The college is on the record recommending or suggesting that we need to take another look to broaden our horizons with regard to how we pay physicians.
Many of the patients we look after in family practice are people who have comorbidities, several medical conditions going on at the same time. Many have chronic conditions. The proportion of frail elderly in our practices is rising. Therefore, looking after these people well, we feel, requires a broadening of how we look at this.
Some of the models, which I described earlier, have a model of payment that is what we refer to as a “blended funding model”, where a physician gets a fee or the practice gets a fee per patient per year to look after them, and then there are some services within this that are provided where there's a fee-for-service component.
This is a model that we would suggest is the preferred model, and certainly might facilitate a more comprehensive and proactive caring for patients.