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CMAJ
CMAJ - May 2, 2000JAMC - le 2 mai 2000

NS radiation oncologists opt for salary

CMAJ 2000;162:1341


It's bye-bye fee for service and hello salary for Nova Scotia's 9 radiation oncologists. The move to "fixed payments" is part of the health department's efforts to increase the number of cancer specialists practising in the province. "Cancer specialists are in high demand across Canada and throughout North America," says Health Minister Jamie Muir. "Moving from fee for service will help us attract and retain radiation oncologists, enabling us to provide high quality cancer care to patients. The agreement enhances the working environment for these doctors by allowing them to spend more time with patients and involved in research and academic interests."

The proposal to put radiation oncologists on salary was originally brought forward last spring by Dr. Paul Joseph, the provincial head of radiation oncology. He says the new method of payment means that the province can now offer the specialists a competitive compensation package — an important factor in recruiting. On average, Nova Scotia's radiation oncologists were making 20% less than their Canadian counterparts. The new payment method "frees us from the yoke of fee for service," says Dr. Andrew Padmos, Nova Scotia's Cancer Care Commissioner. "We're in a position to match or better salaries paid for medical oncologists in other parts of Canada."

The strategy has worked. Last year there were only 6 oncologists on staff at the Queen Elizabeth II Health Sciences Centre, and several vacancies. This fall the last 2 vacancies will be filled, despite stiff competition across the country, where there are more than 20 vacancies for these specialists. The health department has also approved the addition of 3 new radiation oncologists to the province's cancer care team. These positions will be phased in by October.

But staffing is only the beginning, notes Padmos. "We've plugged the holes in the roof. Now we're going to start on serious renovations. We have an organizational structure and mandate to make cancer care better. We're poised to do a lot of change in the system in a short period." — Donalee Moulton, Halifax

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