Saskatchewan family doctors say provincial budget short on needed reforms

Reactions over 2023-24 Sask. budget WATCH: Finance Minister Donna Harpauer and NDP Leader Carla Beck speak about the province's $1 billion surplus.

Saskatchewan family doctors say the province's latest budget fails to make needed reforms that would help keep them here as some look elsewhere for work.

Saskatchewan Medical Association President Dr. John Gjevre said the Saskatchewan Party government's budget doesn't do enough to transform primary care so that more people can access a family doctor.

While he welcomes new funding for health care, Gjevre said it has been frustrating to watch other provinces make program changes that doctors in Saskatchewan have long asked for.

"Our concern is that we're falling behind relative to other provinces," he said Friday. "A lot of them are retiring or moving to other provinces because of the high costs associated with running a practice."

Family doctors in Saskatchewan have been advocating for different payment models and for primary care to be delivered through a team of employees led by a physician.

The Saskatchewan budget released Wednesday did not offer those changes.

Newfoundland and Labrador is moving ahead with a voluntary model that pays doctors a set annual fee for each patient and a reduced fee-for-service each time they see that patient. British Columbia has moved to a more flexible model where doctors can be paid for their time.

The College of Physicians and Surgeons of Saskatchewan has previously asked the province to urgently transform its payment model, noting B.C.'s will be attractive to new graduates.

Dr. Adam Ogieglo, a family doctor in Saskatoon, said he has heard some family doctors are considering leaving.

"It's a big thing to move out of province and that has elevated the conversation for some people," he said.

"There are talks of 'what can we do to respond to this?' This doesn't seem to be falling on anyone's ears, so can there be talk of job action? What can we do to get their attention?"

Gjevre said he knows of a colleague who is winding down their practice because the budget doesn't address "pain points."

Facing questions Thursday from the NDP Opposition about the lack of reforms, Health Minister Paul Merriman said the province has been consulting with the association and is looking at potential changes.

The province plans to spend an additional $431 million on health care in the coming fiscal year, with a focus on hiring more health-care staff. The budget sets aside $500,000 for a primary care strategy and $1.3 million for a physician assistant program.

Gjevre said there are about 200,000 people who don't have access to a family doctor in Saskatchewan.

Many doctors have said changing the payment model would attract more to the profession. They would like to be compensated for their time rather than under the fee-for-service model.

The fee-for-service system sees family doctors go through multiple patients a day but they only get to spend limited time with them. Instead, many would rather spend more time with patients who often have complex needs.

"We're not compensated for spending time with our patients, which is what we want to do. We want to manage these complex needs appropriately," Ogieglo said.

Gjevre said the current fee-for-service model is outdated and inadequate to meet patient needs, noting family medicine is the backbone of a "strong health system."

"It does take time, but in the meantime, we got to do something to stabilize things for our family physicians who are here in the province right now," he said.

"People who have been here, they understand this is a great place to live, but even those folks now are getting frustrated and looking at potentially leaving. So, we do need some changes."

This report by The Canadian Press was first published March 25, 2023.