Rural Retention Program Review

Rural Retention Program Review

The Rural Retention Program (RRP) Review is a two-year, comprehensive evaluation to improve RRP’s stability and relevance as a policy lever to attract the next generation of physicians to rural British Columbia (BC). The Review is guiding the Joint Standing Committee (JSC) on Rural Issues in improving RRP’s rural points methodology and eligibility criteria and is one of the largest consultations of rural physicians to ever be conducted in BC.

Achievements & Impact

Developed a comprehensive knowledge base and recommendations to the JSC  to stabilize the RRP

 

 

 

Consulted health authorities on RRP eligibility criteria

 

 

 

 

Submitted final report to the JSC and contributed to a more stable, sustainable, and robust program to serve rural physicians’ needs 

Rural Retention Program Review Overview

Throughout the course of the past year, the RRP Review team led by Dr. Ed Marquis and Doug Blackie, developed a comprehensive knowledge base and, using a collective action approach with key system partners, a set of recommendations to stabilize the RRP by reducing the year-over-year variability of rural points. The new ‘rolling average’ system was described by one partner as “beautifully simple” in that it introduced a five-year average system to mitigate annual adjustments in RRP points (due to changes in some rural factors). As a result, RRP points may change each year, but the impact of that change is spread over an average of the preceding four years. This enables points to change marginally each year, thereby reducing the financial impact on physicians (due to changes in the RRP payment) and/or eligibility for rural support programs. These recommendations are being implemented by the JSC, effective April 1, 2021.

The RRP Review team also undertook a series of workshops with medical and administrative leads at health authorities to evaluate the RRP’s eligibility criteria. The evaluation tested the hypothesis that the current criteria (requiring physicians to live in a rural community for nine months of the year and earn in excess of $75,000 per calendar year) may disenfranchise some physicians from taking parental or medical leaves, modifying their practice patterns for personal or professional reasons, or contemplating a pre-retirement reduction of their practices. The RRP Review found that, while the current criteria is robust and flexible, there is an opportunity make minor adjustments that are more reflective of changing physician practice patterns. The RRP Review team tabled two key actions and eight recommendations to improve the RRP’s eligibility criteria to the JSC in November 2020. The team further recommended that the JSC’s Evaluation Working Group consider these proposed actions for future implementation.

The RRP Review team issued its final report to the JSC on March 31, 2021. The Review has resulted in a more stable, sustainable, and robust program that will serve the needs of rural physicians well into the future. In addition, the foundational work undertaken by the Review, including the rural physician survey, literature review, and environmental scan, are legacy resources that will support policy analysis and JSC discussions.

How have we shown or built resilience in BC during a challenging year?

“The RRP Review demonstrated the resilience of rural physicians to provide generalist care to their communities, often under demanding circumstances. Our work is dedicated to those rural physicians who provide the full spectrum of care—prenatal, primary, surgical, emergent, chronic, and end-of-life—in rural communities throughout British Columbia. The Review, itself, was impacted by the pandemic, which forced our team to quickly pivot from in-person to virtual collaboration to complete its engagement work with health authorities, the Ministry of Health, Doctors of BC, and the Joint Standing Committee on Rural Issues.”

Dr. Ed Marquis
Medical Lead, Rural Retention Program Review, RCCbc

“Rural physicians in BC often face considerable professional and personal challenges and these have been exacerbated by the COVID-19 pandemic.  The improvements to the Rural Retention Program help to stabilize the program and,  more importantly, recognize and value the ongoing commitment and resilience of rural physicians to provide care in their communities during these demanding times.  The RRP Review itself was caught up in the pandemic and required our team to become virtual and nimble to constructively engage with rural physicians, health authorities and provincial health system leaders at the Ministry of Health and Doctors of BC. The improvements to the RRP demonstrate the commitment of the Joint Standing Committee on Rural Issues to develop and improve programs that attract and support rural physicians -and strengthen their resilience- through this challenging time enabling them to have fulfilling careers in BC’s rural communities.”

Doug Blackie
Project Co-Lead, Rural Retention Program Review, RCCbc

Team Members: Anne Lesack

Some Related Areas

Recruitment​ &​ Retention​