Payment model impact on the resilience of rural communities: Exploratory study.

Objective: To explore rural physician perspectives on how remuneration impacted their experiences of contributing to community resilience during the COVID-19 pandemic.

Design: Exploratory, qualitative subanalysis.

Setting: Twenty-two rural communities in 4 Canadian provinces.

Participants: Family physicians, other health care professionals, and patients in rural communities in British Columbia, Alberta, Saskatchewan, and Ontario.

Methods: Semistructured, virtual interviews conducted between November 2021 and February 2022 were included in the subanalysis. Interviews were audiorecorded, transcribed, coded, and analyzed thematically.

Main findings: Participants expressed working under an alternative payment plan (APP) model facilitated greater engagement in their communities and said they were generally fairly compensated for nonclinical duties. Increased time allotted to each patient re-centred care priorities to meet the long-term needs of the community. Finally, APP physicians stated their systems of care supported their own wellness throughout the pandemic.

Conclusion: Findings suggest physicians working in an APP model felt they had increased ability to engage with the community and contribute to its resilience. The flexibility of APPs may allow for more physician involvement in community sustainability that is not directly related to patient care.