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081028 Physician Recruitment MINMINUTES: Meeting for the Committee "Physician Recruitment and Retention Committee" Moved by Tom McHugh Seconded by David Morris AND RESOLVED THAT THE Minutes of July 2, 2008 be adopted as presented. "Carried" BUSINESS ARISING FROM THE MINUTES 1. Proposed Incentive Program Status Tom McHugh outlined that Dr. Rowland has had a commitment from the committee for $60,000 and has a potential doctor. Tom outlined that we entertained a recruit who is both a family doctor and an anesthesiologist over the last few days. We had previously paid for a potential recruitment to Core Health that did not materialize. Therefore, this new person could be received for a discounted rate. Of the $180,000 these are the claims against the program. There was an original program of $60,000 that had a payment into the clinics over a period of time should they receive results. This did not seem to be very productive so we contracted with Core Health. $75,000 was committed to Core Health and we were looking for three. We paid a downpayment of $26,000 to Core Health and if the next recruit comes we can use this downpayment as credit toward that program. There is potential funding program to pay for underserviced areas and there is also REAP - relocation expenses. 2. Recruitment Activities FMRW - We are going to this conference - Core Health will be attending. Anyone interested in this was asked to let Tom McHugh know. It is December in Grand Bend. Him - over the years it was the same as previous years. This was not as productive as some other things. Several were second or third year medical students. We have made email contact with any that made contact with us at that show. Suzanne represented us. 3. Display Board/Promotional Materials, etc This item to be eliminated. 4. Family Medicine Residents This is FMRW and can be covered under recruitment activities 5. Sponsoring Electives for Medical Students/Residents at TDMH MINUTES: Meeting for the Committee "Physician Recruitment and Retention Committee" Keep this on but nothing to report at this time. 6 Strategy for Candidates already.practicing but looking for a change Remove. 7. SWOMEN Tour 2008 PAIRO - Keep this on. 8. Local Kids Activities Keep that on but nothing to report at this time. NEW BUSINESS 9. Fact Sheet - Family Health Organization (requested by Dr. Roth, to be circulated) 10 21 FHO Fact Sheet (draft 1).doc This item was introduced and explained by Dr. Lamb. Previously we were all on a fee for service program, billing CHIP for visits. Recruiting in the office meant reducing the overhead for the office by having an additional help available. Then we became a Family Health Organization where we are paid a monthly amount per patient based on the age per year. Now recruiting to have an additional person means that not only do not make additional funds but if the recruft sees one of our patients we have to pay that individual. Discussion regarding a capping amount of the number of patients. The new doctor has no patients coming in but has time to build up thefr.practice and will probably take a year or two to build up there clientele. Recently we have added two new doctors in two of our offices and they did not haXe individuals beating down their door. Also, surveys indicate that Oxford County has one of the lowest rates of people reporting not having a family doctor in Ontario. Discussion was held regarding how the payments between doctors and members of the FHO. There are three local FHO's The limit is 2500 patients per doctor so with 6 doctors are 15,000. This system set up by the province is not very enticing for new doctors. In the new system a now doctor gets paid $176,000 but they have to pay expenses out of that and they cannot bill OHIP out of that. Any work at the Hospital outside of the office are separate and can be billed per service. The Doctor must come up with 1100 patients before they can be at a level to be a part of the FHO. Discussion regarding pre-rostering clients and building up a clientele before you get a doctor however the province will not allow this unless you have a contract ahead of time. You can have patients sign forms saying they require a doctor. This is s'disincentive to getting a new doctor. If the town wants to encourage new doctors it would cost $75,000 for six months to subsidize this new doctor. Can a doctor work in a FHO office and not be a FHO member? Yes, but every time this new doctor works in an office and sees the FHO doctor's patients it will cost those FHO doctors. Dr. Lamb considered that MINUTES: Meeting for the Committee "Physician Recruitment and Retention Committee" the new doctor will be billing CHIP for other projects that will help cover some of the costs of those doctors. You are more motivated to replace someone. If there is a retirement you can move someone's clientele over to a new doctor right away. If we choose to subsidize a doctor to enter into an existing office it could be structured to reduce overtime as they build their clientele. Discussion regarding the amount of demand for doctors. Holowachuk wouldn't take a patient if they had a doctor already in town but if they had a doctor outside of town he would take them. In six months he was able to take on 500 new patients. Optimum numbers for a FHO doctor is around 1500 - 2500. Tom McHugh - From the hospital's perspective there is an envelope of money and it is up to this committee to decide how many doctors we need. I see it as we may not need as many doctors as we thought. This may mean we have more funds to concentrate toward specific goals. For the new doctor (Ed) it will only cost $15,000 more. We will lower our doctor requirements we knew the number we had was not a firm number. If decide to do this we need to speak with the same voice and say there are enough doctors at this time. Then we can proceed with a slower and steady recruiting system. We must be aware that this does not mean that people won't occasionally have long delays to see their doctor for certain things but that is a factor of how doctors get paid which is out of our control. Also some people may dislike their doctor and not be able to change. This will still happen but it will be a considerable minority. Dr. Lamb - When we speak of subsidy we are not going to make a profit Discussion regarding how doctors retire. A doctor normally gives his partners ample warning. Discussion regarding the requirements of human rights to sign up patients in the order the come regardless of any merit this ensures that doctors do not accept new patients. Tom McHugh - From the hospital's perspective - we are going to say we are using the same pot of money - just using it in a flexible way. Once this crisis is over we use the same format and group that we currently use. We are on the cusp of adding two new doctors and that is good news but we must all communicate that this is great news. Tom McHugh - Can prepare a brief synopsis to the committee and 1 don't think we need a motion from the hospital. Brian Stephenson - If there is a doctor shortage - the FHO is a detriment. Dr. Lamb - I think it is an unexpected consequence. Brian Stephenson - Do we need to oppose this system? The group responded unanimously - NO! Dr. Lamb we all want physicians to take care of our people - if a new physician recruited to this system are not being subsidized by the office that they move into - we are all (at this table) sharing the cost of this system. Dr. Holowachuk - FHO's are good - they are awkward and difficult for a year or so - but after that it is very worthwhile Dr. Rowland - If we need a small group to work on the next steps, be glad to help. MINUTES: Meeting for the Committee 'Physician Recruitment and Retention Committee" John Moylan - I am willing to support the expenses for the first year. Discussion was held regarding the amount of subsidy;. ROUND TABLE > NEXT MEETING ADJOURNMENT Moved by Dr. Roth Seconded by David Morris AND RESOLVED THAT the meeting be adjourned. "Carried" Town of Tillsonburg Approval Received: (1 of 1) Lana Lundlrillsonburg (Thursday March 11, 2010 02:22 PM)