Victoria Divisions of Family Practice

Urban Locum Program - Greater Victoria Pilot FAQ

Please click the links below:

  1. Pilot development and operations
     
  2. Participation and eligibility
     
  3. Payments, rates, and overhead
     
  4. Locum contract, hours, and charting time
     
  5. Scheduling and matching with host physicians
     
  6. Locum orientation and support
     
  7. Host physician responsibilities
     
  8. Evaluation and quality improvement

  1. Pilot development and operations

What is the purpose of the program?

The locum program aims to address family physician wellness as well as recruitment and retention needs, provide a career pathway for new physicians entering longitudinal practice, and encourage retiring physicians to remain in practice a bit longer.

Where and when is the pilot taking place?

The program will be piloted in the South Island and the Victoria primary care networks from October 1, 2022, to June 30, 2024. It will have an ongoing evaluation that will inform conversations with the Ministry about provincial spread. The Victoria Division of Family Practice will be responsible for local implementation of the pilot in Greater Victoria.

Why is the pilot only in Greater Victoria?

Although we recognize there are significant challenges everywhere, Victoria and the South Island have an extremely high rate of patients without a longitudinal family physician (30–40%). The goal is to test this concept, evaluate the outcomes, and then, based on early results, expand it across the province in a timely way.

What are the expected timelines for the pilot?

  • Accepting locum applications: ongoing until filled
  • Accepting host physician applications: starts August 8, 2022
  • First locums in clinics: October 2022
  • Pilot end: June 2024

Who was consulted in developing the pilot program?

The pilot program working group held focus groups with stakeholders and obtained feedback. In many cases, the suggestions were integrated into the proposal. Stakeholders included: family physicians, residents, locums, divisions of family practice, the health authority, and FPSC. Care was taken to coordinate with the Rural Coordination Centre (the home of the Rural Locum Program).

How is the program administered and supported?

The Victoria Division is responsible for the local administration, coordination, and reporting. The FPSC provides provincial leadership, coordination and oversight of the program’s evaluation, financial management and accounting.

How is the program funded?

The BC Ministry of Health is funding the locum contracts and overhead. FPSC is funding the program administration over the pilot period.

Pilot participation is limited to hosts covering 0.5-1.0 Full Time Equivalents who work in Longitudinal Family Practice. Why?

These criteria were agreed upon during the program’s creation, and again by the pilot’s Oversight Committee, as a way to initially limit the scope of work and create manageable parameters while we build our pool of locums, and for the purpose of testing the concept and evaluating outcomes. In the future, and with successful evaluation results, the goal is to rapidly expand the program across the province and to a wider demographic of family physicians.

How does this program relate to the Rural GP Locum Program?

The program meshes and complements the rural locum program. The Urban Locum Program was designed to support the Rural Locum Program—as opposed to conflicting with it.

Further anticipated work includes collaborating with the other Joint Collaborative Committees, rural communities, and mid-size communities to develop a comprehensive provincial urban locum program. More information about this effort will be shared in the fall of 2022.

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  1. Participation and eligibility

Who is eligible?

Eligible host family physicians:

  • Are a full-service family physician working a minimum of 0.5 FTE providing clinic-based longitudinal care to a panel of patients
  • Are a member of their local primary care network (PCN) in Greater Victoria (Victoria, Westshore, or Saanich Peninsula)
  • Agree to the program’s Memorandum of Understanding (MOU), including hosting rules and responsibilities

These criteria were agreed upon to initially limit the pilot scope and create manageable parameters while we build a pool of locums, and for the purpose of testing the concept and evaluating outcomes. In the future, and with successful evaluation results, the goal is to rapidly expand the program across the province and to a wider demographic of family physicians. If there is a surplus of locums during the initial pilot phase, criteria will be expanded at that time.

Eligible locum physicians:

During the pilot, preference will be given to new-to-practice physicians from inside and outside of BC who are not currently attached to a patient panel. In addition, family physicians nearing retirement who are seeking increased flexibility or work/life balance and international graduates are anticipated to participate.

