This year is an important year for all BC physicians. In the fall of 2005 we will begin negotiations on the Master Agreement. The Master Agreement is the foundation of our working relationship with government. It defines the fundamental premise under which physicians provide their services to British Columbians.
While the nuts and bolts of the Master Agreement are not top-of-mind to most of us and the document is far too complex to make for compelling reading, I can’t stress enough how important it is and how vital the upcoming negotiations will be. The current second Master Agreement represents the cumulative evolution of many years of negotiations with successive governments.
The Master Agreement governs the overall relationship between government and physicians, including how the payment and provision of services should be managed. The Master Agreement also contains many important provisions that protect physicians’ autonomy and supports their economic and professional well-being. Some of the provisions that could be lost or diminished if the Master Agreement is significantly weakened or eliminated include the following:
• Physician control of the Fee Schedule
• Protection against the prorationing of fees.
• Physician benefits plans such as CME support, CMPA reimbursement, the Physician Disability Plan, the CPRSP, and maternity leave.
• The Rural Recruitment and Retention payments and their value.
• Limits on the government’s ability to unilaterally change the Fee Schedule, service contracts, or sessional or salary payments.
• Protections against coercing physicians to change from fee-for-service to other forms of payment.
• Maintenance of a single Available Amount (the budget for fee-for-service) which limits government in determining where physicians can practice.
• The requirement that government reimburse physicians for the costs when it changes its data or billing requirements.
• The requirement that government meaningfully consult with the BCMA and physicians on health policy initiatives.
• The right to have separate subsidiary agreements (currently Rural, Salary, Sessional, Service Contract, and General Practice).
• The right to be represented by the BCMA during their individual contract negotiations.
• The creation of physician advisory committees, including the Joint Utilization Committee and the Guidelines and Protocols Advisory Committee.
• Physician involvement in, or control over, audit and inspection and patterns of practice.
The BCMA has previously negotiated the sole right to bargain with the government on behalf of BC doctors. This ensures that no government can divide and conquer small groups of physicians who can’t muster the financial resources and expertise needed to mount an effective negotiation.
Preparations for the Master Agreement negotiations are a top priority and you have my commitment that we will mount a vigorous defence of its many important provisions and precedents. We owe this to our many past colleagues who have given thousands of hours of their time to ensure that our rights to practise with professional autonomy are protected. We owe this, as well, to our present and future colleagues. Most importantly, we owe this to our patients, who depend on their doctors to speak for them and ensure that our health care system delivers to them the highest quality of timely medical care.
—Jack Burak, MD
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:
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- Page numbers are not abbreviated.
For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org