Dr. Sunita MacMullin, who has an office in Sussex, billed the province nearly $1.7 million for medical services last year, more than any other physician. (Facebook)
A record 37 New Brunswick doctors were paid more than $1 million by the province for medical services last year and for the first time a general practitioner — not a radiologist — led the list of top billers.
Dr. Sunita MacMullin, a family doctor from Fredericton who relocated to Sussex after the size of her practice became a problem to manage, billed just under $1.7 million during the fiscal year ended March 31, 2019. She's also the first woman to lead the list of top billers.
MacMullin is away until the new year, according to her office and could not be reached for comment.
It's just the fourth year the province has released amounts it pays medical practitioners following a recommendation made in 2012 by Auditor General Kim MacPherson.
Last year Dr. Martin Finnegan, a diagnostic radiologist at the Dr. Georges-L.-Dumont hospital in Moncton led the list, displacing Dr. Stewart MacMillan, a radiologist in Miramichi who topped all earners in the first two years
This year, Finnegan tied for third on the list and MacMillan tied for fifth, costing the province just over and just under $1.5 million respectively.
Although controversial in other provinces, including Ontario, where doctors have fought to keep their billings secret, the public disclosure of doctor pay in New Brunswick has the official endorsement of the local medical community.
The province spent $666.6 million on medicare last year and New Brunswick medical society president Dr. Chris Goodyear said the public has a right to see where that money goes.
Dr. Chris Goodyear, president of the New Brunswick Medical Society, says taxpayers have a right to know how much doctors are paid by the province. (New Brunswick Medical Society)
"The New Brunswick Medical Society supports the publication of payments to physicians," said Goodyear in a statement released by the society. "It provides transparency and accountability to taxpayers on how their provincial health-care budget is spent." Goodyear is a general surgeon at the Dr. Everett Chalmers Regional Hospital in Fredericton and is himself part of the disclosure. He was paid just under $750,000 by the province last year, in a group tied for 91st on the province's list of medical earners.
New Brunswick has nearly 1,900 practising physicians. The majority earned less than $350,000 from the province last year but the number who make more than $1 million continued to grow.
Former Fredericton doctor happy in Sussex
MacMullin's billings have increased steadily over the four years from just under $1 million in the 2016 fiscal year, when she was tied for 25th on the list, to her current spot at the top.
MacMullin made news in 2017 when she sent a letter to her Fredericton patients informing them she was leaving the city for Sussex because other family doctors in the area complained her practice had grown too large with too many patients in hospital for them to cover for her during off-hours or vacations.
"Every proposal I had was met with a simple, 'No, we're not going to give you any backup,'" MacMullin wrote, in explaining her decision to relocate.
"This in itself is risky for me to be on 24 [hours], seven days a week and never having any vacation. "Luckily, my colleagues in Sussex … have welcomed my practice of medicine to the area and have created a healthy system of "on-call" support for one another."
MacMullin is one of several family doctors among the province's top billing physicians. Dr. Luan Le of Saint John billed the province just under $1.4 million last year and appears seventh on the list, and Dr. Gerard Losier of Miramichi tied for eighth for billings of just under $1.3 million.
Dr. Gerard Losier, left, of Miramichi billed the province $1.3 million for the year ended March 31, 2019. Losier has also given millions of dollars over the last decade to the Miramichi Regional Hospital Foundation. (Facebook/Miramichi Regional Hospital Foundation 2014 Gala)
Losier has long operated one of the largest medical practices in New Brunswick but is better known for donating much of what he earns back to the community.
According to the Canada Revenue Agency, Losier gave more than $625,000 to Miramichi medical charities in 2018 from his and his wife's foundation — most of that to the local hospital and hospice.
The top-earning specialist in the province last year — and second on the list to MacMullin — was Fredericton ophthalmologist Dr. Kenneth Roberts. He was paid just under $1.6 million.
Roberts has been second on the list of top medical earners in New Brunswick all four years it has been published.
In total, 37 doctors were paid more than $1 million by the province last year, up from 31 two years ago.
New Brunswick Auditor General Kim MacPherson called for public disclosure of doctor billings and salaries in 2012 and for the last four years the province has complied. (Jacques Poitras/CBC)
In 2012, MacPherson found doctor billings in New Brunswick operate mostly on the honour system, and she recommended more attention be paid to the issue, including the public disclosure of what doctors charge the province for their services.
"In order for the department to demonstrate proper accountability for over half of a billion dollars in annual spending, we believe the distribution of this spending should be publicly reported and subject to public scrutiny," MacPherson wrote.
