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 funding totalling 77M for this current PMA.  Decision pending for EM and other specialties after another time consuming process by SEM FFS Committee. Previous PMA saw a successful allocation of 3.16 million to the SEM for intersection and interprovincial disparity amongst specialties.

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 final review – likely available October 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 October 2023 that also allows for billing once the patient arrives. 

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 eventually further disparity funding. We are also attuned to providing increased funding in 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.

Activities by the SEM that have benefited APP EPs in BC:

1.Increases in annual payment of $13,700/ FTE above the general increases other physicians received in BC via successful applications to the Allocation Committee (AC) over the past 4 year.

• In 2019, 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. In 2020, the SEM will be applying to the Doctors of BC/ Ministry of Health afterhours committee for additional pay to compensate EPs for after hours shift work.

• This new pool of funds came about through 2 years advocacy by the SEM executive for increased after hours funding.
• Application will require face to face meetings and a written application.

3. Successfully lobbied to Doctors of BC to negotiated with the government to greatly increased annual, funding to address workload inflation within the most recent Physician Master Agreement (PMA)

• SEM provided assistance to individual APP groups with applications for additional funding
• 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.
• Assisting individual EP groups during contract negotiations with Health authorities

4. Advocating for the protection of current working hours per FTE contained within the current contracts during the most recent PMA negotiations.

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 the Emergency Services Advisory Committee (ESAC)

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 helped convince Government to add many sites to the APP system, and helped push for additional ER Physician-staffing to APP sites in 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 helped push for additional APP ER Physician-staffing in the new PMA, and has recently helped coordinate region-by-region applications for the
• We made the successful arguments to the Alternative Payment Committee (APC) that provided increased funding to Emergency Fees (approximately $11,000/ APP ER FTE) and recently-paid retro-payments up to 2015
• We made the successful arguments to the Allocation Committee (AC) that provided increased funding to Emergency Fees ($5,000/ER FTE) starting April 2016
• We are presently crafting and articulating the argument for further increases to the “grid” funding/FTE for ER physicians on APP to the new Allocation Committee “AC” based on problems of recruitment and retention

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.