August 15, 2016

This week, the UBC’s Centre for Health Services and Policy Research at the Faculty of Medicine’s School of Population and Public Health (CHSPR) released a research paper that analyzes whether British Columbia’s primary care reform (initiated in 2002) has reached its aim of promoting full-service family practice through incentive payments and other practice support programs.  

The GPSC’s incentive program enables family doctors to spend more time with patients who have complex and chronic health needs. This means doctors can better understand their patients’ issues and can provide a better treatment plan –leading to better continuity of care for the patient. Research   that studies a comparison between incentive-based and non-incentive based groups that shows that fee-based care is improving care for patients across BC.

The GPSC fully supports ongoing, robust evaluations. Over the years, evaluations have led to adjustments and changes to programs. However, there are some significant flaws in the CHSPR study. Researchers focused on only one incentive fee in the first two years of what has been a nine year initiative that encompasses a range of fees. As a result, it doesn’t capture the broad experience and changes over time. The fees themselves are part of a much bigger complement of primary care initiatives that all work together to support the patient experience. None of this information is captured in the CHSPR study.

Last year, family doctors told the GPSC through the visioning consultation that incentives overall have been key to encouraging them to join and remain as full service family physicians. More than a decade ago - when the GPSC was first formed – family doctors’ morale was at an all-time low, many family doctors had stopped delivering babies, withdrew their hospital privileges, and walk in clinics were on the rise. Today, as a result of the GPSC’s programs including incentive fees, we have more medical students than ever choosing family practice. Family doctors feel supported by the system, and feel they have the resources – a game plan even – to better take care of their patients with chronic and long term conditions.

The GPSC recognizes that, absolutely, there is more to be done. Primary care is constantly evolving. The GPSC and its partners are moving forward to design the future of primary care system to focus on continuous, integrated care. And, as an important part of its planning, the GPSC will continue to evaluate its programs and initiatives as well as welcome outside perspectives.

by Dr Shelley Ross, GPSC physician co-chair

For more information, please email the GPSC at: