SYDNEY, N.S. — The president of Doctors Nova Scotia hopes there may be enough in the new contract for doctors to entice physicians back into providing in-patient coverage at community hospitals.
The decision by some doctors to withdraw from providing in-patient coverage at community hospitals due to a pay inequity has been an issue locally at Glace Bay and North Sydney. Without the in-patient coverage, there has been additional pressure placed on the emergency department at the Cape Breton Regional Hospital.
“I think the new agreement will help those docs,” Gary Ernest said in an interview. “Family docs doing comprehensive care will be helped because they are one of the targeted groups to benefit more than some of the others.
“It will hopefully help them in terms of just making them more content and perhaps stay doing what they’re doing and perhaps reconsider going back and doing in-patient care. If they feel better about the agreement in general, about their work environment in general, sometimes that will make people rethink things.”
As well, rates for emergency department coverage will also increase, which should also assist physicians doing ER work.
Ernest said the community hospital in-patient (CHIP) model has been made more flexible, allowing each hospital to determine, within the funding envelope provided, what works best for it.
“In that model, certainly the family doctors who are doing in-patient hospital care will make significantly more than they did in the past before this model existed,” Ernest said.
Doctors who have withdrawn from providing in-patient coverage at community hospitals have outlined concerns about an inequity in what they are paid, versus doctors in Sydney. The issue arose after the introduction of hospitalists — family doctors who work out of hospitals, seeing patients who have been admitted that don't have family doctors, and have a maximum number of patients they would see.
“I think the new agreement will help those docs" — Gary Ernest
In addition to higher pay, the hospitalists are also paid for being on call and they don't have the overhead associated with operating their own practices, from rent to staff. The province has also offered the hospitalist line to family doctors serving regional hospitals, but not those working in community hospitals. Doctors have said that ties the hands of people working to recruit new physicians to community hospitals.
Ernest said there unfortunately are many side-deals that the government has okayed over the years which have created a number of other issues and which will now have to be addressed by parties including the Department of Health and Wellness, the Nova Scotia Health Authority and doctors. He said those deals have to be ended so that there is a level playing field.
“It’s not the end of that discussion, there’s work to do down the road,” he said. “At least it helps the problem and from there it gives up a jump off point for future conversations with the government because the inequity for people doing the same work for in-patient hospital care and getting paid different amounts is not right and needs to be addressed and it will be addressed in future discussions.”
Ernest added it’s a relief to have the contract talks settled noting the government showed more movement over the last several months, resulting in an agreement that looks much different than what was anticipated during the early days of talks.
The contract includes an eight per cent raise over four years. It was approved by Doctors Nova Scotia members this week. It includes $55.5 million in new funding for specialties including family physicians, anesthetists, emergency physicians, psychiatry and obstetrics/gynecology.
The contract was ratified with 94 per cent of voting members in support of the master agreement while the clinical academic funding plan contract was ratified by 96 per cent of voting physicians and 12 of 12 departments. In total, 69 per cent of eligible members voted.
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