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Written Response: Provincial Announcement on Support for Rural Health Care

Supporting document for April 24, 2020 President's Letter.

After weeks of public advocacy by rural physicians and the Alberta Medical Association, Health Minister Tyler Shandro today announced major support dedicated to rural medicine. We thank rural physicians for all their efforts and also the many Albertans who expressed their own concerns.

While the AMA believes that today’s announcement is a very positive step, which will help physicians in the short-term, the lack of certainty, clarity and collaboration in government’s approach with physicians, needs to be addressed. We need long-term solutions to real challenges, not one-time ad hoc decisions. We need a partnership between physicians and government. Building the system with patients and in keeping with their needs is our first consideration.

Commenting on the Minister’s announcement, AMA President Dr. Christine Molnar noted:

“We are pleased to see the Minister has acted on the problems created by the Physician Funding Framework he imposed. Just a couple of weeks ago, his office was characterizing some of these issues as “minor”. Clearly they are NOT minor. The AMA and physicians have been telling the Minister for months that his funding framework would cause terrible disruption in the health care system, undermine medical practices across the province and have real negative impacts on patients. Today, he essentially clawed back the bulk of framework changes, at least for now. This will help to stabilize physician services during the pandemic. We appreciate that Minister Shandro has taken this step today.

"Many of the impositions have not been definitively removed. If it is the intention to impose these ideas again, history will repeat itself with government having to put out fires they started themselves. That would be unfortunate for patients, physicians and the provincial treasury.

"This is the real problem. If government is serious about “bending the curve” on our health care spending, improving patient care and keeping medical practices sustainable, there’s an easy way to do it – work with us. We are the leaders in the system and influence over 85% of health care decisions.

"Instead, government tore up our contract, continually misrepresented physician compensation with misleading information and has even taken away binding arbitration to settle disputes – something that is afforded to every other category of essential workers across the country. The trust relationship is severely damaged.

"Given that government has, temporarily at least, walked back significantly its funding framework, the AMA is calling on the Minister to reinstate the contract with physicians and return to negotiations in an effort to find permanent, prudent and sustainable solutions for Alberta’s health care system.

"The AMA represents Alberta’s 14,000 doctors, resident physicians and medical students. The AMA is ready and willing to work collaboratively with government. This current step is positive, while more of a reprieve than a real solution.

"Our actions speak loudly. Physicians remain strong and united with the public in standing up for health care in Alberta”

Media Contact

Shan Rupnarain, MBA
Assistant Executive Director, Public Affairs
Alberta Medical Association

Cell: 780.907.9003
[email protected]


Letter to section members from Section of Rural Medicine President Dr. Ed Aasman

 

Rural Colleagues,

Today the government reversed some changes for rural Alberta and physicians. The Rural Sustainability Group, which you know I am an active member of on behalf of the Section of Rural Medicine, responded with the attached press release. I offer you the following reflections.

The crisis we have in health care, rural included, is a void of leadership by the UCP government. They were voted in with a majority government, but do not seem to understand the difference between leadership and power. This is clearly demonstrated by Bill 21 and the tearing up the AMA contract with Alberta’s doctors. It is further seen in the new Bill 10. We are at a challenging time for Alberta again. We have seen the swing of ups and downs in the oil prices and yet we still have not seemed to be able to plan for this.

Leadership brings people together to find solutions, it does not impose solutions. There is no doubt we would be much farther ahead if the government saw the value in this. For me, the Alberta Medical Association has and will always be the venue for physician leadership. The AMA does more than just negotiate on behalf of us as physicians, it is an incredible, and more so, a credible change organization. When I look back at my career in medicine, I think of all the changes I have gone through. To start, the implementation of the EMR, which would not have occurred without the thoughtfulness and support of the AMA. The implementation of our Primary Care Networks and the Patient's Medical Home which has now led to the discussion of the Health Neighborhood. This goes on the more recent discussions of health system sustainability. The AMA has provided a leadership which brings groups together, the AMA has been inclusive. The AMA strives to build relationships with Alberta Health, with government, with Alberta Health Services, with the Colleges.

The foundation for the Alberta Health Care system is how we work together. It is not rural against urban, it is not Family Physicians vs Specialists, it is not doctors against nurses, it is not front line vs administration. The foundation is about value for our patients and respecting the value we all bring to the service we provide. It is critical to sustain this system. This is not done by random cuts, but by thoughtful changes. These changes may include fee reform for physicians but also need to include a look at service value, appropriateness, research and data. We have done a lot of work with Choosing Wisely, a look at when lab and diagnostics need to be done. When is surgical intervention appropriate. What medical therapies add value and at what cost.

It is a healthy health system that allows rural health care, including physicians, to deliver the care we can. We need to work with our urban colleagues in Family Medicine to build a robust Rural Patient Medical Home and a strong supportive Primary Care Network. We need specialists and centres for higher levels of care when needed for our patients. We cannot be separated from this greater system. We need to be part of it and be able to do our part to contribute to the system to provide care in our communities.

I keep hearing the mob mentality of this government stating doctors are overpaid, where is the money, oil prices are down. Yes, there most certainly is a loss of revenue. The greater and more important loss is that of leadership by this government to bring the responsible parties together for the health care system of Alberta to work together to find savings while still providing a quality service to all Albertans.

The Alberta Advantage has never been the money and oil. It has been the leadership seen in all sectors including Health Care.

Regards,

Dr. Ed Aasman President, Section of Rural Medicine