New Payment Method for Internal Medicine Specialists

Health Minister Jim Smith announced today a new pay structure will replace the traditional fee-for-service method for 120 internal medicine specialists at the Queen Elizabeth II Health Sciences Centre in Halifax. Nova Scotia is one of the leading-edge provinces in moving to alternative payment for doctors.

"This is the largest alternative funding agreement reached to date in Nova Scotia," said Dr. Smith. "The new agreement is a significant step to enhancing health care services in Nova Scotia. Replacing the traditional fee-for-service funding method will allow doctors to spend more time with patients and their families to discuss their situation and to address their concerns."

Doctors affected by today's announcement work in the specialty areas of: cardiology, dermatology, endocrinology, gastroenterology, general medicine and palliative care, hematology, infectious diseases, medical oncology, nephrology, neurology, physical medicine and rehabilitation, respirology and rheumatology.

These doctors have traditionally been compensated under a system that paid a certain amount of money for each procedure performed. Starting Jan. 1, they will receive a stable and competitive income rather than fees tied to particular functions or services.

Dr. Smith said the guaranteed stable funding will play a vital role in recruiting and retaining specialists in Nova Scotia. Improving access to specialists' care is one of the principle objectives of the alternative funding agreement, which includes an outline of appropriate physician numbers in the various sub-specialty groups as well as a recruitment plan for the next three years.

Evaluating the services these specialists deliver in clinical care, academic programs, research and administrative services is also part of the agreement announced today. The evaluation will allow for activities to be pursued that were not previously paid for by insured fee-for-service billings such as family conferences. The evaluation will also serve as a tool to measure the success of the new funding method to determine if this is the best way to proceed. The agreement expires March 31, 2001.

The majority of the funding for these physicians will continue to come from the Department of Health. Dalhousie Medical School and the QEII will also put forward some funding as part of the agreement as it relates to increased opportunities for these specialists to teach or conduct research projects.

"This funding plan provides an opportunity for the QEII to recruit and retain some of the best internal medicine specialists in a highly competitive environment," said Bob Smith, president and CEO of the QEII Health Sciences Centre. "In addition to offering a stable fiscal environment for these physicians, the agreement will strengthen education and research and the delivery of quality patient care."

The Department of Health is committed to this alternative method of physician payment as it believes it will greatly assist in achieving stability in the delivery of specialty services, improve access to patient care at the QEII, and enhance the academic and research activities of Dalhousie Medical School in a predictable and financially responsible manner.

Other alternative funding agreements have been previously reached with such groups as the neurosurgery division of the QEII as well as surgeons, anesthesists and radiologists at the IWK Grace.