David Raymond Amos "In order for the department to demonstrate proper accountability for over half of a billion dollars in annual spending, we believe the distribution of this spending should be publicly reported and subject to public scrutiny," MacPherson wrote.
Amen
David Raymond Amos
Methinks I should be fair and disclose that whereas Higgy and his cohorts will not issue me a Medicare Card I have had to pay for my health care and I have found the doctor fees to be reasonable and their service is excellent. Obviously I cannot say the same of the government denying me my right to free health care N'esy Pas?
Chris McNee
Reply to @David Raymond Amos: Hi David, by the number if posts you make online, surely you could use your time better to find employment that offers benefits like medical coverage?
David Raymond Amos
Reply to @Chris McNee: Methinks your lawyer should check my work N'esy Pas?
Chris McNee
Reply to @David Raymond Amos: I don’t know your situation, but witness similar with knowing others who don’t have full medical coverage. Free medical is the coverage of hospital care only (in a basic definition) I feel all prescriptions should be covered, regardless of income. To simply complain about the government and to throw around the word lawyer seems like an idle threat and the government retains its own lawyers. I hope you win your case, I really do. I did my full career in the army as my parents drilled into me the importance of a pension (albeit a small one, and lastly medical benefits)
David Raymond Amos
Reply to @Chris McNee: Methinks you should have read my lawsuit against the Queen (Statement 83 in particular) before the ex army dude in you jerked my chain N'esy Pas?
Chris McNee
Reply to @David Raymond Amos: I have know idea what your referring to about a suit against the crown? Reply with a link? I very much enjoy learning about wrongs being righted!
Theo Lavigne
Reply to @David Raymond Amos: Cry me a river.
David Raymond Amos
Reply to @Chris McNee: Ask the lawyers at NB Power to show you my file BTW I was accepted to RMC in 1970 but opted not to go
David Raymond Amos Reply to @Theo Lavigne: What would you do without a Medicare Card?
Chris McNee Reply to @David Raymond Amos: you should have gone to RMC, it was free education, a touch of B.S. from time to time mind you :)
David Raymond Amos Reply to @Chris McNee: Thats what I smelled coming from the dudes trying to recruit me Hence I did not go. However clearly you learned that portion of your studies well. Why else would you try to recruit others?
Greg Miller I presume comments will be limited on this subject for fear of reprisal --such is the environment we find ourselves in with a doctor "shortage". I find it difficult to believe we can't recruit doctors when some are billing well over a million.
Zapata Rigoreto
Reply to @Greg Miller: They're billing over a million because they work 80+ hours a week. Doctors are private contractors paid by the job. Billing rates are set by the province. The reason they can bill so much is that there is a doctor shortage so plenty of work available.
Greg Miller
Reply to @Zapata Rigoreto: In the case cited that's $442.71 assuming 80 hours a week and some holidays.
Greg Miller
Reply to @Greg Miller: Figure above is per hour.
David Webb
Reply to @Greg Miller: Minus expenses don't forget. Hired a good lawyer lately?
David Raymond Amos
Content disabled
Reply to @David Webb: Methinks many would agree that there is no such thing as a "good" lawyer Some just charge more than others because they are better connected within a corrupt justice system N'esy Pas?
David Raymond Amos
Reply to @Greg Miller: My doctor does not charge me that rate
David Raymond Amos
Reply to @David Raymond Amos: BINGO
Graham McCormack
Reply to @Greg Miller: That's not what they made, it's what they billed.
Donald Gallant
“ The average Physician - Family Practice salary in Maine is $196,599 as of November 25, 2019, but the range typically falls between $173,162 and $225,622.” (sic)
Billing’s of this kind especially for Family Doctors are suspect and need to be investigated.
David Raymond Amos
Reply to @Donald Gallant: Good point
Lou Bell
Much more time spent in Med school these days on how to get top dollar from their patients . One thing that they should be paid well for what they do , but methinks some of these doctors REALLY , REALLY need to be audited !!!!
Steve Kravcik
Reply to @Lou Bell: This is not true.
David Raymond Amos
Reply to @Lou Bell: Methinks you think it funny to mimic me N'esy Pas?
Bill Hamilton
Reply to @Lou Bell: Absolutely incorrect. Med students receive nothing about how to set up a practice.
James Risdon
I wonder how how feminist groups are going to spin this to perpetuate their fake narrative of women being paid less than men and to argue that there is systemic discrimination in our society.
Aaron Morris
Reply to @James Risdon: You are just as obsessed it seems.
David Raymond Amos
Reply to @Aaron Morris: I concur
Chris McNee
Reply to @James Risdon: oh ohh, now you’ve done it :)
David Raymond Amos
Reply to @Chris McNee: What is it you find so funny?
