Pilot program offers bonuses to family doctors to expand hours of practice By: Danielle Da Silva Posted: 12:49 PM CST Monday, Feb. 13, 2023

Family doctors and pediatricians who keep their clinics open beyond the typical 9-to-5 can cash in on a new bonus from the Manitoba government, as it looks to bolster physician availability amid a province-wide shortage.

On Monday, Health Minister Audrey Gordon announced a 20 per cent premium on physicians billings for extended hours. The new incentive is part of the Progressive Conservative government’s $200-million health human resources action plan, which was announced in November 2022.

Primary care doctors and pediatricians can now bill the province at a higher rate for services provided weekdays 6-8 a.m. and 5 p.m.-midnight, and on weekends and recognized holidays between 7 a.m. and midnight.

“We do know that not everyone works in set hours and we want to be flexible,” Gordon said.

The premium took effect Feb. 1, and will be offered for an 18-month pilot period.

It’s too early to know how many doctors will keep clinics open longer or how many additional hours could be added to the system, Gordon said. However, at this time, the province has not set a limit on the program budget and is inviting doctors to take part, she said.

“It’s been 13 days into this, so we are crunching the numbers, we’re looking at how many physicians will actually take advantage of this or want to be part of this process,” Gordon said. “But we, certainly, are open to looking at those numbers and ensuring as many physicians as possible can join this program.”

In the 2021-22 fiscal year, the province paid $913.9 million in fee-for-service billings from doctors.

Doctors Manitoba, a physicians advocacy and professional organization, recommended government provide a premium for extended clinic hours.

Board chairman Dr. Kristjan Thompson said the province has a serious physician shortage and incentives, increased flexibility and control over their practice, and additional mental health support, are reasons for doctors to stick around.

At a recent town hall hosted by Doctors Manitoba, just under half of the 80 physicians who participated said such funding would encourage them to work longer, Thompson said.

“We’re optimistic that at least this funding will be an incentive for other clinics to provide these hours and then, hopefully, those who are already providing the hours, will continue to do so in the face of inflation and rising costs.”

The group will also receive $450,000 for its physician peer support program, which is designed to help doctors manage stress, burnout and take care of their mental health.

About half of Manitoba doctors are experiencing high levels of burnout, which can affect patient care and outcomes, said Dr. Shelley Anderson, Doctors Manitoba medical lead for physician health and wellness.

The funding will expand the mental health resources Doctors Manitoba offers and incentives to expand clinic hours will help with work-life balance, she said.

“Anything that allows for a little bit more control and agency over how care is provided will help physicians’ well-being overall.”

Manitoba has the second-lowest number of family doctors per capita in Canada, at 109 per 100,000, according to 2021 numbers from the Canadian Institute for Health Information. The Canadian average is 124 per 100,000.

A recent survey of its members by Doctors Manitoba found 43 per cent intend to retire, leave Manitoba or reduce their hours in the next three years.

To cushion against the projected exodus, the province also gave the University of Manitoba the green light to expand its undergraduate physician training program, its one-year international medical graduate bridging program, and its two-year post-graduate medical education program for internationally educated students.

The government-funded expansion will add 80 additional physician training seats over a three-year period, with 15 seats being added this year to both the undergraduate and post-graduate programs, respectively.

“Anything that allows for a little bit more control and agency over how care is provided will help physicians’ well-being overall.”–Dr. Shelley Anderson

Max Rady College of Medicine dean Dr. Peter Nickerson described the program expansion as “pretty rapid,” and noted the incremental additions are balanced with residency program capacity.

“We saw this as a sustainable goal and one that wouldn’t add burden to the physicians that are going to be training these individuals,” Nickerson said.

Currently, the U of M accepts 110 undergraduate medical students each year. The 40-seat increase will put the program back on track with population growth in Manitoba, he noted. An estimated 94 training seats per one million people is considered sustainable, Nickerson said.

“So, getting these additional 40 seats over the next few years will keep us at that number, because right now we’re basically eroding,” he said. “We think that’ll help us to achieve sustainability going into the future.”

Manitoba Liberal Leader Dougald Lamont said the Tory government must do more to help health-care staff to recover from burnout and to license internationally educated medical professionals.

“The good news is that health care can be fixed, and there is no shortage of federal money to fix it. The bad news is that the PCs still won’t do what it takes,” the St. Boniface MLA said.

In a statement, NDP health critic Uzoma Asagwara said the changes made by the Tory government are too little, too late: “An election-year announcement won’t be enough to make up for seven years of health-care cuts from Brian Pallister and Premier (Heather) Stefanson.”

danielle.dasilva@freepress.mb.ca

Danielle Da Silva
Reporter

Danielle Da Silva is a general assignment reporter.

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