Doctors at rural hospital say new payment model hurts inpatient care

CBC

2 days ago

Musquodoboit Harbour residents are raising concerns about inpatient care at Twin Oaks Memorial Hospital amid a pay dispute between the province and five doctors at the hospital.
However both the province and the MLA for the area are seeking to reassure the community that hospital services will continue as usual.
In a letter to the province dated May 9, the doctors said they would resign on June 14 in protest over a change to how they are paid for inpatient care. However the doctors rescinded their resignations on May 24 and will now stay on the job for at least another six months as they continue discussions with the province.
"We rescinded our resignations despite the lack of flexibility from [the health department] basically to keep the hospital open," one of the doctors, Dr. David Brandon, told CBC News in an interview.
The local MLA, Kent Smith, said he was contacted by several constituents about the status of inpatient care.
"The doctors are in ongoing discussions with respect to their coverage of inpatients. I am cautiously optimistic for a favourable outcome," he wrote in a Facebook post on May 22.
"The most important thing to understand is that this issue of inpatient coverage has absolutely no impact on any other services offered at Twin Oaks. We are all working hard to ensure continued excellent care for our community."
The payment model the five doctors have criticized is part of the most recent contract between physicians and the provincial government. The previous payment model paid doctors for each service. Longitudinal Family Medicine (LFM) is a payment model that offers physicians higher compensation if they take on more responsibility, such as taking on more patients or providing additional services or working longer hours.
The five doctors say the change will negatively impact how they are paid for inpatient care at Twin Oaks. They say the model doesn't fit the unique needs of small communities. The rural hospital has 15 inpatient beds in addition to an emergency department that is open 12 hours per day.
Dr. Gehad Gobran is the president of Doctors Nova Scotia, which negotiated the contract on behalf of the province's 3,300 physicians.
"We're educating physicians about the new model and trying to support any necessary solution-minded service delivery changes, within the existing remuneration structure, that will sustain services, while not disadvantaging the physicians financially or increasing practice burden," he said in a statement to CBC News.
CBC News requested an interview with the Nova Scotia Health Authority but received a statement instead. The statement says steps are being taken to ensure patients continue to receive medical care and the emergency services will operate normally.
"The emergency department will remain fully operational, with no changes to its services," it says.
"Virtual urgent care, which is already available at the hospital and underutilized, will continue to support patient needs."
Brandon says the hospital should have six physicians on staff, but they currently only have five. As part of a temporary agreement, the province has allowed them to hire an additional physician.
"The one thing that [health department] has made possible is that they've allowed us to bring in another doctor if we can find one using locum funding until a new doctor can be hired."
For now, Brandon says, the doctors remain, but they will submit their resignations again if the conflict persists and communication with the province does not improve.
"The hospital is going to stay open. The hospital is not going to close. We are going to do our best to provide the best care that we can within the limitations of the system, which is what we always do."