What US Doctors Should Know About Moving to British Columbia with Dr. Maryam Zeineddin

Inside the Life and System of a BC Family Doctor: A Conversation with Dr. Maryam Zeineddin

Welcome back to the Interesting MD Blog! I’m Dr. Rob Beck, your host and fellow explorer of what medical professionals do both in and out of the clinic. If you’re a US physician—especially in family medicine—who has ever wondered what it’s like to practice north of the border, today’s post will shed some light on the unique realities, joys, and challenges of primary care in British Columbia (BC), Canada.

Recently, I had the honor of interviewing Dr. Maryam Zeineddin, a dedicated family physician and passionate advocate for change in the Canadian healthcare system. We went deep into her journey, how primary care works in BC, the recent seismic shift in how family doctors are compensated, and practical advice for our American colleagues who might be dreaming of a move up north.

Let’s dive in!

Dr. Maryam Zeineddin: From Iran to BC—A Journey of Compassion and Advocacy

Dr. Zeineddin’s story is a global one. Born in Iran, her family left during the Iran-Iraq war—living in several countries before landing in Sweden, and eventually, Canada. After earning her undergraduate degree in physiology at the University of British Columbia (UBC), she completed her medical training and embarked on a career in family medicine that has now spanned over two decades.

What makes Dr. Zeineddin’s career especially fascinating is not just her dedication to patients in West Vancouver, but also her leadership—she served as the president of BC Family Doctors and played a key role in negotiating for better compensation models for physicians in BC.

What Does a Family Doctor in BC Really Do?

Here in BC, family medicine often means “cradle to grave” care. Family physicians are community pillars—caring for children, adults, seniors, and everything in between. Dr. Zeineddin’s practice, for example, started by taking over a retiring doctor’s solo practice and growing it into a group clinic that now serves over 15,000 patients.

For our American readers: Unlike the US, where many primary care physicians are now employees of hospitals or large multi-specialty practices, Canadian family docs often run their own small businesses or work as partners in physician-owned clinics. There are also increasing corporate-run clinics, but the backbone remains locally-owned practices.

The Canadian Medical Training Path

Interested in moving? Here’s what to know. To be a “Primary Care Provider” in Canada, you must complete two years of post-medical school family medicine training (residency) and receive certification from the College of Family Physicians.

We do have pediatricians and internists, but only family medicine residency grants access to the new BC compensation model (more on that in a sec). In the US, internal medicine and other specialties sometimes provide primary care, but the lines are more clearly drawn in BC.

How Family Doctors in BC Are Paid: From ‘Fee-for-Service’ to ‘Longitudinal Family Practice’

Historically, BC followed the “fee-for-service” model—quick visits, low per-visit fees (sometimes just $30–$40), and relentless, unpaid administrative work. This led to 10-minutes-a-patient conveyor belt medicine, physician burnout, and a shortage of family docs as many opted for higher-paying work or hospital shifts.

Dr. Zeineddin and her colleagues pushed for reform—and in 2023, BC launched the Longitudinal Family Practice (LFP) payment model. Here’s how it works:

• Hourly Pay: Physicians earn based on their time spent, encouraging quality over quantity.

• Complexity Bonus: Compensation adjusts for patients with complex medical needs—finally recognizing the realities of social determinants of health and the nuances of women’s health.

• Indirect Work is Paid: Reviewing labs, managing referrals, and other “invisible” tasks are finally billable (at around $130/hour for indirect work).

For the first time, BC’s model makes a real effort to recognize that not every patient is the same—and that high-touch, complex care shouldn’t be penalized.

Social Determinants, Gender Equity, and Systems Change

One of Dr. Zeineddin’s passions is advancing equity—she shared how past systems penalized female physicians who often attracted more complex female patients. Billing codes didn’t even exist for common women’s health issues, and procedures like IUD insertions or speculum exams were shockingly under-compensated. Thanks to persistent advocacy ("I said the word ‘vagina’ 37 times in one hour of negotiation!") fees for women’s health visits have been elevated, improving income equity and patient care.

Should US-trained Doctors Consider Moving to BC?

Short answer: Yes—but do your homework.

• Licensing: US family medicine grads may smoothly transition, but other specialties (like internists or med-peds) must check closely with the BC College of Physicians and Surgeons, as your designation and billing options may differ.

• Openings Galore: With around one million BC residents recently lacking a family doctor, there’s both demand and opportunity.

• Lifestyle & Community: Want to own your practice? Join a group? Take extended breaks? Tailor your work to your life? BC offers that flexibility—though, fair warning, Vancouver living isn’t cheap.

• Supportive System: Both BC Family Doctors and Doctors of BC are excellent starting points for practical information and community.

A Note on Work-Life Balance

Dr. Zeineddin walks the walk. She works two to three days a week in clinic, leaves time for leadership, and still carves out weeks at spring break and summer for family. Most family docs in BC balance patient care with advocacy, research, or outside pursuits—which is, after all, the spirit of Interesting MD.

Remember: achieving that elusive balance isn’t always easy—housing prices, clinic overhead, and healthcare politics can be challenging. Yet, if clinical autonomy and real patient relationships matter to you, BC is an incredibly rewarding place to practice medicine.

Final Words to Hopeful Immigrants from Dr. Zeineddin

“Look at everything holistically. What do you want for your life, your health, and your family? Canada’s system isn’t perfect, and some of our problems mirror those in the US. But the beauty here is our willingness to talk about change, innovate, and collaborate. If you’re searching for safety, balance, and a system hungry for new voices, BC welcomes you.”

Thinking About Moving? Start Here.

• Visit the College of Physicians and Surgeons of BC for licensure info.

• Contact Doctors of BC or BC Family Doctors for up-to-date policy and advocacy details.

• Have more questions? Reach out to me, Dr. Rob Beck, directly—let’s make this amazing community even stronger.

Thanks for joining me for another behind-the-scenes look at what it really means to be a doctor in Canada. Whether you’re considering a move or just curious about life outside your own exam room, stay curious, stay inspired, and keep exploring the Interesting MD.

Curious about future episodes? Subscribe and follow us everywhere you get your podcasts and check out our YouTube channel for more deep dives with fascinating doctors from around the world.