Chris McNee
Reply to @David Raymond Amos: what I find funny is how this person will point out a valid view and fact based claim only to potentially be word womped :) (womp isn’t really a word I think)
Chris McNee
Reply to @James Risdon: To say nothing of the fact that well over half of all university degrees go to females. But that's okay!! lol
David Raymond Amos
Reply to @Chris McNee: Methinks this is an interesting quote N'esy Pas?
"Thank you for taking the time to review the most flexible and well rounded person you might ever meet.I bring specialized skills that have been developed and proven domestically"
Chris McNee
Reply to @David Raymond Amos: finally someone has read my resume :)
Chris McNee
In life you get what you pay for. I’m great full to have such a great family Dr. Our dr is amazing, she makes in the $300 -$350 range and after you subtract taxes, office fees and other things she is paying out, it goes down quickly. Healthcare is so expensive on the province but it’s a necessity for a fit community. If people could also keep in mind to not miss appointments without real cause, as that’s also hurting our bottom line. I’m so lucky and grateful to have our family dr.
David Raymond Amos
Reply to @Chris McNee: Methinks you should be grateful to have a doctor who is well paid by my tax dollars because you are lucky enough to have a Medicare Card her services are free to you. I trust that your lawyer understands why I will sue the government you adore to insure my right to the same health care you enjoyN'esy Pas/
Matthew Locke
I'm familiar with Sussex NB. A fantastic community!
David Raymond Amos
Reply to @Matthew Locke: Me Too
Mike Connors
It sounds to me like Dr. MacMullin should be thanked instead of vilified. How many people would not have a doctor if she did not take them as patients. If she made that kind of money, there is a problem with our health care system. Surprised?? Nope.
Colin Seeley
Reply to @Mike Connors: Seriously.
If there is a problem it lies with the regulators.
New Brunswick Nurses Union president Paula Doucet has been trying to find out why universities haven't been graduating more nurses. (CBC)
Internal documents, obtained by the New Brunswick Nurses Union and shared with CBC News, show universities weren't trying to enrol more nursing students all these years — they were trying to afford the ones they already had.
Twenty per cent of those grads left to go practise in other provinces, making it all a frustrating situation for the nursing union, who has been pushing for more aggressive action for years. "We're in the midst of the crisis," said Paula Doucet, president of the nurses union.
"Had they listened to us many years ago and put precautionary measures in place, we probably wouldn't be having this conversation today."
It was something that we needed to uncover."
- Paula Doucet, New Brunswick Nurses Union
With a critical shortage already looming back in 2005, the province entered an agreement with the University of New Brunswick and the University of Moncton to graduate more nurses.
The province would give them about $15,000 annually for each new nursing seat created. The universities were to add 100 seats to their year one classes.
But the number of students didn't rise. It fell — a puzzling outcome that finally pushed the union to take the "extreme" step of making a right to information request to get answers.
"We kind of questioned over the years, because of the number of graduates that were coming out of the program … the numbers weren't there," said Doucet.
The nurses union received hundreds of pages of documents related to the 2005 agreement through a right to information request. (CBC)
The union obtained several documents related to the 2005 agreement. They include emails between the universities and the Department of Post-Secondary Education, starting in 2018.
In the correspondence, the schools cite financial challenges related to the nursing program and question their ability to increase enrolment. They also express frustration at the lack of communication with government.
The documents also include the text of the 2005 agreement, which was never released publicly. In addition to the funding for new seats, the agreement recognizes the high costs of training nursing students and says the province will give universities $3,300 annually for each nursing student they already have.
But in the emails, the universities tell government the costs to nursing faculties have exploded in the past 15 years, and the funding hasn't been sufficient.
"There is no way we could contemplate increasing enrolment," reads one message from UNB.
Why is teaching nursing so expensive?
Nursing is one of the most expensive programs to run at any university, because the costs increase rather than drop for each student taken on.
For example, it costs $24,000 to offer nursing to one student for one year at UNB, about three times the cost of a student in the arts and science program.
The University of New Brunswick and University of Moncton received provincial money for years to address the nurse shortage and create more seats for nursing students. But instead of creating seats, the universities dropped some. What happened? 3:00
Even with tuition being slightly higher than for other degrees— currently at $8,411 — the universities say they absorb an annual deficit of about $12,000 per nursing student and have always had to take money from other parts of their budgets.
What makes nursing so pricey is the hands-on training, which makes up more than a third of class hours.
It's done in small groups of seven, which means rather than paying one professor to lecture to an auditorium full of students, dozens of additional experts have to be hired each semester.
