NB Riverview Physician Says After-Hours Clinic Pay Structure Not Financially Viable – New Brunswick | Globalnews.ca

Riverview family doctor Brian Davidson was forced to permanently close his after-hours clinic in May for financial reasons.

“With the pandemic we had, the number of patients we were seeing went down, our expenses didn’t get any better, and paying (support) staff after hours usually means paying a premium,” he said Thursday.

In New Brunswick, most family physicians are paid for service, like Davidson.

For one-time visits that typically occur in a clinic after hours, they are paid $29.40 per patient, compared to $47.74 for more comprehensive visits that typically occur in a physician’s regular practice.

Davidson says that between inflation and pandemic-related challenges, that’s not enough.

“Our operating budget got to a point where we actually had a couple of staff checks that bounced due to a number of different things. When you get to that point, you’re not able to hold different things,” he said.

He explained that staffing was also a challenge, in part because the low pay for after-hours clinic work prompted doctors to look elsewhere.

“So now I had gaps in the schedule where no one is working, can’t make money, and expenses don’t go down.”

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In a statement sent to Global News on Friday, a spokesperson for the Department of Health explained that in order to receive payment of the higher rate, doctors must meet the requirements of a comprehensive office visit, which includes follow-up care and update of the patient care chart. .

This fee structure also applies to physicians on eVisit NB, an online service where New Brunswick residents can virtually consult with a nurse practitioner or physician.

Payment rates are negotiated between Medicare and the New Brunswick Medical Society.

Anthony Knight, chief executive of the medical society, said in an interview Friday that he believes there are many factors that contribute to night clinics reducing their hours or closing.

“Moncton has the largest number of outpatient clinics in New Brunswick. When you compare Fredericton, there are two. When you look at Moncton, there are 20. That’s a high proportion of clinics after hours,” she said in an interview on Friday.

While acknowledging the demand for after-hours clinics, he said physician recruitment efforts are more focused on creating permanent practices.

“Ideally, in the event that a new physician enters the practice, we would like to encourage them to establish a full community practice and be a constant access point for 1,000, 1,200 patients.”

He said that overall the system is in a “highly stressed state” and it would be difficult to ask doctors to do more than they are already doing.

“I think there are pressures on doctors to provide more,” he said.

“The level of burnout, of burnout, of frustration with the system is at an all time high and we are deeply concerned about the welfare state of doctors in our province.”