Health P.E.I. not imposing a minimum number of patients on family doctors, says CEO
'We're not asking the physicians to take on a larger panel than they've ever had'
A gap is developing between what Health P.E.I. says and what the Medical Society of P.E.I. insists is the case when it comes to the patient roster benchmarks the province is asking family doctors to meet.
Earlier this month, the society announced it planned to sue the health agency for breach of contract over proposed targets saying a full-time family physician should have 1,600 people on the roster and see 24 patients a day.
The medical society said at the time that the proposed "minimum" workloads for doctors would lead to burnout and drive physicians from the province.
But on Thursday, Health P.E.I. CEO Melanie Fraser told CBC News those targets are "maximums," and said they would be scaled back if doctors perform other duties — like emergency room work and other hospital shifts.
There would also be different expectations for doctors who practice on their own versus those who work in a team-based patient medical home, Fraser said.
"We're not asking the physicians to take on a larger panel than they've ever had — 1,600 was the maximum benchmark, it remains the maximum benchmark," she said in an interview. "At the same time, we do need to have some measure to understand how many patients [we can] affiliate to a particular physician."
Last August, the government, Health P.E.I. and the medical society together announced a new physician services agreement.
It saw the Island become the first province in Canada to recognize family medicine as a specialty and promised a 35 per cent boost to doctors' pay over the next five years.
But then last month, Health P.E.I. introduced a draft version of its new operational guide, which included a requirement that each family doctor see two dozen patients a day, based on an average appointment being 15 minutes long. The guide also said each full-time family doctor's practice should have a panel of 1,600 patients, with penalties imposed if that target isn't met.
We do value our doctors, we do want to retain all the physicians that we have…. I'm confident that we can get through these concerns.— Melanie Fraser, Health P.E.I. CEO
The draft guide clearly states that the targets were minimum standards.
"Physicians will be expected to maintain a minimum panel size as described within the Family Physician Panel Policy," says a section on page 24 of the guide.
"The resulting FTE [full-time equivalent] is then used to calculate a physician's assigned panel benchmark, based on a reference point of 1,600 patients per 1.0 FTE."
'That is not possible to do'
Fraser's language on Thursday told a different story. She said a 1,600-patient panel has been the maximum since 2016; it hasn't changed since then; and Health P.E.I. is not intending to change it.
Family doctors who spoke to CBC News over the past week seemed to be of the understanding that they would have to meet the benchmarks as minimums, however.
"This is not possible to do, what they're asking," Summerside family physician Dr. David Antle said in a June 15 interview. "People, including me, are already teetering on burnout and this will send us over the edge."
Antle said he has 900 patients on his roster and sees about 20 of them each day when working at the Summerside Medical Centre. That's in addition to emergency room shifts, and the time it takes to review patient test results and consult with other doctors about care.
"If this goes through — and it's going to be forced upon us with threats of potential punishment if you don't meet it — I can't provide the care that's needed for the patients I have. Full-stop," he said. "There's no way I can do it and there's no way my colleagues can do it."
Fraser acknowledged Thursday that the talks between Health P.E.I. and doctors have broken down, but said she's confident negotiations on operating guide will be resolved.
The consultation process is scheduled to continue into July.
"We're really hoping to have the input and feedback brought back to the process so that we can consider it and move forward," Fraser said.
"We do value our doctors, we do want to retain all the physicians that we have, all the staff that we have…. I'm confident that we can get through these concerns, through the process that we have."
The CEO also noted that three more family doctors have been hired for P.E.I. in the last three weeks, but wouldn't say where in the province they are expected to work.
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With files from Wayne Thibodeau