(Photo-illustration by Maclean’s, photo courtesy of Renee Fernandez, background photo via iStock)
Dr Renee Fernandez shares with Macleans how B.C. rolled out the Longitudinal Family Physician payment model.
When I started medical school, I planned to be an obstetrician. But as I completed my training, I realized that what I really enjoyed was family medicine—the opportunity to build a long-term relationship with a patient over 20, 30, maybe even 40 years. I was inspired by colleagues who had attended a birth early in their career and then were later present at the birth of that person’s child.
As I began practising, I soon became concerned with how family doctors in B.C. and across the country were struggling to provide patients with care. Around one in five people in B.C. and 6.5 million Canadians across the country don’t have a family doctor. I’ve had patients come in with concerns about bleeding who haven’t been able to access a pap test or cervical cancer screening because they didn’t have a family physician. By the time I’d seen them, they already had cervical cancer, an illness that is entirely preventable or detectible with early monitoring.
I wanted to change this system, so I joined BC Family Doctors as its executive director in 2018 and watched as these issues got worse during the pandemic. In May of 2022, physician organizations and patient groups protested on the steps of the B.C. Legislature in Victoria to call for better access to family doctors. Within that week, BC Family Doctors and Doctors of BC sat down with the B.C. government to work on a brand new way to pay physicians: the Longitudinal Family Physician, or LFP, payment model.