Allocation Committee Submission
Guidance and Background
Please review the guidance and background before completing this submission.
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CONTACT INFORMATION & ATTESTATION
Physician/Group/Section Name:
Contact Person:
Work Location(s)
Phone
Email
I hereby certify that the information provided on this form is truthful and accurate to the best of my knowledge
I acknowledge that submission of information or data that is materially different from objective data sources may jeopardize the success of the submission
INFORMATION ABOUT THE CURRENT PAYMENT ARRANGEMENT
Service Contract
Salary
Sessional
FFS
Blended
Primary Payment Method
Individual
Group
Section
Is this submission by an individual a group or a section?
If Group or Section submission , how many FTE's are funded?
If group, how many physicians are parties to the contract(s)?
Health Authority/Agency:
Describe the number of years of postgraduate residency/fellowship training required to provide the services under the Service Contract or Salary Agreement.
CURRENT PRACTICE CATEGORY
Anesthesia
Cardiac Surgery
Community Medicine/Public Health (Area A)
Community Medicine/Public Health (Area B)
Community Medicine/Public Health (Area C)
Community Medicine/Public Health (Area D)
Critical Care
Critical Care (Pediatrics at BCCH and BCWH)
Dermatology
Emergency Medicine (Non- hospital-based)
Emergency Medicine Area A (GP)
Emergency Medicine Area B (Specialist/CCFP-EM)
Forensic Psychiatry
General Pediatrics
General Pediatrics (Defined Scope)
General Practice - Defined Scope A
General Practice - Defined Scope B
General Practice - Full Scope (Non- JSC Community)
General Practice - Full Scope (Rural) - Area A
General Practice - Full Scope (Rural) - Area B
General Practice - Full Scope (Rural) - Area C
General Surgery
General Surgical Oncology
Gynecological Oncology
Hematology/Oncology
Hospitalist
Internal Medicine
Laboratory Medicine
Maternal Fetal Medicine
Medical Genetics
Medical Oncology
Neurolgy
Neurosurgery
Nuclear Medicine
Obstetrics/Gynecology
Ophthalmology
Orthopedic Surgery
Orthopedic Surgery - Enhanced Scope
Other
Otolaryngology
Pediatric Radiology
Physical Medicine
Plastic Surgery
Plastic Surgery at VGH/SPH
Psychiatry
Radiation Oncology
Radiology
Subspecialty Internal Medicine
Subspecialty Pediatrics
Thoracic Surgery
Urology
Vascular Surgery
If Other, Please specify
CURRENT GROSS INCOME
Compensation
Value
Service Contract Payments
$
Salary Agreement Payments
$
Fee-For-Service Payments
$
Sessional Contract Payments
$
University salary/stipend/honoraria
$
Workers Compensation
$
ICBC/Automobile Insurance payments
$
Medical - Legal
$
Other third-party insurance
$
Other
$
If other, please specify here
Total
$
What is the average annual gross pay per full time physician in your group or for you for services covered in this submission
per year
(excluding benefits)?
$
MEDICAL ON-CALL AVAILABILITY PROGRAM
Yes
No
Do you or your group receive MOCAP?
Do you or your group receive MOCAP during 0800 hrs to 1800 hrs during Monday to Friday per week?
What is the Value of your MOCAP Contract on an annual basis ?
$
/year
OVERHEAD COSTS
Yes
No
Do you or your group pay any office overhead costs assiciated with the income reported in Part 3 (e.g. lease costs, MOA salaries, EMR costs)?
If yes, how much on average do you or a full-time physician in your group pay per year?
$
per year
WORKLOAD
What are the total hours of deliverables included within the scope of your or your group's service contract or employment agreement?
Include clinical services, bedside teaching, clinich research, clinical administrative services and services provided when called. Do not include didactic teaching, non-clinical administration & on-call/availability hours.
hrs/year
Excluding time spent providing on-call/availability, what are the annual hours of work for a fulltime physician in your group or for you? Please exclude hours provided by senior residents, fellows or clinical associates.
hrs/year
Hours worked on-site?
Hours worked off-site?
Hours worked on regular weekdays (i.e. Monday -Friday between 0800 to 1800)?
Hours worked during week day evenings (i.e. Monday -Friday between 1800 to 2300)?
Hours worked during nights (i.e. 2300 to 0800)?
Hours worked on weekends (i.e. 0800 to 2300)?
What is the average on-call ratio per physician in your group?
physician/day
When on call, how many hours are spent delivering patient care?
hours/call day
What percentage of your or your group's total hours of service are provided by senior residents or fellows under your direction?
%
INTER-PRACTICE CATEGORY DISPARITIES AND RISING BUSINESS COSTS
Please describe issues of disparities between the Payment Ranges and/or issues related to increasing business cost that the Allocation Committee should consider. Information regarding Patient Complexity or Location Complexity can be included in this part of the Submission.
RECRUITMENT AND RETENTION
Please describe issues of Recruitment and Retention that the Allocation Committee should consider. In particular, please include information related to where physicians working under your alternative payment arrangement are recruited from and where they leave for.
RECOMMENDATION TO THE ALLOCATION COMMITTEE
Recommended Payment Range for 2025/26:
$
Recommended Payment Range for 2026/27:
$
Recommended Payment Range for 2027/28:
$
Recommended Payment Range for 2028/29:
$
Please explain how you arrived at the recommended ranged:
COMPARATORS FOR RECRUITMENT AND RETENTION
COMPARATOR GENERAL INFORMATION
Comparator Group Name
Contact Person
Practice Category
Location
Telephone
Email
Describe the number of years of postgraduate training required to provide the Services under the Service Contract or Salary Agreement:
What is the average annual gross pay per full time physician (excluding benefits)?
$
per year
GROSS INCOME
Payment Type
Annual Value (if N/A,leave blank)
Service Contract (does not include benefits)
$
Salary Agreement ( include benefits)
$
On-Call payments
$
Other
$
Total
$
If other, Please specify here
WORKLOAD
What is the average annual number of working hours per full-time physician?
hrs/year
OVERHEAD COSTS
Yes
No
Does the comparator group pay any overhead costs assiciated with the income reported above?
If yes, how much on average does a full-time physician pay per year?
$
per year
Note: You may add up to 3 comparators in total.
Please refer to
Service Contract Payment Rates
&
Salary Contract Rates