let mare “4 kop On-call pay contentious part of offer Doc bonuses to rise sharply THE PROVINCIAL gpov- ernment is offering local doctors nearly $605,000 more than what they now receive.as an incentive: to stay in tawn, indicate fig- ures fram the health mini- stry. That figure is the differ- ence between . -the $1,233,995 now being paid oul under the existing Northern Isolation Allaw- ance of 14 per cent on top of regular billings and the $1,838,250 under the new retention program offered _ two weeks ago. All told; the provincial total offer, as it relates to _ Terrace doctors, works out to $2,902,000 miltion. - There’s $50,000 for ~~ $10,000 signing bonuses to fill five’ vacancies in the ‘city's physician supply plan, ; And there’s $138,400 to provide up to $4,400 for each physician for continu- ing medical education. ~~ The most contentious part of the province's offer rests with the $660,000 it wants to pay to local spe- ~ Cialists: tobe on call 24 hours'a day, seven days a week, ‘It- amounts. to $75,000 ‘ per year for each core speci- ‘alty considered crucial for emergency medical care and $12,000 for specialties not considered as crucial for “emergency treatment. The money for each spe- cialty is to be divided be- tween each physician within that category who agrees to be on-call. Thus, two core specialists who want to be on.call one night in every two. -would each get $37,500. * But that’s a problem in the: -northwest.: Although each heaith council in‘Ter- race, Kitimat and Prince Rupert, for instance, can get -_ $75,000 each for a core spe- cialty, that’s only the case if 4 each maintains an on-call system within their own boundaries. In the northwest, the general.surgeon in Kitimat, the two here and the one in Prince Rupert share on-call duties within the region so that each is on standby one night in four. And because they share on call, Kitimat, Terrace and Prince Rupert cannot each get $75,000 for general surgery. They must share $75,000. That means each of the .four general surgeons must Share the $75,000, working out to $18,750 per person, Doctors here say that’s unfair, pointing to the deal signed between the province and Prince George doctors in June. That deal provides each core specialist $1,000 a day to be on call. Under that ar- rangement, four general sur- geons in Prince George who are on-call one night in four would each receive a touch over $91,000 over the course of a 365-day year. The provincial offer here also contains $215,350 for general practitioners to be on-call provided they stay at the hospital, That works out to $590 for each 24-hour period on top of any regular billings they might make during the on-call time. That appears to be a pret- ty generous offer, but the problem is that on-call here doesn’t work like that, says Dieter Kuntz, the chief ex- ecutive officer of the Terrace Area Health Council which runs Mills Memorial Hos- pital. Instead of being on-call at the hospital, doctors are on-standby at their offices or homes, he said: “T don’t think our dactors want to live in the hospital when on-call,” he said. That being the case, Kuntz doubts the $215,350 The Terrace Standard, Wednesday, October 4, 2000 - AS Wi Retention 63.9% Spacialist on-call payments 22.7% [in-house on-call payments to GPs 7.4% [continuing Medical Education 4.8% Fe Recruitment 1.7% Where the new doctors ; money goes ‘Retention’ _. $1,838,250.00 Specialist on- -call payments 2. ; $660,000.00 ‘In-house on-call payments to GPs®> _ $216,350.00 Continuing Medical Education‘ $138,400.00 Recruitment ° $50,000.00 Totalcost sy Existing Northern Isolation Allowance payments® $2,902,000.00 $1 233,995.00 Net Increase over and above existing benefits’ $1,668,005.00 1, Each general practitioner who stays. past one year in Terrace would receive $45,000 a year and a specialist $56,250 a year for remaining in practice here. That's based on maintaining full time officer hours. Adjusted for part time physicians. Health ministry fig- ures indicate there are 19 full time equivalant general practitioners here and 13 full time equivalent specialists. 2. For the six core specialities considared crucial to emergency care, $75,000 for each specialty to be divided between the doctors wha practice that specialty in return for praviding 24-hour a day, seven day a week coverage. For non-core specialties which are those considered not crucial to emergency care, the amount is $12,000 a year. 3. This is based on general practitioners agreeing to providing 24-hour coverage, saven days a week in the hospital itself. Amount is $590 for a 24-hour shift, plus fee for ser- vice billings. Mills Memorial Hospital does not have such an in-house schedule and it is doubtful if it will introduce one. But general practitioners have apparently agreed to an- other on-call program providing them $10 an hour plus full fee for service. This program does not require physicians to be in the hespital itself. 4, Each physician to receive up to $4,400 each for continuing medical education. 5. Thare is a $10,000 signing bonus ta fill vacancies in the physician suppiy plan for the area. The health ministry says there ara five existing vacancies — four specialists and ona genaral practitioner. Terraca and Area Health Council officials say they ara aware of two vacancies — an obstetrician and a psychiatrist. 