Negotiations Updates

Negotiations Updates

The last round of negotiations took place throughout the summer of 2019. During this process, if the parties are unable to achieve a negotiated deal, DNS may, after following the appropriate process, choose an alternate path to reach a resolution. Those options may include mediation or arbitration.

The negotiations team advocates for DNS members at the negotiation table and is committed to reaching an agreement. If necessary, DNS will request a meeting with the Premier to discuss the status and pace of negotiations.

C/AFP Department Heads take a stand

In early July, the department heads of all 12 C/AFP departments penned a letter to the government stating that they will not take part in any further discussions of a new deliverables framework without DNS present and actively involved in the negotiation. Together, they requested that government honour DNS’s legislated role of sole bargaining agent for Nova Scotia’s doctors.

Committed to stabilizing the physician workforce

The physicians and DNS staff who negotiated on behalf of physicians were committed to reaching a deal that begins to stabilize the physician workforce, which will require meaningful improvement in both compensation and work environment for Nova Scotia’s physicians.

Stay connected

It is necessary to keep negotiations developments confidential, as DNS needs to maintain a strong negotiating position, but the association keeps members updated when possible.

Negotiations continue

Negotiations between Doctors Nova Scotia (DNS) and the Department of Health and Wellness (DHW) have surpassed the six-month mark. The conversations to date have been challenging, and we expect they will continue for some time yet. The existing Master Agreement and Master C/AFP contracts expired on March 31. Everything in those contracts continues until a new contract is in place.

We remain committed to negotiating until we reach a deal that helps to stabilize the physician workforce in Nova Scotia. Discussions are slated to take place on May 1, 14 to 16, and 28 to 30.

Government continues to roll out proposed inpatient care model

In response to a growing crisis in inpatient care around the province, DNS and the DHW spent many days at the negotiations table, working on a solution that would stabilize inpatient care in community hospitals across the province. Unfortunately, both parties could not come to an agreement.

Regardless, government is prepared to make an investment in inpatient care through its new Community Hospital Inpatient (CHIP) model. Although the DNS Board of Directors did not endorse this model, DHW representatives have been introducing the model to community hospital sites across Nova Scotia. Some conversations have been constructive, and others have not been.

While the board believes there are many positive elements to the CHIP model, the Board also has significant concerns. If you or your group have questions about the DHW’s proposed model, its positive elements and its limitations, reach out to DNS for support.

Proposals approved

The Board of Directors approved the final proposals for Master Agreement and C/AFP contract negotiations at its meeting on Nov. 9. The Board believes Nova Scotia must stabilize the physician workforce, with material improvement in both compensation and work environment. Physician remuneration should be increased to be the highest in Atlantic Canada and to meet the national average, within a reasonable timeframe, to support a stable physician workforce. The proposals were shared with the provincial government on Nov. 9.

Negotiations objectives

Contract negotiations are guided by a set of negotiation principles and process and outcome objectives established by the Board.

Principles – process

  • Board members are actively involved in all aspects of the negotiations process, including:
    • Board meeting participation
    • Championing DNS efforts and perspectives throughout the process
    • Seeking member engagement, through community meetings and one-on-one discussions with colleagues
    • Promoting ratification
  • The Board will do its utmost to share information with members in the lead-up to and during negotiations, within the bounds of its obligation to maintain confidentiality of formal negotiations discussions.
  • Details of the agreements must be finalized to the greatest extent possible prior to seeking ratification, and details and contract language will be shared with members as part of the ratification process.

Principles – outcome

  • The 2019 agreements should improve the ability of the province to retain and recruit physicians, by addressing issues such as:
    • More competitive compensation
    • Enhancing physicians’ practice environments and professional satisfaction
    • Enhancing physician engagement in system decision-making
  • Doctors Nova Scotia will pursue and/or accept targeted investments, which means some members may receive greater increases than others. At the same time, DNS will attempt to minimize further divisions within and between specialties.
  • The level of Master Agreement and C/AFP investment does not have to be the same proportionally.
  • We will not pursue relativity between different physician specialties at this time. We recognize that there are differences in compensation between different physician specialties but do not believe this can or should be tackled through 2019 negotiations.
  • Negotiated commitments (and as many details as possible regarding each commitment) need to be documented and contractualized.
  • The current physicians services spend must be the starting point or “base” for the new contract (including the recurring portions of the March 19, 2018, $40-million investment).
  • If an agreement is not concluded before March 31, 2019, the new contract must be retroactive to April 1, 2019.
  • The risk of any new investments lapsing or being underspent or delayed must be mitigated to the greatest extent possible.

Objectives – process

  1. Negotiation objectives and principles to be clearly articulated by the Board and shared with members.
  2. Negotiation process, activities and responsibilities to be clearly articulated to staff and Board.
  3. Communications plan to be implemented to set expectations among membership and share process and progress with members and staff.
  4. Physicians involved in-depth with the negotiation process will be prepared with information and strategy for negotiation meetings.
  5. Negotiation strategy to be developed and adjusted as necessary to respond to changing environments and opportunities.
  6. Board to demonstrate leadership throughout negotiations.

Objectives – outcome

  1. Agree upon a new payment model for primary care.
  2. Increase compensation to bring physicians in Nova Scotia closer to national average.
  3. Make progress on enabling physicians to better leverage technology in their practices.
  4. Ensure the majority of members are satisfied with the process and outcome of negotiations.
  5. Secure adequate funding to enable DNS to continue implementing initiatives that benefit physicians and the health system.
  6. Implement a contract governance mechanism that enables nimble oversight of contract issues (such as MAMG, C/AFPMG, C/AFP and related standing committees).

Members are invited to provide feedback to the negotiations team by emailing

Negotiation teams approved

Six physicians agreed to serve on the contract negotiation teams: Drs. Mike MacDonald, Heather Johnson and James Clarke will serve on the Master Agreement Negotiations Team, and Drs. Mike Teehan, Kirk Magee and Christine Short will serve on the C/AFP Negotiations Team. The Board is extremely grateful to these physicians for this significant commitment of their time and resources.

These physicians, along with the DNS staff negotiation team members, met daily during negotiations with the physicians on the Members’ Advisory Forums to bring the physicians’ perspective to the negotiating table. See who represents you on the Members’ Advisory Forums.

Draft proposals near completion
The Doctors Nova Scotia (DNS) Board of Directors discussed the draft proposals for the Master Agreement and Clinical/Academic Funding Plan (C/AFP) contract negotiations at the Board meeting on Sept. 28 and again at a special meeting on Oct. 14. The Board’s feedback was incorporated and the final version of the negotiations proposals will go back to the Board for approval on Nov. 9.

Framework for new primary care payment model
The Board approved a framework for a new primary care blended payment model. The development of the model was overseen by the Blended Payment Model Working Group, which incorporated input from DNS members obtained via three webinars, a survey, and engaging the Primary Care Physicians Representative Council and Policy and Health Issues Committee. The framework was incorporated into the negotiations proposal for consideration by the government and the health authorities.