Pig in a poke

Issue: BCMJ, vol. 48, No. 8, October 2006, Page 374 Editorials

The doctors of British Columbia are presently embroiled in yet another confusing round of arbitration and macro- and micro-allocations of contract monies. This is really too bad, and probably unnecessary.

When the doctors voted to accept the government’s offer of a 10.5% fee increase over 4 years, and another 8% to go to targeted programs, I believe most thought that was probably what they were going to get. That is, a 10.5% fee increase over 4 years for all doctors.

This is not the case, of course. All of that money is up for grabs, and the negotiations between the Society of Specialists and Society of General Practice have broken down and have gone to arbitration.

Once this arbitration is completed, then the Society of Specialists will take whatever amount has been allotted to them and a micro-allocation process will start to try to allot the money between 26 specialist groups. If this cannot be done, by unanimous agreement, then this process too will go to arbitration.

It seems to me that this is an unbelievably cumbersome process. In most jurisdictions in the world general practice negotiates at a setting completely separate from specialists. In Britain it is done on alternate years. Similarly, surgical groups negotiate for their own contract.

This method of voting for a contract that will probably bear little resemblance to what each subgroup actually sees seems like buying a pig in a poke. In my opinion, this method of distributing the money of the contract (after it has been voted on) allows too much room for decisions based on political ideation.

It would be better if the groups negotiated separately and were able to vote on a contract that actually represents what they may get, as opposed to what appears to be a bait and switch.


Anthony J. Salvian, MD. Pig in a poke. BCMJ, Vol. 48, No. 8, October, 2006, Page(s) 374 - Editorials.

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