Working the service

Updated November 18, 2024

Table of contents: 

Who can work the service

Family physicians who are members of the following divisions of family practice can sign up to staff the service:

  • Langley Division of Family Practice
  • Shuswap North Okanagan Division of Family Practice
  • South Okanagan Similkameen Division of Family Practice
  • South Island Division of Family Practice
  • Thompson Region Division of Family Practice
  • Victoria Division of Family Practice

How this differs from traditional call

When thinking about staffing the After Hours Care program, many physicians assume it will be similar to traditional “call.” It is quite different:

Aspect Traditional call After Hours Care
Purpose
  • Meant for urgent medical issues that can’t wait until the office re-opens.
  • Also handles critical results from lab, medical imaging, pathology, and calls from other physicians.
Staffed
  • Whenever the family practice clinic is closed.
  • Does not cover weekdays from 9:00 a.m.—5:00 p.m.
Shift duration
  • Typically overnight; may be for multiple days.
  • 3–4 hours depending on time of day and day of the week.
Availability of on-call physician
  • Only requirement is the ability to receive a phone call/page; e.g., might be at a grocery store, sleeping, etc.
  • Required to be in front of a computer for the shift duration, monitoring a list of patients who are waiting for a call back; i.e., not sleeping, even during the 3:00—6:00 a.m. shift.
Compensation
  • When physician speaks with a patient, they may bill fee-for-service for that encounter or bill the LFP Payment Model for that encounter + direct patient care. Under an APP (Alternative Payment Plan) contract such as the NTP (New-to-Practice) contract, care coverage after hours may be included in the overall contract compensation.
  • Hourly compensation regardless of the number of calls.
Call documentation
  • May vary with expectations of the call group.
  • Encounter SOAP note is created and sent to the patient’s longitudinal family physician or nurse practitioner.
Billing
  • Required.
  • Monthly invoicing is handled by the After Hours Physician Group on behalf of the staffing physicians.
Call volume
  • Varies with number of physicians participating in the call group but can range from no calls to many calls overnight.
  • The number of calls can fluctuate depending on time of day and day of week. Administrative calls and lower acuity calls are handled by the Navigators and Nurses respectively. There are also processes such as “call pause” to ensure the volume does not overwhelm the staffing physician.
Main complaints
  • Patients call with any issue such as cancelling an appointment, asking for a sick note, or calling with chest pain and shortness of breath. 
  • Only calls about symptoms/medical issues will be triaged to physicians staffing the service.

Expectations

Onboarding, training and support

  • Compensated training will be provided as part of the onboarding process that covers HealthLink BC’s EMR (MOIS), how to use Zoom, and how to access shared resources.
  • Access to CareConnect, Pharmanet, and HealthLink BC's EMR, will be provided to physicians working the After Hours Care program. 
  • As the program is simultaneously covering more than one region, you will receive calls from outside your local area. You will have access to community overviews and lists of resources such as hours for the nearest emergency department, location of nearby after-hours pharmacies, etc. However, as the program focuses on semi-urgent and urgent issues, many of the connections to services that you would make during a clinic day won’t be required after hours.

Answering calls

While efforts are made to ensure that the service is for urgent issues experienced by attached patients in community, we recognize that some calls may be connected to physicians working the service that fall outside of this. It is difficult to develop black and white rules when many issues may become urgent depending on time of day, day of week or some other circumstance.

In such a case, the expectation is that the staffing physician does their best to manage the patient’s issue—which may include referring the patient to the emergency department or even back to their longitudinal family physician or nurse practitioner in community—and notify the Clinic Program Support team after the call is complete so that processes can be modified to help better direct calls.

Working shifts

  • The expectation is that in return for hourly compensation, you will be working for the duration of your shift, which involves monitoring the EMR queue of patients and calling back as required. Logging into the EMR for the duration of the shift to monitor patient notifications is required for your review and response to patients.
  • We're asking people who sign up to work the service to sign up for a minimum of 3 shifts (9 hours) per month (split fairly between evening, overnight and early morning) so they don't need to repeat training on how the service works.
  • The shifts are short (3–4.5 hours) so that they shouldn't adversely affect the following day's clinic hours. 
  • Physicians will be able to sign up for consecutive shifts (e.g., 11:00 p.m. to 3:00 a.m. and 3:00 a.m. to 6:00 a.m. if that is more convenient for scheduling.
  • Physicians are asked to work an average of 3 shifts per month, and at most 10 shifts per month—these numbers may vary depending on the number of physicians signed up to work the service and the anticipated patient demand.

Compensation

  • Family physicians are paid through an hourly physician group contract with the Ministry of Health. The Ministry's funding envelope complies with the Physician Master Agreement. 
  • The After Hours Physician Group sets the actual compensation rates to drive desired service delivery, recognizing that:
    • The service is compensating for time during each shift and not volume of calls. (While there is no minimum, the maximum number of calls will be 3–5 calls per hour based on how long it actually takes to address those calls and chart.)
    • As this is an extension of the work of longitudinal family physicians, compensation must be consistent with and in consideration of other available opportunities such as working in-clinic, as a hospitalist, or at a UPCC.
    • The service is offered during less desirable times to work.
  • If you have any questions about compensation, please email ahcp@doctorsofbc.ca.

Sign-up form

Sign up to work the service