2025 PMA Update: After-hours elective surgery surcharges
The 2025 Physician Main Agreement (PMA) includes a range of improvements to after-hours compensation, including higher fees for out-of-office care, surgical and anesthesiology surcharges, hospital visits, and emergency medicine care. This reflects a key BC Family Doctors priority for physician compensation: supporting physicians who provide care outside regular daytime hours.
It also introduces new after-hours fees for elective surgeries provided on evenings, weekends, and statutory holidays. Work is now underway to design these new fees.
The new elective surgery surcharges will apply to surgical assistants, surgeons, and anesthesiologists. Their values, descriptions and notes will mirror the existing operative and anesthesiology after-hours surcharges. For family physicians who provide surgical assistance, anesthesia, or surgical services, this is an important recognition of the additional demands of elective care provided after hours.
However, a significant gap remains for maternity care. As currently designed, the new premiums exclude pediatricians and family physicians who attend elective caesarean sections to provide neonatal resuscitation and newborn care.
These physicians are essential to safe caesarean section care. Excluding them from after-hours compensation risks creating another barrier to maternity services that are already under pressure, particularly in rural and smaller communities.
BC Family Doctors and other Sections have identified the need to address this gap. We have asked Doctors of BC and the Ministry of Health to work together on options for improved after-hours compensation for physicians providing neonatal resuscitation and newborn care at elective caesarean sections.
The goal is simple: after-hours payment should support the full clinical team required to provide safe, timely maternity and surgical care.