A contract between Island Health and its hospital-based doctors in Victoria has expired and talks have ended without a deal, leaving patients caught in the middle.
Island Health said Tuesday patients would not suffer as a result of the contract’s July 1 expiry.
Island Health administrators were at Victoria General and Royal Jubilee hospitals early Tuesday to welcome hospitalists to work and explain payment options.
A hospitalist on shift said he received no such welcome but did receive a letter outlining payment options.
After two months of negotiations, the contract between Island Health and Victoria Hospitalist Physicians Inc., which represents about 60 hospital-based doctors, or hospitalists who work as subcontractors to their corporation, expired Tuesday.
Both sides in the dispute agree the negotiations have nothing to do with money. Island Health said the hospitalists are providing a high level of service and always have.
The problem is that Island Health wants the hospitalists to work under a so-called new model of care. The heath authority doesn’t want to extend, or renegotiate the old contract.
Dr. Tom Dorran, executive medical director overseeing patient care for Island Health, explained the focus is on a new collaborative approach that involves bringing together a team of doctors to work together to produce faster results and more timely discharges for patients.
VHPI lawyer Murray Tevlin, who has negotiated on the part of hospitalists in various B.C. health authorities, said the hospital-based doctors have always worked in a highly collaborate team manner.
In one of the most successful examples of collaboration with hospitalists, a short-stay unit at Royal Jubilee has produced better outcomes and lengths of stay for patients, said Dr. Wayne DeMott, negotiations lead for the South Island hospitalist group. Yet, Island Health has proposed removing a nine-hour hospitalist shift, DeMott said Tuesday.
“I don’t know how they can enhance collaboration,” DeMott said. “It’s hard to believe when, at the same time, they are cancelling a nine-hour shift on a celebrated unit.”
Tevlin said it’s highly unusual for the health authority not to extend the current contract through negotiations. There are term and renewal clauses that allow the contract to continue for six months while the parties renegotiate.
The hospitalists’ corporation has given notice it wants to extend the contract, but Island Health has refused, Tevlin said.
He’s at a loss to explain the “hardball” tactics.
“Why the government will not co-operate now is a mystery and a mistake for patients and patient safety, in our view,” Tevlin said.
Island Health spokeswoman Suzanne Germain said Tuesday patients would continue to receive quality care and that the health authority wants to negotiate a deal that is fair and reasonable and in the best interests of both patients and the hospitalists.
“From our perspective, we want patients to know if you are sick and you are sick enough to go to the hospital, go to the hospital and if you are sick enough to be admitted and you need care from the hospitalists, you will get the care you need,” Germain said.
The hospitalists are required by the College of Physicians and Surgeons to show up to work. However, because the contract between Island Health and VHPI has ended, getting paid is more complicated and has led to some confusion.
Until now, the family physicians have been told that once their contract expired they could not get paid through their corporation, DeMott said.
Island Health has advised hospitalists that they are now required to sign a daily contract if they want to be paid through the health authority, or they can opt to bill their services on a fee-for-service basis through the Medical Services Plan.
Working on a fee-for-service basis is not sustainable, DeMott said, because hospitalists cater to complex, older patients who are involved with multiple-care systems and require many services for which there is no fee code.
The VHPI said it is invoking a dispute resolution clause to settle the disagreement over the contract extension, which has been sent to mediation. Island Health has said it will not pay half the bill for such mediation, Tevlin said.
Island Health is advertising for hospitalists or a group of hospitalists to work at its Victoria hospitals as a back-up plan if a contract can’t be reached. Island Health said that as of Friday, no one had applied.
