the 2025-26 fiscal year would see a $20-million spend, Fitch said, with potential increases in years after based on uptake.

Paula Doucet, president of the New Brunswick Nurses Union, is not convinced the updated compensation model will help fill the province's primary care gaps. 

"This government's choice to incentivize physicians to expand their private practices is not the solution ... It will weaken the public health-care system by drawing more health-care resources out of the public system," she said in an email.

It also promotes "structural inequity" among health care professionals, Doucet said, and won't be effective "considering the magnitude of New Brunswick's nurse shortage."

Doucet said the government should focus on "multidisciplinary, nurse-practitioner led, primary care clinics," managed by the regional health authorities.

The provincial government defines a collaborative-care clinic as a practice with family physicians and "allied health-care professionals," spokesperson Bruce Macfarlane said in an email. 

"There are a total of 54 collaborative health-care clinics across New Brunswick," he said. 

That total includes community health centres operated by the regional health authorities, nurse-practitioner clinics, family-medicine practices, N.B. Health Link clinics, Vitalité family-health teams, Macfarlane said.