Doctor money ‘wonderful’ but more needed: SMA

As with anyone looking at a higher paycheque, the Saskatchewan Medical Association (SMA) said the boost to the rural and remote doctor incentive is welcome, but its president believes more could be done to get doctors to the province.

On Wednesday, the provincial government announced it’s more than quadrupling the incentive for doctors to set up practice in rural and remote parts of the province – from $47,000 over four years to $200,000 for five years of service.

“This new financial incentive should help to address what is a long-standing challenge of keeping physicians, recruiting them to start with but also retaining (them),” said Dr. John Gjevre, president of the SMA.

But Gjevre thinks money is only part of the solution, that the province needs to change how it organizes and delivers primary care.

“The SMA advocates for a shift to physician-led, team-based care in the community with the patient at the centre,” explained Gjevre.

He said that would mean a group included nurses, specialists like a rehab doctor or diabetic counsellor or mental health professional, all working together in a team with a doctor.

“That approach is what we need to have a real change overall in health care and a new approach and direction towards primary care,” said Gjevre.

He believes it would be good for patients but that it would also provide support and a good working environment that would be enticing to doctors.

Gjevre said it would also be an opportunity for doctors who don’t want to be caught up in the “fee-for-service” model that has been criticized by some as being a disincentive.

Gjevre said Saskatchewan has a lot to offer people – like clean air, safe communities and a good place to raise a family – but right now this is a fly-over province. He thinks that if you can entice people to come here, then they’ll be able to see for themselves, and stay.

“We’re a small province in a big country but we have a lot to offer and I think this investment helps people to at least look at us,” said Gjevre.

Health Minister Paul Merriman called the incentive increase “significant,” though he also said he doesn’t want to get into a “bidding war” with other provinces.

“We want people to choose Saskatchewan for the right reasons. We don’t want them to be here for just five years, we want them to set down roots and have their life here in Saskatchewan,” said Merriman, who noted that if other provinces went higher with their incentives, then Saskatchewan might have to take another look.

The minister said he’s also having discussions with the SMA about other parts of doctor compensation like how well the fee-for-service model is working, whether the fees added in during the pandemic still need to be there, and if there are other things the government needs to be looking at.

Merriman acknowledges that attracting health-care workers isn’t always about the money, it’s often about the working environment and the community.

“So those are some of the things that I think Saskatchewan can offer that other provinces can’t,” said Merriman.

The Saskatchewan NDP agrees, with Health Critic Vicki Mowat saying the incentive is fine but there needs to be more.

“What we’ve heard from physicians that we’ve spoken to has been that it’s not simply the need for an incentive to sweeten the pot, it’s also about the quality of life and the job in front of you in terms of retention,” explained Mowat.

Mowat said doctors want more flexibility in terms of a payment model like not wanting to be tied to fee-for-service and wanting to be able to work on a contract basis with the health authority instead of always having to basically be a small business owner.

She also pointed out the incentive is only for doctors working in rural and remote northern locations.

“We’ve done a lot of outreach with folks in rural Saskatchewan and being able to have (health-care) access out there is critically important. We also have pressures in our urban centres as well and we know that being able to find a family doctor is a problem across this province,” said Mowat.

Merriman couldn’t say at the time how much money has been budgeted for this program increase.