I would like to express my appreciation for all of the hard work that the BCMA has put into the recent arbitration process and hence the subsequent award recommended. I would, however, implore that this settlement be used more wisely and with the future of health care in mind.

It is now no secret that the trend for family physicians has changed from the traditional full-service GP toward the walk-in clinic GP. At first it was our new graduates who were choosing the WIC-type practice, but now we are seeing our previously established traditionalists jump ship toward the WIC method of practice as they slowly desert many of the roles of the full-service doctor. [Dr Heidi Oetter’s] comments to the media that we have a shortage of doctors is in my opinion incorrect with respect to GPs; they are simply misplaced!

With the pending 11.5% fee increase, the BCMA has the power to halt this trend or to accelerate it. If our 0100 fee is increased by 11.5%, others will move toward the WIC type practice, as a comfortable living can be made on that billing alone. I have seen the faxes from soon-to-be-established new WICs recruiting doctors and partners. They are already crunching the numbers with the assumption that the 0100 will be worth $30+.

I would implore that the BCMA increase our 0100 fee by 0% and instead increase the other full-service items by 20% or more (e.g., hospital visits, nursing home visits, obstetrics, counseling, complete exams, pap smears, house calls, care of the fragile elderly, and so on) and create more fee items that support the role of the GP as a full service physician (e.g., family counseling by telephone or in office regarding a sick relative who is in or out of hospital, advice by phone day or night, arranging a specialist consult including forwarding of a letter and pertinent information to the specialist, being available for calls out of office, and the hundreds of other non-paid services we do daily). These services used to be a part of being a family physician, not paid for directly but compensated for in our total billings.

I have written in the past asking that the walk-in clinic problem be solved and have only seen apathy as a response from the BCMA. Please do the correct thing now, before the rest of the full-service GPs abandon the sinking ship.

—Ron De Marchi, MD
Burnaby