6. This represents the total of the 14 per cent fee for service premium local physicians now receive. They have the option of continuing this program or signing onto the new offer. 7. This figure is determined by subtracting the total cost of the new package at $2.902 million from the existing isclatian allowance top up. Since Mills does not have an in- house generat practitioner coverage program, this figure must be viewed with caution. For a better understanding of what the government says it is offering physicians to stay in Terrace, subtract the existing isolation allowance amount of $1,233,995 fram the ra- tention offer of $1,838,250. can be used here. “This option doesn’t , apply to us,” he said. : +Health ministry: official Jeff Gaulin said the money could be used as an induce- ment to attract general prac- titioners to Terrace for tem- porary duty. CORRESPONDENCE FOR THE TERRACE STANDARD The Mail Ba Dark clouds on horizon Dear Sir: As a family physician - practising in Terrace since 1992, I am alarmed at the way our provincial govern- ment is trying to solve the - problem of physician short- ages in rural B.C. There now exists a na- tion-wide shertage of doc- “tors: due to cutbacks in - medical school enrollments, retirements, and physicians leaving Canada. Northern and rural areas feel its ef- fects first. The settlement with Prince George doctors pays ‘them more to work there than anywhere else in the province. “-Tcan’t see how Terrace, or any other rural commun- ity. with: fewer resources than. Prince George, can hope.to attract new doctors in times of shortage to re- place those who leave. Without parity with Prince George, I am afraid we will lose our existing specialists to Prince George and elsewhere, If they are nat replaced, some general practitioners will be driven to leave as well. 1 fear what this will do to our community, Doctors in this cam- munity. have many options. Every one of us can find a job elsewhere, and most of us will have better working conditions and better pay if we do. ‘Those doctors already here appreciate the value of living in Terrace for more than just work opportuni- ties, I don’t think new doc- tors will be able to see ~. much beyond the differences in pay, especially at first when they are making their decision about where to re- locate. lam worried about the people living here, who call Terrace home. It will be dif- ficult, expensive, and dan- gerous for people here to have to travel to receive their health care elsewhere, The doctors, in their ac- tions, are trying to bring at- tention to this problem, and the BC government has failed to respond appropria- tely. The people of Terrace deserve better than that, Dr. Chia-Wen Hsu Terrace B.C, No dialogue Dear Sir: If Gordon Campbeli’s Sept. 19 Dialogue on Health Care forum was to be a dialogue with the people of the northwest area, why was it held in ‘such a small room, why were the people that he chose to talk to only the unelected health care elites, and why were the few in the liny public gallery ignored? If Mr. Campbell truly wanted to find out the con- cerns of the people in the northwest, then he should have taken more time and provided more people the opportunily to taik. -The record is clear. Mr. Campbell and his caucus encouraged the draconian cuts that were made by fed- eral Liberals over the last ten years, cuts that have contributed hugely to the structural problems in the health system today. Mr. Campbell enthusias- tically played the cheer-lea- der waving his pom-pom of voodoo economics. Not surprisingly, Mr. Campbell did not invite one health care representative from the aboriginal com- munities, where real health crisis exists. It is there, where the de- vastating affects of poverty can be seen in the higher infant mortality rates, the high number of deaths due to cancer, heart disease and a myriad of the other health problems that are the every- day experience of the abori- ginal communities both in the centres and the rural areas. But that is something that Mr. Campbell may not want to talk about given his oppesition to the legitimate aspirations of the First Na- tions people to provide more sustainable and self- determining lives for their communities. Larry Guno Terrace B.C. Lib forum was a sham Dear Sir: I was very disappointed, but not surprised when | showed up at the Gordon Campbell meeting. I was told the panel had already been selected and al- though I was not part of it I would be able to voice one or two concerns. It became very obvious some people were allowed to talk while others were not. This leads one to con- clude that this was nothing but a political gambit by | "Flash" Gordon Campbeil, around the perceived magni- “If a locum knows he can make something extra in ad- dition to’ his 9 aim! to 5 p.m’ billings by taking’a’ shift ‘at the hospital,’ that could act as an inducement,” said Gaulin. In any event, general practitioners here have ac- cepted an arrangement that’s separate from the $2.9 mil- lion offer. That ‘arrangement, in place elsewhere in the pro- vince, will see them being paid $10 an hour to be on- call in addition to their re- gular billings. GORDON CAMPBELL was in Terrace two weeks ago to hold a Liberal party health forum. But not everybody was happy with the results. tude of the problem, which, if one remembers, is due to the billions in cutbacks to transfer payments to the provinces, which began in 1995. [have a hard time believ- ing Mr..Campbell is even