The shape of things to come…


The Minister of Health announced today that his department and the New Brunswick Medical Society have agreed upon a new contract for New Brunswick fee-for-service doctors.  No details are available at this time and the agreement will not be in force unless it is ratified by the affected physicians.

I have never had much luck predicting the future, but that doesn’t stop me from trying.

Here’s how I expect it will play out…  figures are approximations only.

There will be no raise in the new contract.   There will be a one time offer of $16,000 for any doctor who signs on with the Velante EMR program.   NBMS will pitch it as a clever way to extend the handout previously offered via the Canada Health Infoway.   They will claim it amounts to an effective 4% increase over each of the two years of the contract, assuming average gross billings of $200,000 ($8000/$200,000 x 100 for two years).  Those who have already qualified for Infoway funding will get nothing (but who cares, they are already caught in the web).  Those who refuse to switch EMRs will also get nothing and will be deprived of the fee increase they might otherwise have received.

From the Velante perspective this is brilliant.   It effectively extends the “pot o’ gold” for another two years and presents doctors with a choice of getting nothing, or getting a handout for buying the Velante product.  It is even possible that the government will get sucked into paying the money up front for any “enrolled” physician, where it can be invested, or used to pay the Velante staff, or incrementally doled out as the sales folk continue to badger more people into signing on.

From the DOH perspective it is also brilliant.   It gives the illusion of offering something of value to doctors.   However, the underlying DOH assumption is that doctors didn’t like Velante before, and they won’t like it now.   DOH will end up paying virtually nothing because very few fee-for-service doctors will buy into Velante, and the DOH will have neatly and effectively dodged any fee increase for doctors.

The only people who won’t like this scheme are doctors.    We have already determined that the Velante plan is doomed and physicians don’t like having it crammed down their throats.  Doctors will be left with the equally unappealing prospects of getting 0% and 0% on the contract, or reaching for the cash and buying into an EMR program we don’t like and don’t want.    If we complain we will be painted as not being team players, or moneygrubbers.


If this, or something close to it, is the deal that is offered, doctors should vote it down and send both parties back to the drawing board.

The fee-for-service contract must not be linked to the EMR program.   They are separate issues and the provisions of the former must not be used to coerce doctors in to accepting the latter.


One thought on “The shape of things to come…

  1. Well, I was half right. The negotiating committee did manage to wring out a increase in fee-for-service Medicare payment with the new contract. Unfortunately there is also a provision to pay off users of competing EMR vendors to switch to the Velante product. As predicted, no effort has been made to follow the wishes of the NBMS membership, and promote a competitive, inclusive EMR milieu, which would provide doctors with more than one software choice, and avoid the establishment of a disastrous corporate monopoly. Instead, we are offered further misuse of taxpayers’ money. Sad, but predictable.

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