Government and Doctors Reach Agreement in Fee Dispute

Government and Doctors Reach Agreement in Fee Dispute

The settlement of an arbitration case involving the Department of Health and the Medical Society of Nova Scotia has resulted in the elimination of patient tray fees, stabilized in-patient physician services at provincial hospitals, and given doctors the opportunity to spend more time with their elderly patients, Health Minister Jim Smith said today.

"Our agreement to introduce a new geriatric fee reflects the very real demands being placed on doctors by an aging population," said Dr. Smith. "Other changes to the way doctors are compensated will further strengthen Nova Scotia's already successful program of physician recruitment and retention. This province had a net gain of 56 doctors last year and, as a result of this new agreement, we can expect that number to go even higher."

The medical society originally proposed two new fees and changes to the way physicians are compensated for in-patient hospital service. When the government turned down the request, the medical society referred the matter to arbitration.

As the arbitration date approached, both sides decided to try to see if a compromise solution was possible using the alternate dispute mechanism in the physicians' agreement with the province. After lengthy discussions, a settlement was reached and presented to the arbitration panel. The arbitrators accepted the proposal.

"We estimated the cost of the society's proposals could have run as high as $40 million a year. That was a lot of money to risk losing at arbitration. The compromise settlement will cost the province about $13 million," said the health minister. "We were fortunate that the dispute settlement mechanism in the physicians' agreement allowed us to find a less expensive solution."

The settlement provides for one new fee code. Beginning April 1, the government will pay doctors a special geriatric office visit fee for seeing patients 65 years of age and over. This new fee recognizes that many seniors suffer from multiple health problems and that doctors should be compensated accordingly.

"The extra compensation contained in the new geriatric fee will make it possible for physicians to spend more time with their elderly patients, many of whom may suffer from a number of illnesses. This change will certainly enhance the quality of care for our seniors," said Dr. Smith.

The agreement also authorizes a small increase in the general office fee paid to doctors. The increase was considered important to keep rates in Nova Scotia competitive with the rest of the country. In addition, the agreement provides for additional funding with respect to services doctors deliver to patients in hospital.

The department reached agreement with the medical society on a number of other issues, including the elimination of some tray fees. Tray fees are the charges levied by doctors to cover the cost of supplies used during various office procedures. As a result of this new agreement, Nova Scotians will no longer be required to pay for supply costs associated with pap smears, vaccinations and provincial government childhood immunization programs.

"This extra financial cost to the patient could discourage them from having these procedures carried out. This is particularly true for those on low or fixed incomes," said Dr. Smith. "By eliminating these fees, we will be helping to ensure improved access to important health care procedures."

Extra funds will be made available to pay for hospital-based services performed by general practitioners. This new payment structure will help guarantee that Nova Scotians receive stable and uninterrupted care whenever they require hospitalization.

"Improving access to the health care system is a major government priority. One way we can do that is to ensure that physicians are available when and where needed," the health minister said.