In what hour increments can host physicians request daily coverage?

Host physicians can request coverage for 4-hour half days of service or 8-hour full days of service.

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  1. Payments, rates, and overhead

How much are locums paid?

Locums are paid $1175.80 per 8-hour day of service for the first 60 days, pro-rated for any partial day of service. The daily rate increases to $1275.80 from day one once locums complete 60 days of service (paid retroactively in a $6000 bonus). Calculation of the completion of 60 days of service will include both full days of service and any accumulated partial days of service (e.g., 55 full days of service and 10 half days of service).

How are the locum physicians paid?

The payment for in-office work will be through a contract, offering a guaranteed payment per day. Hospital, maternity on-call, and work done outside the contracted hours can continue to be billed to fee-for-service.

Is the $1175.80 the take-home amount?

Yes, $1175.80 is the take-home amount.

What is the program's overhead payment to host physicians?

The program's overhead payment to hosts is $404.76 /day (pro-rated for partial days).

How was the daily compensation rate decided?

The program’s working group reviewed multiple contracts available to family physicians in BC in order to make recommendations on a compensation model. 

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  1. Locum contract, hours, and charting time

Are locum physicians obligated to cover a specific number of shifts once the contract is signed?

You are not committed to any specific dates of coverage, nor do you have to provide a minimum number of assignments. Being part of the ULP does not prevent you from doing private locums or other work. ULP will fit to your schedule. We do ask that locums provide an estimated range of days of service for the term of the contract in order to assist the program in knowing how many locums are required to fill the requests throughout the term. The locum has the flexibility to accept coverage dates that work with their schedule.

Do locums have the right to decline an assignment if it is given with less than 14 days of notice (see article 12.3 of the contract)?

Yes, locum physicians have the right to decline an assignment as it is a “request”.

How many patients are locums expected to see per hour?

Program staff work with each locum and to determine the appropriate number of patients per hour for each assignment, taking into account many factors including if you are newer to practice, if the clinic is new to you and if you are unfamiliar with the EMR. 

What time is given for charting?

Historically ULP locums have been following a roughly 3:1 direct/indirect patient care ratio, though there is flexibility for each locum based on your experience level, familiarity with the clinic and EMR and other factors.

What is considered indirect patient care?

Indirect patient care means patient-specific service provided when the patient is not present. Examples of indirect patient care include, but are not limited to patient-specific conferences, team meetings, telephone consultations and chart/report writing, review and follow up of lab results and other patient related correspondence.

Can locums work under this contract in conjunction with other payment forms (i.e., FFS, LFP, hourly rate paid by physician on group contract, or the Rural Locum Program)?

Yes, locums can work under more than one contract or payment form as long as that work is completed outside of the physician’s contracted ULP pilot hours.

Are there evening or on-call requirements for locums?

No, there are no evening or on-call requirements. All contracted hours are to take place in-clinic, between regular weekday business hours. If a locum does decide to do any work on behalf of the host physician out-of-office/out-of-hours (e.g., hospital or home visits) it must be billed to fee-for-service outside the contracted hours.

Can locums decide to do out-of-office/out-of-hours work (e.g., hospital or home visits) on behalf of host physicians?

Yes, locums can decide to do out-of-office/out-of-hours work for host physicians; however, this must be billed outside the contract.   

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  1. Scheduling and matching with host physicians

Will locums work in one clinic per coverage request, or several?

Coverage requests are based by clinic and can vary from partial to full weeks. Depending on the offerings and what shifts locums are interested in, locums might decide to work all week in the same clinic or part-time at one and fill in shifts at another.  

For ease of coordination and consistency, and to give locums a better chance of being in a clinic for a longer duration, we are encouraging multi-physician clinics to consider taking back-to-back weeks.

Is there flexibility in scheduling (e.g., 2-3 days per week)?