interested in improving the public health care system. How does he equate the massive tax breaks for big business, with any feasible consideration for the working and non-working folks? Those big tax breaks have to come from somewhere! Do you suppose, the al- ready suffering poor should get ready for more cutbacks? Mr. Gordon Campbell is one scary guy, | ue Gerry King Terrace B.C. Medical Briefs Six moved out SIX PEOPLE had been transferred as of last Friday from Mills Memorial to other hospitals because of the doctors’ strike. Those were peaple who were at first brought in to be treated as emergency cases and then, when stabilized, were sent elsewhere because doctors were refusing to treat all but emergency cases. The job action ended: over tie weekend after doctors and the government agreed to mediation. Another six people had been transferred out as a regular course of routine procedures since the job action began in mid-September. They were people who need treatment that couldn't be provided for here or needed to see specialists not based here. The hospital was caring for about 15 people a day under the strike, or roughly half of normal. They included post-operative patients and elderly people waiting for a long-term care bed ‘in another facility. They also include maternity cases as baby and mother care wasn’t affected by the strike. Maybe, maybe not DR. GBADE AYOADE still hasn’t said whether or not he’s moving to Terrace ta be the city’s second obstetrician. From Ontario, Ayoade spent three weeks here in late August and early September so he could check out the community and in turn be checked out by the local medical community. He then left back to Ontario, saying any decision to move here would first have to be preceded by a visit by his family so they could look.over the area. Dieter Kuntz of the focal health council did reach Ayoade last week by telephone. He said Ayoade is aware of the new offer by the provincial government which says it wants lo pay doctors more than what they now get to stay in places such as Terrace. Number crunching HEALTH OFFICIALS here continue to pore overt the new budgel sent two weeks ago by the provin- cial government. They’re trying to get at the real number of what- .ever increase there might be for patient care in lime for the Oct. 12 meecling of the Terrace Area Health Council. Once it knows the actual budget increase, itll then decide haw it'll be used. The province provided $2,015,810 more than last year for a total of $17,364,665 for Mills Memorial Hospital and Terraceview Lodge. Of that increase, nearly $500,000 is for new equipment, meaning that $1.5 million is left for day to day costs. At the same time, the new money must cover a deficit of approximately $400,000 incurred since April 1, the beginning of the new budget year. This deficit occurred because the health council was asked {o maintain services at last year’s level without getting any new money for general cost in- creases until two weeks ago. More moncy for ophthalmology surgery and. to: establish an alternate care ward for:elderly patients top the priorities list. From front Group plans new health care rally Businesses are being asked to send their employees to an Oct. 13 rally at the R.E.M. Lee Theatre beginning at 7 p.m. that’s being planned by the Terrace Health Watch Group. “T think we, as a community, have to show our support otherwise we are going to have no specialists,” Terrace and District Chamber of Commerce president Justin Rigsby said. The chamber threw ils support behind the rally after hearing from local doctors last week on why they’ve re- jected the province’s latest compensation offer and have continued their job action. “We want our businesses to support our doctors. We want it resolved,” said Rigsby Rigsby said the level of medical care in Terrace is a key component when it comes to qualily of life, and at- tracting new residents and businesses to town, “We can’t continue to - lose specialists to other communities, other parts of Canada and to other parts of the province,” he said, re- ferring ta the compensation package struck in Prince George and physicians pay- ments in other provinces. He pointed out that inter- nist Michael Kenyon told the chamber Sept. 28 that he’s considering taking a position in Nanaimo, where the pay is comparable, bul where there are better hospi- tal services and on-call § ee schedules. Rigsby suid Terrace Tom Sager stands ta lose more than just physicians and specialists if the situation doesn't im- prove, “We are in a grave situation of losing businesses and attracting businesses,” he added. Health Watch spokesman Tom Sager said public sup- porl is key to convincing the government to improve the offer. A rally in Prince George drew 6,000 people the same day a deal was signed there with doctors, It’s that doc- tors elsewhere want t o at least match. ae By contrast, Health Watch rallies in Terrace have oan 4 numbered in the low hundreds, i “They see 250 people and they don’ or ae pressure,” Sager said, referring to the health i a The first of the local meetings took place Sept. 10 and _ the second Sept. 16. Local doctors now question the province’s commit- ment to preserving specialist medical services here. “The aim of this government .is to get rid of medium- sized hospitals,” Dr. Geoff Appleton warned. “The north- west is going lo be taken care. of through Prince George,”