Palliative Care Physician

Oxford County Palliative Care Outreach Team (PCOT)

Oxford County, Ontario

The Oxford County Palliative Care Outreach Team (PCOT) is seeking a Palliative Care Physician to join our established specialist palliative care program serving Oxford County in Southwestern Ontario.

Located between London and Kitchener-Waterloo and approximately two hours west of Toronto, Oxford County offers an opportunity to practise comprehensive palliative care across community, hospice and hospital settings while working within an experienced interdisciplinary team.

The Position

The successful physician will provide specialist palliative care consultation, shared care with primary care providers, and Most Responsible Physician (MRP) care for patients with serious and life-limiting illness.

Care is provided across multiple settings, including:

• Patients’ homes and other community settings
• Sakura House residential hospice
• Woodstock Hospital, including its Palliative Care Unit
• Consultation and shared care with community primary care providers

The team provides coverage throughout Oxford County, including Woodstock, Ingersoll, Tillsonburg, Norwich and Embro.

The successful physician will also become a member of the Department of Palliative Care at Woodstock Hospital.

Our Team and Model of Care

The physician will join an established group of palliative care physicians working collaboratively with an interdisciplinary community team that includes:

• Community palliative care nurses
• Community paramedics
• Ontario Health at Home (OHaH) Care Coordinators
• Primary care providers
• Hospice and hospital-based teams

Our model emphasizes collaboration with primary care, continuity across care settings, timely access to specialist palliative care, and supporting patients and families in their preferred location of care whenever possible.

Our physicians are also part of the Palliative Care Base Hospital Program through the Southwest Ontario Regional Base Hospital Program, providing physician support to community paramedics. Call volumes associated with the Base Hospital role are currently very low.

Position and Clinical Volume

Our preference is to recruit a physician interested in a 1.0 FTE position. However, positions of 0.5 FTE or greater may be considered, depending upon the candidate and the needs of the program.

A graduated onboarding arrangement is also available. This allows a new physician to progressively build their clinical practice and patient roster while becoming familiar with the team, community resources and regional model of care.

A mature full-time community practice would typically include an active MRP patient load of approximately 30–40 patients, in addition to consultation and shared-care activities.

After-Hours and On-Call Coverage

Community Palliative On-Call (CPOC)

Oxford County participates in the Community Palliative On-Call (CPOC) Program, which provides funded after-hours physician coverage for patients receiving palliative care in the community and at Sakura House.

CPOC coverage is currently shared among six physicians.

Call can generally be provided from home, with telephone support available to community nursing and community paramedicine. In-person assessment may occasionally be required based upon the clinical situation and discussion with the community nursing or paramedicine team.

Current CPOC remuneration for scheduled after-hours coverage is:

• Weekday: $500
• Weekend day: $620
• Statutory holiday: $836

Hospital Burden Based On-Call (BBOC)

Hospital inpatient on-call coverage is funded separately through Burden Based On-Call (BBOC) funding.

The physician providing hospital on-call coverage is available to provide telephone support for inpatient palliative care issues and management, with in-person assessment when clinically required.

Current BBOC remuneration is $120 per day.

CPOC and BBOC are separate on-call funding streams and cannot be claimed concurrently by the same physician.

Cross-Coverage and Holidays

Physicians within the group provide cross-coverage for one another during holidays and planned absences. Coverage arrangements can be discussed and organized in advance within the physician group, allowing physicians to plan vacation and time away while maintaining continuity of care for their patients.

Remuneration and Practice Infrastructure

The position is currently remunerated through Ontario fee-for-service billing, supplemented by funded after-hours coverage.

For physicians carrying an active patient load of approximately 30–40 patients, typical clinical billings may range from approximately $20,000–$30,000 per month, depending upon clinical activity, number of home visits and individual practice patterns. This amount is before overhead and does not include CPOC, BBOC or other on-call funding.

Actual billings will vary according to patient volume, services provided, practice patterns and applicable OHIP billing rules.

Monthly practice overhead is $2,500, which includes:

• Full-time administrative assistant support
• Accuro EMR
• Electronic fax
• Office telephone
• Administrative infrastructure supporting the practice

Qualifications

Applicants must:

• Hold CCFP(PC) certification with substantive palliative care experience during training and demonstrated experience providing palliative care in clinical practice; or
• Hold appropriate Royal College specialist certification with training in palliative medicine
• Hold a current, unrestricted licence to practise medicine in Ontario through the College of Physicians and Surgeons of Ontario (CPSO)
• Be eligible for appropriate hospital privileges
• Demonstrate experience and comfort providing palliative care across community, hospice and hospital settings
• Be comfortable working collaboratively with primary care providers, nursing, paramedicine and other members of an interdisciplinary team
• Be willing to participate in shared after-hours coverage

Experience with community-based palliative care, home visits and longitudinal management of patients with serious and life-limiting illness would be an asset.

Why Join Oxford PCOT?

This position offers the opportunity to practise comprehensive palliative medicine across the continuum of care, rather than being restricted to a single hospital or consultation setting.

The successful physician will join an established program offering:

• An experienced group of palliative care physicians
• A manageable shared on-call model
• Funded CPOC community after-hours coverage
• Separately funded BBOC hospital coverage
• Physician cross-coverage for holidays and planned absences
• Strong collaboration with community primary care
• Established relationships with community nursing and paramedicine
• Residential hospice care through Sakura House
• Hospital-based palliative care and a dedicated Palliative Care Unit
• Established administrative and EMR support
• Flexibility for graduated onboarding
• Opportunities to participate in the continued development of palliative care services across Oxford County

Oxford County provides a mix of small urban and rural communities with convenient access to London and Kitchener-Waterloo and connections to the Highway 401/403 corridor.

Position Summary

Location: Oxford County, Ontario

Primary communities: Woodstock, Ingersoll, Tillsonburg, Norwich and Embro

Position: Palliative Care Physician

Preferred commitment: 1.0 FTE

Alternative arrangements: 0.5 FTE or greater may be considered, including graduated onboarding

Typical active MRP roster: Approximately 30–40 patients at a mature full-time practice

Remuneration: Fee-for-service plus funded CPOC and BBOC coverage

Estimated clinical billings: Approximately $20,000–$30,000/month with a 30–40 patient active roster, before overhead and excluding on-call funding

Overhead: $2,500/month, including administrative support and practice infrastructure

Community call: CPOC, shared among six physicians and generally provided from home

Hospital call: Separately funded BBOC coverage

Holiday coverage: Cross-coverage available within the physician group and arranged in advance

Licensure: Current CPSO licence required

Certification: CCFP(PC) or appropriate Royal College specialist certification

We welcome inquiries from physicians interested in joining an established community-based palliative care program and contributing to the continued development of integrated palliative care across Oxford County.