There is certainly flexibility with scheduling, however, this will depend on the available practice coverage offerings.

What is the process for matching and scheduling shifts?

The ULP Program is using an online scheduling platform called Connecteam, with the ability to post and claim shifts via a mobile and web application. The ULP Project Team posts all host physician coverage requests on this platform and ULP locums are able to claim shifts directly from the platform. All new locums to the program are provided with orientation on the use of Connecteam and feedback thus far has indicated that the platform is intuitive and easy to use.

What happens if there are not enough locum participants to support the needs of interested host physicians for the duration of the pilot?

Presently we have greater host need than available locums, so we are encouraging hosts to select coverage dates that do not fall during peak times in order to increase the likelihood of a match. We post all host physician requests and encourage flexibility from both the hosts and locums. It is our hope that as the program grows, our locum pool will be such that we can support the needs of all interested local physicians.

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  1. Locum orientation and support

Is locum orientation provided for new clinics (e.g., EMR tutorials)?

Yes, up to two hour of orientation will be provided at each clinic that is new to the locum, and this is included in the locum's billable hours. Our hope is to try to match locums with EMRs they are familiar with or interested in learning. However, if this is not possible, an EMR overview would be provided by the host physician clinic.

Is there orientation available for locums that are new to Greater Victoria?

Yes, any locums new to Greater Victoria can connect one-on-one with a program mentor to receive a general orientation (e.g., community services, Island Health services, etc.) and can be taken through sign-up for Pathways and other local systems.

Will locums have access to qualified MOAs for the duration of coverage?

Yes, access to qualified MOAs for the duration of locum coverage is required by the host clinic.

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  1. Host physician responsibilities

Where can I see a list of the host physician responsibilities?

You can view the host physician roles and responsibilities within the Memorandum of Understanding (MOU).

What assurances are in place to ensure that labs/tests/consults ordered by the locum are followed up on?

Host physicians have to sign a Memorandum of Understanding indicating that they will make all necessary patient follow-ups after the locum’s coverage is complete.

Who would be responsible for checking critical results/tests/consults on the weekend or non-clinic days?

It is the host’s responsibility to secure after-hours and on-call coverage for their attached patients for the period of the locum coverage. Locums are expected to follow up on non-critical results the next clinic day.

Tasks during shift: Locums are responsible for inbox tasks during their shifts

Urgent After-Hours: Critical tasks after hours/weekends go to clinic's after-hours coverage

Non-Critical After-Hours: Locums handle non-critical tasks next business day

Coverage Gaps: Locums are not responsible during off-duty gaps (i.e. Locum works 4 out of 5 days)

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  1. Evaluation and quality improvement

What’s the purpose of the evaluation?

Provincial oversight and evaluation of the pilot will enable FPSC to learn how a locum coverage program can be an effective tool for recruitment and retention of physicians in community-based longitudinal family practice, particularly in under-served communities, and to build appropriate structures and supports in preparation for an expanded provincial roll-out of the program, if future funding is secured. Should the locum coverage program expand to other BC communities in the future, the leadership role of the FPSC may also evolve and expand accordingly.

Are there any requirements to participate in evaluation activities?

Both locums and hosts will be required to participate in the evaluation of the efficiency, quality, and delivery of the Urban Locum Program pilot (e.g., peer and interdisciplinary reviews, surveys).

Where can I provide feedback?

Feedback can be provided on our online feedback survey. 

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Return to How to apply

Have more questions? Please contact Becky Litt at

urbanlocumprogram@victoriadivision.ca 

FPSCBritish ColumbiaDoctors of BC

The Divisions of Family Practice acknowledge that we work on the traditional, ancestral, and unceded territories of many different Indigenous Nations throughout British Columbia.

Acknowledging that we are on the traditional territories of Indigenous communities is an expression of cultural humility and involves recognizing our duty and desire to support the provision of culturally safe care to First Nations, Inuit, and Métis people in BC.