Family Medicine: Toronto vs. Vancouver

[DoctorORG]

Hi everyone,



I am graduating from a family medicine program in US and moving back to Canada. I am from Toronto originally but I am thinking of maybe moving to Vancouver.


I am wondering if anyone have insights on potential income difference between the two province? Some of my friends have mentioned to me that generally physicians in BC are paid less than Ontario GPs. Is this true? (Given equal number of patients per day in FFS setting).


I also know that new GPs joining a FHO group in Toronto (if lucky!) will be paid around 200k (before overhead) for a roster of ~900 patients and will increase as the roster increases in subsequent years. This is way below what FFS doctors are making in Vancouver area. So I’m confused of why the general census is that FHO pays really well in Toronto etc?


Thank you

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[bearded frog]

I don't have the answers you seek, but you can look up billing fees for each province to compare, if that helps.

 

[DoctorORG]

I don't have the answers you seek, but you can look up billing fees for each province to compare, if that helps.

Thank you for your reply.

BC pays 15% less on FFS ($36.85 vs. $31.62), that means that for every 40 patients you see in ON you'd have to see 46 patients in BC to get the same amount of compensation (assuming that you see 40 patients per day). However, the argument stems from the fact that FHOs in Toronto are getting $280 on average for females and $210 on average for males for each patient rostered (I can send you the link of where this information comes from), so if you have a patient panel of 1200 patients in Toronto with 50%-50% male vs female, you'd be having a salary of $294,000. Now, let's assume that 1200 patients visit you 4 times each during the year, that would be around 5000 visits per year that you'd have to fulfil. If you work 4 days a week and 50 weeks a year, that'd be 200 days of work, so 5000 visits / 200 days = 25 visits per day. In FFS if you see 46 patients in Vancouver for the same amount of work (200 days / year) you'd be doing 9200 visits which would be equal to ~$298,000 / year. So in Ontario you'd be seeing 25 patients per day, in BC you'd be seeing 46 patients per day to make the same amount of money. That's working twice in BC to making the same amount in ON (if you had a FHO practice).

Where am I going wrong with this calculation?

 

[Gos81238ia]

Thank you for your reply.

BC pays 15% less on FFS ($36.85 vs. $31.62), that means that for every 40 patients you see in ON you'd have to see 46 patients in BC to get the same amount of compensation (assuming that you see 40 patients per day). However, the argument stems from the fact that FHOs in Toronto are getting $280 on average for females and $210 on average for males for each patient rostered (I can send you the link of where this information comes from), so if you have a patient panel of 1200 patients in Toronto with 50%-50% male vs female, you'd be having a salary of $294,000. Now, let's assume that 1200 patients visit you 4 times each during the year, that would be around 5000 visits per year that you'd have to fulfil. If you work 4 days a week and 50 weeks a year, that'd be 200 days of work, so 5000 visits / 200 days = 25 visits per day. In FFS if you see 46 patients in Vancouver for the same amount of work (200 days / year) you'd be doing 9200 visits which would be equal to ~$298,000 / year. So in Ontario you'd be seeing 25 patients per day, in BC you'd be seeing 46 patients per day to make the same amount of money. That's working twice in BC to making the same amount in ON (if you had a FHO practice).

Where am I going wrong with this calculation?

Your estimates on yearly payments for FHO patients might be a little high; varies based on your age skew - FHO Model Payment Summaries also don't forget in a FHO you can lose money if your patients access care at walk ins etc. FFS docs are also usually excellent billers since your whole income depends on billing skill, lots of little detail things you can potentially bill for if you know the billing schedules inside and out. But yes, the benefit of a capitation model in general is you can earn the same if not more for less patient visits, but you can spend more time during your visits managing your patients well. FFS docs can certainly outbill a FHO doc's yearly capitation if they are able to see a large amount of patients daily and consistently and bill well for them.