Dr Leo Dai’s workday doesn’t end when his Burnaby clinic closes.
The family physician works late into the night poring over lab reports and updating charts for his 2,000 patients. It has been that way for the past decade because a full panel means he has no choice.
But thanks to the Longitudinal Family Physician (LFP) Payment Model, Dr Dai now has more help. Since the LFP came into effect in February 2023, Dr Dai has recruited five full-time equivalents of family doctors to his clinic.
Many of the new physicians came from other provinces like Alberta — as well as two from the United States.
“After the LFP model came out, BC became the most attractive place for family doctors,” says Dr Dai, who is currently serving as the Board Chair of the Burnaby Division Family Practice. “We were able to recruit quite a few doctors who started in longitudinal care, and they wouldn’t have done so if not for the LFP model.”
The Ministry of Health with Doctors of BC and BC Family Doctors developed the LFP Payment Model in response to an urgent need to retain and attract family physicians in community longitudinal practice by compensating them appropriately for the work they do.
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Read more about the LFP Payment Model:
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Dr Dai says having more doctors has meant expanded cross-coverage and same-day appointments for his patients, who are mostly Chinese speaking. If he’s busy, patients who need urgent care are more likely now to get care from another doctor on the day they need it.
“We tried to make same-day appointments available even before the LFP model, but LFP definitely made it easier,” he says.
The model also allows new physicians in his clinic to chart their own course in terms of patient loads and work-life balance, Dr Dai adds. This, in turn, means more quality care for patients.
“They have that time to really get to know their patients, to build their panels and to review those old records,” he says. “They have the option to really take their time and provide quality care.”
For Dr Dai, who has an established practice, the model has also translated into a pay boost, compensating him for everything he does in a day while covering the rising costs of running a practice.
Thanks to the LFP model, he is paid for everything he does to care for his patient panel, including patient visits, care coordination, and required paperwork.
“I practiced under fee-for-service for quite a long time and the LFP model was quite refreshing,” says Dr Dai. “Changing over to LFP did not really give me the opportunity to spend more time or expand my panel because I was already at full capacity. But what LFP did for me, is it really compensated me for all the work I was already doing for free.”
In the past, Dr Dai would have had to see more than three patients per hour to sustain his overhead. This was tough because besides patient visits, Dr Dai is the medical director of his group practice, dealing with patient complaints, college requirements, supervising provisionally licensed physicians, and medical teaching.
When he previously brought in a student, Dr Dai says he would lose money because he had to book fewer patients. Now he gets paid at least $130 per hour regardless of the number of patients he sees while teaching. “We don’t get much of a stipend having learners around so it was a bit of a pay cut for doing work we enjoy doing and I feel we should be doing. And it’s nice the longitudinal fee code does compensate for that teaching,” Dr Dai says.
The new time fee codes also kick in for mental health visits. Under the old model, Dr Dai would spend up to two hours with a patient “who needs to be listened to and needs the time,” but could only bill $50 for a counselling visit. The LFP model means he is compensated for the additional care he provides.
“That’s a huge difference if I need to spend that time,” he says.
“It is a game changer,” Dr Dai says. “Interestingly, in our practice we have a few physicians nearing retirement, and they told us that because of the LFP they want to work a bit longer.”