New patient targets for family doctors could hurt P.E.I.'s reputation, says national college

The College of Family Physicians of Canada is raising concerns over new targets for family doctors on P.E.I. and calling on all parties to work together to find a solution.

"I'm feeling pretty sad. There seems to have been a significant breakdown in trust and in the relationship, and that's really hard, when people stop being able to trust one another," college president Dr. Carrie Bernard told CBC News: Compass host Louise Martin.

Last week, the Medical Society of Prince Edward Island announced plans for legal action against Health P.E.I., citing what it says is a breach of its agreement with the province.

The society said the new targets for how many patients each doctor needs to accept are not what it agreed to when it signed a new physician services agreement with the province last year.

Bernard said that agreement, which made P.E.I. the first province to officially recognize family medicine as a specialty, a move that includes higher pay, was celebrated across the country.

But she said the recent policy development undermines that progress and can make physicians feel not valued and respected by the system in which they play a foundational role.

What’s happening with P.E.I. family doctors has physicians elsewhere in Canada watching

18 hours ago

Duration 1:02

The dispute between the P.E.I. Medical Society and Health P.E.I. has caught the attention of doctors across the country. The president of the College of Family Physicians of Canada, Dr. Carrie Bernard, says doctors are talking, and are disheartened by what is happening in P.E.I.

Health P.E.I.'s new operational guide includes key performance indicators, or KPIs, that include a requirement that each family doctor will see 24 patients a day, based on an average appointment being 15 minutes long.

It also says each full-time family doctor should have a minimum of 1,600 patients on the books, or panel size, which Bernard calls an "arbitrary number."

Penalties can be imposed if the minimum isn't met.

Impact on recruitment and retention

On Monday, P.E.I. Health Minister Mark McLane told CBC News that the targets are intended to help the government collect information and evaluate how the new physician services agreement is working.

He also pointed out that Health P.E.I. was giving doctors and their association six weeks to provide feedback on the new guidelines, and said there will be no punitive measures during the first year of the agreement.

P.E.I. health minister ‘confident’ province, family doctors can reach compromise on workload targets

5 days ago

Duration 7:17

Health Minister Mark McLane responded for the first time to the legal battle brewing between the province’s medical society and the P.E.I. government over new targets for how many patients family physicians see per day. McLane tells CBC News: Compass host Louise Martin that the guidelines are still in draft form, and says he wants to work with doctors to resolve their pending legal challenge.

Bernard agreed that accountability matters.

"I don't think any family physician thinks they should not be accountable. We expect the accountabilities, however, to be informed by the professionals who are actually providing the care," she said.

The good news story 100 per cent was well shared across the country with great excitement, and right now there is a significant pause in that good news and a significant second look across the country about what's going to happen in P.E.I.— Dr. Carrie Bernard

"This just sort of came out of nowhere, without consultation and discussion and collaboration and negotiation."

She added that setting a blanket number for patient panels is too simplistic and doesn't reflect the reality of family practice.

Bernard warned that just as the news of last year's agreement was celebrated across the country, this policy shift could have consequences on physician recruitment and retention.

"Family doctors talk, and they talk to each other, not just to recruiters," she said.

"So the good news story 100 per cent was well shared across the country with great excitement, and right now there is a significant pause in that good news and a significant second look across the country about what's going to happen in P.E.I."

New target 'out of keeping' with national average

Bernard said the 1,600 figure is "out of keeping" with the national average of about 1,200 patients per family physician.

"The issue of numbers is that if a doctor has too many patients for the number of hours they have available to see their patients, you might have a family doctor in name, but you may not be able to actually see your family doctor," she said.

She added that even the 1,200 average can vary greatly depending on the complexity of patients.

Society representing P.E.I. doctors is suing Health P.E.I. over new targets for family physicians

8 days ago

Duration 2:40

Health P.E.I. is planning to change how family physicians are expected to work in the province. The Medical Society of P.E.I. says that was not part of negotiations that led up to a new Physician Services Agreement, so it has initiated legal action, saying some doctors will leave the province over this. CBC's Stacey Janzer reports.

For instance, doctors who serve many patients with chronic illnesses, as well as newcomers or refugee families who require translation, may need to spend more time per visit, which means they can handle fewer patients overall.

The same is true for physicians with added responsibilities, such as teaching or taking on leadership roles in the community or hospital system, she said.

"In smaller places like Prince Edward Island, where we're asking many family doctors to take on leadership roles — same thing," she said. "If you have to take on a leadership role, either in your family health team or at the hospital, that limits the number of patients you can see."