Practice and payment preferences of newly practising family physicians in British Columbia.

OBJECTIVE

To examine the remuneration model preferences of newly practising family physicians.

DESIGN

Mixed-methods study comprising a cross-sectional, Web-based survey, as well as qualitative content analysis of answers to open-ended questions.

SETTING

British Columbia.

PARTICIPANTS

University of British Columbia family practice residents who graduated between 2000 and 2009.

MAIN OUTCOME MEASURES

Preferred remuneration models of newly practising physicians.

RESULTS

The survey response rate was 31% (133 of 430). Of respondents, 71% (93 of 132) preferred non-fee-for-service practice models and 86% (110 of 132) identified the payment model as very or somewhat important in their choice of future practice. Three principal themes were identified from content analysis of respondents' open-ended comments: frustrations with fee-for-service billing, which encompassed issues related to aggravations with "the business side of things" and was seen as impeding "the freedom to focus on medicine"; quality of patient care, which embraced the importance of a payment model that supported "comprehensive patient care" and "quality rather than quantity"; and freedom to choose, which supported the plurality of practice preferences among providers who strived to provide quality care for patients, "whatever model you happen to be working in."

CONCLUSION

Newly practising physicians in British Columbia preferred alternatives to fee-for-service payment models, which were perceived as contributing to fewer frustrations with billing systems, improved quality of work life, and better quality of patient care.