Specialty sections: Mirroring medicine in the 21st century

While specialization is now an established part of the medical landscape, this was not always the case. In the 1920s medical specialties emerged and medical practice began to shift from home to office and hospital. Internal medicine and general surgery were the first specialties recognized by the Royal College of Physicians and Surgeons of Canada in 1931. Since the 1950s general practice has become a specialty in its own right. As medicine changed, so did the range of specializations. 

Every medical specialty at Doctors of BC is represented by a section. While sections vary greatly in their membership numbers, dues, activities, and history, they share the same purposes: to advance the scientific, educational, and professional matters of their specialty and, in particular, the section’s economic affairs. When fee guide or billing issues arise, a section representative (the president or economics representative) can bring concerns to the Tariff Committee for discussion. 

Ten years ago there were 24 sections; today they total 40 and represent approximately 10 963 practising physicians (52% GPs; 48% specialists). This sudden jump to 40 sections occurred following the dissolution of the BC Society of Internal Medicine. One of the oldest sections and created 62 years ago, the BC Society of Internal Medicine dissolved into nine sections after a ballot cast at their final fall meeting in 2005, voting unanimously in favor. Allergy & Immunology, Neurology, and Rheumatology had already become independent sections before Internal Medicine’s umbrella group fully disbanded—and since that time a few more sections have joined the ranks. 

The Section of the Public Health Physicians is the newest section and is presided by Dr Réka Gustafson. This specialty deals with populations or groups rather than with individuals, and “much work remains, particularly in the context of continuing public health threats such as an aging population, the epidemic of chronic disease, preparing and responding to disasters and emergencies, and emerging infectious diseases.”[1]

Nothing captures the exponential growth in medical procedures, services, and their related fees quite like the fee guide. It was not until the 1950s that the then BCMA had a province-wide fee scale for fee-for-service physicians. When comparing today’s Doctors of BC Guide to Fees to a 1950s version with a one-page wee index,[2] the differences are glaring. It’s like comparing a tome to a booklet: 679 versus 53 pages and 4952 versus 1415 fee items. Physicians’ fees have changed in the last half century too. The fee to perform an appendectomy for a perforated appendix was $150 in 1957, while today’s fee is $495. 

In 2013–2014 Doctors of BC hosted five successful events for section heads and representatives to ensure ongoing engagement and build relationships with sections. These events included the Audit and Billing Seminar, Negotiations Workshop, Special Services Committee Work Plan Seminar, Privileging Information Seminar, and, most recently, the Negotiations Update.

The history of specialty sections mirrors the rise and advancement of modern health care in BC. As the medical field continues to evolve, there will certainly be more sections in the future related to new technologies and discoveries as yet unknown.

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This article was provided by the Physician and External Affairs Department of Doctors of BC and has not been peer reviewed by the BCMJ Editorial Board.

References

1.    Loh LC, Harvey BJ. A look to the past as we look ahead: The specialty of public health medicine in Canada. Can J Public Health 2013;104:e108-e110.
2.    Canadian Medical Association, British Columbia Division. Minimum schedule of fees. 16 September 1957.

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Ms Lynch-Staunton has worked as a sections coordinator with Doctors of BC since 2000.