Join the SEM Doctors of BC

The Doctors of BC Section of Emergency Medicine has done a great deal to advance the interests of all brands of Emergency Physicians in the province over the past several years. All emergency physicians, whether members of the section or not, have benefited from this work. We hope that those of you who have not yet supported the section through membership dues will reconsider as we move forward, and re-invest a small fraction of what you have gained by joining.

Why Become a Member?

Answer one (1) – It is self-serving:

You may have many expenses – and money may be tight; however, your best investment is your Section of Emergency Medicine (SEM) membership.

The SEM thrives if it represents all Emergency Physicians.
You thrive as an Emergency Physician, when the SEM is strong.

Activities by your the SEM that have specifically benefited FFS EPs in BC or are in the works:

Much like the previous change to ensure all fracture/dislocations could be billed under procedural sedation , we are able to bill both the 07027 Deep Abscess and the 06063 Removal of Foreign Body as the wording has changed with our input.

After lengthy discussions between the College of Physicians and Surgeons of BC and MSP regarding forming a separate section for CCFP-EM so that they may also be eligible to bill the 01810 Consult fee this is a reality since January 1, 2021. 

Lobbying the Allocation committee to make changes to how a FTE is calculated for EM Physicians to place us in a more realistic position for future FTE allocations like Disparity where we obtained 5.18 million funding for this current PMA and previously were successful for an allocation of 3.16 million to the SEM.

New Trauma Resuscitation Code (01871): For active resuscitation of trauma patients for those Emergency Physicians that perform this service on contract as TTL for their HA but bill FFS. Consult fee, non-life threatening procedural fees, call-in fees and non-operative surcharges also eligible. 

New Resuscitation Code (01870): This code is for active resuscitation of critically ill patients while working as the designated On-site, On-duty EP within your ED (as with all 1800 codes diagnostic treatment centers are not eligible). Level fee codes may be billed in addition to non-life threatening procedures if requirements are met and documentation included.  This has been expanded to be used in all life, limb or organ threatening situations for bedside resuscitative care including procedures like lateral canthotomy/cantholysis  for orbital decompression or irrigation and injection for priapism.

A new Preamble for Emergency Medicine released October 1, 2019 in attempt to eliminate the previous ambiguous content. The new preamble contains more specific guidelines including examples. These changes will improve billing simplicity while reducing the variation in interpretation during audit review

A new telephone assessment code for review of our colleague’s microbiology culture and radiological follow-ups has been submitted and is pending Board & MSC review – likely available December 2023.

Realignment of the 14000 series of CCFP EMs and the 10000 series of FRCPC to ensure all are eligible to bill telehealth and face to face advice.

Urgent telephone involvement for CODE STEMI, HOTSTROKE and EVT patients in addition to other patients requiring preED care is pending final approval and will likely be available in December 2023 that also allows for billing once the patient arrives by the same Emergency Physician. 

Fee codes 01850 (clavicle) & 01851 (fibula) have improved to include pediatric patients without any manipulation required.  The word “operation only” has also be dropped from the description of the 01860, 01861, and 01862 and like the 01851/52 will also only be eligible for billing with submission code E (within Emergency Department).

We have clarified our ability to bill 1800 visit fee items and procedure(s) with or without the same diagnostic code within sites where EPs are working On-site and On-duty within the ED.

We have also worked with the GPSC to allow for billing of moulded splints at the same rate as casts as long as these are applied by the physician and not part of a reduction.

September 30^th, 2019 the  SEM Billing Guide was released. This has further simplify billing and serves as an interactive resource for FFS EPs for SEM members within BC. Information for residents transitioning into practice or others new to billing in BC can also be found on the Website. 

We continue to inflate our 1800 visit codes with monies provided through the PMA GFI & COLA and disparity funding. We are also attuned to providing increased funding to our day codes, a way that helps neutralize gender inequality.

Currently we are focusing on a handover fee to assist with end of shift transition of care to decrease admission rates. We are also looking at amalgamating our 1172 & 1173’s to our own procedural sedation fee item to have increased control and potentially inflate this with future funding.

Recent Activities by the SEM that have benefited APP EPs in BC:
1.Increases in annual payment of $5-10,000/ FTE above the general increases other physicians received  via successful applications to the Allocation Committee (AC).

• In 2024 your SEM will again be applying for further increases in annual pay via a written submission to the AC.  This decision will impact pay increases for the next 3 years.

 

2. Increases in annual income as a result of Afterhours Payments of $25-30,000/ FTE above the general increases via successful applications to the DoBC PMA committees.

 

3. Successfully lobbied at the Doctors of BC resulted in the government allotting 18 Million Dollars in 2023 and onwards (46 new EM FTEs) to address workload inflation.

• SEM provided assistance to individual APP groups with applications for additional funding in 2024
• SEM executive members are currently on DoBC committees that will determine allocation of new funding and workload measures that will be added to future contracts.

4. Provincial and individual site assistance with contract negotiations:

• Assisting individual EP groups during contract negotiations with Health authorities
• Assisting groups with issues related to reporting of hours
• Provided assistance to groups migrating from FFS to APP
•  Advocating for the protection of definition of an EM FTE within the current contracts.

 

SEM activities that benefit all of the EPs in BC:
1. Meeting with Ministry of Health and government to solve ED related problems such as overcrowding and workplace safety via Emergency Care BC (ECBC)
2. Provide input to the government regarding urgent care clinics and how they may be shaped to provide excellence in patient care without negatively affecting the care provided within BC’s EDs.
3. Successfully lobby WSBC to reduce the costs for mandatory corporate coverage by over 80% resulting in annual savings for some EPs of over $1500 annually.
4. SEM Executive participation in Key Decision-making Committees within the DoBC: SEM executive members directly promote ED related issues via: Tariff Committee, Alternative Payment Issues Committee, Workload Advisory Committee, Workload Measures Committee Negotiations Co-ordinating group, Patterns of Practice, ESAC, Representative Assembly, Overhead Committee, WSBC Committee, and Emergency Planning committee
Additionally, here are some of our previous accomplishments:

• We won you large fee and sessional increases in 2006 and 2010
• We successfully obtained and distributed funding ($ 450K) for enhanced CME for Emergency Physicians with specialist credentials from Specialist Service Committee (SSC) funds. (Program completed March 2015)
• We successfully applied for income increases for AP EPs via afterhours and allocation committee resulting in increases of over $70,000/FTE over past 10 years above general increases.
• We were successful in lobbying for significant increases in funded EP positions across BC to meet the growing workload demands in all EDs

We are the ones:

• right now representing your interests in discussions at Ministry and Health Authority level regarding ways to address ED Overcrowding and other issues that make life difficult for ED patients and doctors
• Arguing strenuously on your behalf for consistent interpretation of Emergency Fees by MSP. Working to decrease the retributive audit process.
• Protecting your interests in the fine print of Template Contract language

Answer two (2) – It is the right thing to do:

All this work on your behalf requires sacrifice by your colleagues on the SEM Executive: sacrifice of income from clinical shift-work, of time with family and friends, and of energy that could be spent doing things we enjoy doing.

Please, respect the effort your executive makes for you and join (or re-join) today.
Please join over 400 colleagues in shouldering your fair share of the burden.