Canada’s past decade has seen important progress in physician pay for on-call availability. The journey in British Columbia has been fractious, with uneven gains between various groups. While the gains in the recently ratified BCMA Master Agreement are substantial for some members, unfortunately major inequities are entrenched for many isolated and rural practitioners.
At the root of the issue is the government’s MOCAP “callback” category that denies availability pay to physicians in call groups of less than three. Such physicians are put in the untenable position of either refusing to provide coverage (College bait), or providing the coverage without the tens of thousands in availability pay other BCMA members are receiving.
As we witnessed after the Prince George agreement, such extreme inequities can induce chaos into the delivery of care. Undoubtedly, many callback doctors will seek “deep cover” on principle; to deny the coverage that is not being funded. Other callback doctors will continue to put patient interests ahead of their own, but seethe with anger and resentment while doing so. All callback status physicians will face tremendous challenges with retention, recruitment, and locums.
I have spent the last 6 months imploring, even pleading, with the BCMA, the SSPS, and the BC College to be proactive and help avert the carnage. Each one acknowledges the proposed callback system is likely to prove inflammatory, however these organizations seem surprisingly content to watch from downtown Vancouver as the human toll unfolds across the province. Arguably, on-call pay gains have been largely won by the direct actions of the most isolated and rural physicians, and not the BCMA itself. How ironic that these isolated members, or their families, should now have to screen telephone calls, or blatantly lie to colleagues and friends to assert their hard-fought right for paid on-call availability.
So, if our leaders will not lead, once again it is up to the rank and file to act. Numerous actions are a certainty at individual and local levels. At the political level, the SSPS is particularly vulnerable on the callback issue because they must enroll 50% of eligible membership to exist. I urge those who support callback physicians to join me in returning the 2003 SSPS application unsigned (ditto the cheque), and a note offering to sign when they have delivered their constituents effective representation.
Recent history should have taught the Ministry and the BCMA that they ignore the plight of isolated physicians at their peril. MOCAP’s callback status must and will ultimately disappear. What actions will you take to expedite your profession achieving a stable and equitable paid on-call system?
—Kelly Silverthorn, MD
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