Rising costs
The current nursing shortage has only compounded the problem, by driving up costs to hire those clinical experts.
Hospital nurses don't have time to train students the way they used to, so universities have to recruit more professors instead.
Over the past 15 years, the costs to the faculty of nursing have risen twice as fast as those of other programs, according to an email from U of M to the province written in January 2019.
Equipment inside nursing labs, which mimics the hospital setting, is one of the reasons the program is so expensive. (CBC)
The emails show the universities expressing concern to the previous Liberal government.
Over the years, as part of the 2005 agreement, both UNB and U of M had to return money to the government when they missed targets for increased enrolment. U of M had to repay all of it, UNB half.
In 2018, the schools tell the province the agreement isn't working and ask that it be revisited. They are told to wait until after the October election.
Then in January 2019, after the Progressive Conservatives have come to power, UNB submits a proposal to the province to address the nursing shortage.
It would see the province cover the entire shortfall, about $12,000 per nursing student, and UNB increase enrolment to full capacity — 800 students in its four years of the bachelor program, up from about 500 currently.
More than a third of class hours in the nursing program are done in groups of seven students. (CBC)
The university explains its costs rose from $16,800 per nursing student in 2011-2012, to $24,000 in 2017-2018.
That's a 43 per cent increase over six years — or six per cent annually.
"The current provincial nursing shortage has magnified these costs since floor nurses are unavailable to be released from regular duties to supervise clinical training," UNB writes.
Poor communication
Around the same time, UNB's nursing faculty was asking school administration to scrap its licensed practical nurse bridging program because of money struggles. The program had been created in 2013 as an effort to address the nursing shortage.
But the school's emails to the Department of Post-Secondary Education, and its request for a meeting to discuss the proposal, go unanswered.
"I think this makes three requests for a reply, with none," George MacLean, UNB's vice-president of academic, writes in March 2019.
The University of Moncton has several nursing labs. (CBC)
Then suddenly, the school learns of the cuts coming its way.
While focusing on enrolment to defend the cut, Health Minister Ted Flemming said nothing of the other consequence of ending the agreement: the universities lost the $3,300 for each existing student to help with clinical training.
They need to invest, but there needs to be some accountability.
- Paula Doucet, New Brunswick Nurses Union
"The minister said funding was cut because we never met the seat target," wrote Karen Cunningham, UNB's vice-president of administration and finance in an email.
"Absolutely no acknowledgement that clinical has a high cost and that is also cut in this decision." The cut, coupled with a PC-imposed tuition freeze, plunged UNB into a $2.5 million structural deficit, the emails reveal, with the university contemplating its options.
"I fear that we will be unable to continue to protect our people to the same extent now, however, with the result that many essential services to students and administrative support will suffer," Eddy Campbell, UNB president at the time, says in an email.
Hundreds of future nurses turned down
All this was happening as UNB continued to have long wait lists for its nursing program, with hundreds of students being turned away each year.
Upon learning the 2005 agreement was being done away with, Campbell warns that nursing seats will decline in the fall.
Enrolment fell again this fall at the University of New Brunswick in the bachelor of nursing program, despite hundreds of people applying. (CBC)
Enrolment of first year nursing students fell to 136 in September 2019, the lowest number in more than a decade, and some 20 students fewer than last year.
"Funding has never been sufficient and this is part of the reason it became unsustainable and enrolment caps became necessary," UNB wrote to the province when it was pleading for more money.
"With reasonable funding, there is growth possible within UNB's structure."
Disheartening
For Paula Doucet, it's been a frustrating process learning why more nurses haven't been graduating from New Brunswick's universities.
"It was very disheartening, but it was something that we needed to uncover because the math didn't add up," she said.
In July, the Higgs government announced its 10-year nursing strategy, with $2.3 million this year focusing on bringing nurses from other countries and provinces, and $500,000 for the bridging program for licensed practical nurses to become registered nurses.
To Doucet, those are Band-Aid solutions.
In July, Trevor Holder, minister of post-secondary education, training and labour, and Health Minister Ted Flemming announced a 10-year nursing strategy. (Hadeel Ibrahim/CBC)
"I really don't think they understand the complexity as to why we have the nursing shortage that we do."
Doucet said nursing programs are underfunded, but she believes there needs to be some accountability as well to make sure more nurses come through.
"The universities are not producing enough," she said. "For supply and demand, we are nowhere in the ballpark of doing that.
"They need to invest, but there needs to be some accountability that the money that the government is giving universities is earmarked specifically for the faculty of nursing."
No plan for new seats
The government doesn't have any plans to increase funding for nursing faculties.
A spokesperson for the Department of Post-Secondary Education said it has asked the universities to fund their nursing programs within the regular operating grants they receive each year.
