B.C.’s Longitudinal Family Physician Payment Model (LFP) and Alberta’s Physician Comprehensive Care Model (PCCM) were designed to better support family doctors by reflecting the realities of modern healthcare. But these new models narrowed the financial gap between rural and urban physicians, reducing the previous pay advantage for physicians in rural and remote communities.
Challenges for rural family doctors
Rural incentives—such as fee premiums and recruitment/retention bonuses—have traditionally helped attract and keep doctors in isolated areas. These incentives still exist but their impact is shrinking now that urban doctors can earn similar pay while practicing in areas with more healthcare resources.
Some communities are already feeling the effects. Dawson Creek lost seven of its 20 full-time equivalent doctors last year and Prince Rupert has struggled to keep its emergency room open due to doctor departures. In Alberta, rural doctors worry that PCCM’s requirement of a 500-patient panel makes it inaccessible for those who also need to provide emergency room coverage for their communities.
BC Family Doctors led the development of the LFP to strengthen primary care and ensure all communities have access to family doctors. The model was a step forward, but we knew from the start that it would not fully meet the needs of rural doctors and rural communities.
What’s next?
We’re committed to ensuring rural healthcare is supported, including:
- Adjusting payment models to reflect the reality of rural workload and practice
- Improving compensation for emergency and on-call work in rural areas.
- Adapting the definition of longitudinal care to consider clinic and community attachment, as well as seasonal and transient patients.
With Physician Master Agreement negotiations soon to start in B.C. and a review of Alberta’s PCCM coming up, there is an opportunity to improve these payment models. BC Family Doctors will continue advocating for adjustments that will ensure rural communities get the care they need.
For a deeper look at these challenges, read the Canadian Healthcare Network’s interview with Dr. Karen Forgie, Chair of our Economics Committee, here.