Where do fee codes come from?

For many members of Doctors of BC, checking the box to join their section and society may seem like an unnecessary expense. What is a section’s primary role, anyway? What is the role of the two major societies—BC Family Doctors (previously the Section of General Practice) and Consultant Specialists of BC?

Like many things in life, it helps to follow the money trail. The first and foremost duty for sections is to manage their respective fee codes—amending existing codes and creating new ones. Just like conceiving a baby, the birth of a fee code takes two partners—the section and the Ministry of Health. It starts with a section recognizing when a new fee code is necessary to provide optimal patient care and ensure that its members are remunerated fairly. To fund a new fee code, the section must use money from its own budget, as allocated by the Physician Main Agreement. The section writes a proposal for review by the Ministry of Health. The ministry compares the proposed new fee code to existing fee codes and possibly to fee codes in other provinces and confirms the anticipated cost and use of the code. There is an active dialogue with the section about any issues the ministry foresees. Finally, the fee code is presented to the Doctors of BC Tariff Committee for review, and final approval is provided by the Medical Services Commission.

As you can imagine, coming up with a fee code, writing a proposal, interacting with the Ministry of Health, and possibly presenting to the Tariff Committee consumes time and, for most sections, is unpaid work done off the side of someone’s desk. This process is not static. Fee codes must be updated periodically to reflect shifts in practice patterns and to update and modernize language. A large section like BC Family Doctors has staff support and contracted physicians with expertise to complete this crucial work. Consultant Specialists of BC has a single physician undertaking this work. For small sections with only a few executive members, there is no budget for physician stipends or staff. This leaves them isolated doing this work unpaid while putting them at a disadvantage to modernize fee codes and apply for new ones. Membership is a critical means of supporting this work, but more needs to be done.

Even though every couple is unique, the process of having a baby is the same. Similarly, each section and its fee code needs are unique, but the process to create or alter a fee code is similar. Having support to ensure that all physicians in BC have access to adequate economic assistance is essential. This is why BC Family Doctors and Consultant Specialists of BC are advocating for equitable economic support for all BC physicians undertaking Physician Main Agreement–related work, including section leaders.

Please consider becoming a member of your respective group today to support this important work and strengthen the voice of physicians across BC.
—Tahmeena Ali, MD
Chair, BC Family Doctors
—Robert Carruthers, MD
President, Consultant Specialists of BC