UNB gets $115 million from the province and U of M gets $66 million.
When asked why its nursing strategy didn't specifically target the issue of nursing seats, the province said it was a question of efficiency.
"To address the current and future nursing shortage in our province, government is taking action to quickly train more registered nurses to work in the health care system now, versus only relying on new graduates in four years," said Leigh Watson, communications officer for the department.
The bridging program that allows licensed practical nurses to jump to year three of the bachelor of nursing program now has 26 registered students.
While the health authorities say they need to hire 520 new nurses annually, the province disagrees with that number, and has estimated an additional 130 a year will do.
The universities failed to create more nursing seats, despite an agreement that began in 2005 and provided some financial help. (CBC)
There are currently about 8,000 registered nurses in New Brunswick.
Earlier this month, the province's auditor general came down on the 2005 agreement, questioning why $96 millions in incentives had been handed out to universities, without the promised increase in the number of nursing students.
CBC News reached out to both UNB and U of M for an interview, but they did not make anyone available.
The Nurses Association of New Brunswick, a regulating body for nurses, also declined to be interviewed, saying that without details about funding and the needs of the universities, it could not offer much to the story.
Toby Tolly and they cant pass the nursing test cause theyre taught in chiac....
David Raymond Amos
Reply to @Toby Tolly: Methinks its only proper Higgy and his cohorts go into the New Year still battling greedy people within the Health Care system N'esy Pas?
Shawn Tabor This is Business or is it Political, too funny. Little NB, the place to be. Happy New year
David Raymond Amos
Reply to @Shawn Tabor: Both
Political "All this was happening as UNB continued to have long wait lists for its nursing program, with hundreds of students being turned away each year.
Upon learning the 2005 agreement was being done away with, Campbell warns that nursing seats will decline in the fall. Enrolment fell again this fall at the University of New Brunswick in the bachelor of nursing program, despite hundreds of people applying. (CBC)
Enrolment of first year nursing students fell to 136 in September 2019, the lowest number in more than a decade, and some 20 students fewer than last year."
Business "Earlier this month, the province's auditor general came down on the 2005 agreement, questioning why $96 millions in incentives had been handed out to universities, without the promised increase in the number of nursing students.
CBC News reached out to both UNB and U of M for an interview, but they did not make anyone available."
Lou Bell
Patheticism at it's finest ! Reeks of ACOA ! Give lots of money to a business who DOES NOTHING to meet the goals set, and a Government Department that is TOO LAZY to follow through with checks and balances to assure the parameters are being followed !!!!!!!!!!
David Raymond Amos
Reply to @Lou Bell: Methinks you got the government you deserve N'esy Pas?
John Montgomery
Give nurses a deal on school for a guarantee that they will stay in the province.
Fred Brewer
Reply to @John Montgomery: They are already getting a deal but this general idea is what makes the most sense. The NB taxpayer is heavily subsidizing nurses training and then after graduation most of the nurses leave NB. Nurses who benefit from a taxpayer subsidy should be required to practice in NB for a minimum of 5 years.
David Raymond Amos
Reply to @Fred Brewer: Methinks they paid their tuition and got their degree In a free world they should practice their profession anywhere they wish just like all the foreign students who get their degrees here N'esy Pas?
Kyle Woodman
Maybe Higgs should just ask his nurse daughters why they abandoned ship after graduation. Could have something to do with wages. He probably told them to leave because they would never make a go of it here.
Lou Bell
Reply to @Kyle Woodman: Your point ?? Or just " vacant musings" with no substance. Methinks the latter !!\
Kyle Woodman
Reply to @Lou Bell: these are facts I'm relaying.\
David Raymond Amos
Reply to @Lou Bell: Methinks you are just a bitter spin doctor who works within the health care system N'esy Pas?
David Raymond Amos
Reply to @Kyle Woodman: Well put
Paul Bourgoin
Well Government can find subsidies money for New Brunswick Industries who also are the first in line receiving tax breaks and grants. These same employers eliminate jobs working short handed or replace the workers with subsidized mechanization thus eliminating jobs then they bank their profits in off shore banks not leaving much cash for New Brunswickers who pay their taxes and we wonder why our hospitals are qualified labor short handed !.\
Sergio LandZ
Reply to @Paul Bourgoin: Friggen right paul that's so true!
David Raymond Amos
Reply to @Paul Bourgoin: At least you have a Medicare Card
Equipment inside nursing labs, which mimics the hospital setting, is one of the reasons the program is so expensive. (CBC)
More than a third of class hours in the nursing program are done in groups of seven students. (CBC)
