December 15, 2022

Dear Doctors,

Subject: Important Update on the Family Practice AGM

Yesterday, the Section of Family Practice held its Annual General Meeting. The thoughtful group of physicians in attendance raised important concerns, including about a blended model of remuneration. We are concerned some may have left with the wrong impression, so we are sending this message today to offer clarity and to ensure all family physicians have the same information. 

The biggest discussion at the AGM was about the unsustainable and increasing pressure on family physicians, and the need for more resources to better support your practice. We discussed the interest in new remuneration models in other provinces, most notable the new BC longitudinal family medicine model which was announced just last month. This rich discussion was valuable and builds on the work Doctors Manitoba has undertaken over the last year as we prepared to begin negotiating the next Master Agreement.

For a long time now, Doctors Manitoba has heard from a growing number of family physicians raising concerns that their practice is unsustainable as patient complexity continues to increase but remuneration models in Manitoba remain unchanged. We struck a special committee on innovative family practice last year to review a variety of issues, including remuneration models that could offer an additional option for family physicians. We analyzed new models and approaches to physician funding in other provinces. Guided by the ongoing feedback from family physicians, the concept of a blended model was incorporated into our proposals for the next Master Agreement. These were submitted to government just before BC announced their new model.

Advocating for a new additional remuneration model is a priority for us as we negotiate the next Master Agreement, to replace the existing Agreement which expires in March 2023. In the meantime, we are pursuing more immediate supports for family physicians through a fast track lane, as outlined by our President Dr. Candace Bradshaw in her update on negotiations and advocacy yesterday.

The BC announcement has only strengthened our case that a new model is needed, as we described in this message last month. In fact, we have already raised the BC model with government negotiators. Our goal is to advocate for a new blended model to better support physicians practicing comprehensive longitudinal family medicine that incorporates the best elements of blended models in other provinces, including BC. This work is being informed by the feedback we receive from family physicians, the Section of Family Practice and the Manitoba College of Family Physicians, and it builds on other advancements we've been able to achieve together for family physicians in recent years.

We appreciate your ongoing feedback and advice. We have received a lot of messages from physicians interested in seeing a blended model developed here, and we have also received concerns from physicians that a BC-style model could limit their practice. This reinforced the importance of flexibility, and that a range of remuneration models are needed that recognize different approaches to practicing family medicine. It will be important, in the months ahead, for physicians to support each other as we press for a range of options that meets the needs for all.

The discussion at the AGM last night led to a motion from the Section of Family Medicine: "The Section of Family Practice request Doctors Manitoba to negotiate a blended remuneration model as an option for Family Physicians in Manitoba." This motion further helps to reinforce and strengthen our position with government negotiators that an additional model is needed along with strengthening existing models, and we appreciate this clarity from the Section.

As we learn more of the final details about the BC model, we will share an update with family physicians and seek further feedback. We welcome your continued feedback and insights. Please continue to contact us at practiceadvice@doctorsmanitoba.ca.

Finally, we want to say thank you. While ER and hospital pressures are frequently in the news, we know that family physicians have been under tremendous pressure too, and this has been eroding the work-life balance for many physicians. Your continued advocacy for your patients continues to inspire us, and it helps to propel our fierce advocacy for the broad and comprehensive resources and support family physicians need and the innovation needed in primary care.