COVID response; Physician On-Call Program

Dear Members,

COVID task force report

Earlier today I released a statement in response to the report of the Alberta COVID-19 Pandemic Data Review Task Force. The report is very problematic.

Physician On-Call Program

AHS has just completed its review of the Physician On-Call Program (POCP). I am hearing concerns from many physicians that on-call remuneration is being eliminated or significantly reduced as of April 1, 2025.

The AMA is interested in advancing competitive rates to physicians for their availability on a 24-hour basis, similar to other provinces, as well as an expansion of Alberta’s program eligibility criteria to accommodate more call programs. At an AHS-led POCP Advisory Committee, AMA representatives endorsed a report that recommended a return to the four categories of call to be remunerated at ‘pre-2019 levels + 3%’ along with an expansion of the criteria to allow for 50 new programs – adding up to a budgetary ask of $38M. In addition to this (as referenced in previous President’s Letters), the AMA’s Acute Care Stabilization Proposal (member login required) to government estimated that $68M would be necessary to add 100 new programs and restore competitiveness with BC’s Medical On-Call Availability Program.

While we wait to hear back from AHS and government on our endorsed proposals to stabilize acute care, I understand that AHS has made some difficult decisions associated with programmatic expansion while applying reductions to physician compensation. It is disappointing to hear that physicians are being asked to accept a reduction of remuneration that was once paid for 24 hours, down to 14 hours and, in some cases, to provide on-call/availability for free as of April 1. This reduced compensation scenario is unhealthy for physicians who are trying to remain accessible for the provision of necessary services to Albertans while balancing the economic pressures associated with unprecedented inflation and population growth. While other provinces are proactively dealing with these challenges through contractual increases, once again Alberta is offering further constraints to physicians practicing in acute care.

We have sought advice from the College of Physicians & Surgeons of Alberta and from legal counsel on physicians’ responsibilities and obligations. From these perspectives, physicians must be available for their own patients but have no obligation to be available for unattached patients if they are not remunerated to do so. This perspective will put more pressure on AHS as I am aware of dozens of physician on-call programs that are preparing to appeal these decisions, advising that they intend on reducing their availability to see unattached patients or cancel their availability entirely as of April 1. While I support all physicians’ decisions in these difficult times, please know that I also understand how hard it is to be unresponsive to any patient in need at any time.

Physicians deserve fair treatment, and this means competitive remuneration for their services. At the same time, Albertans deserve timely access to life-saving medical/surgical services, and they expect government to be responsible for paying for those services. Today, more than ever, Alberta physicians are affected by what’s going on in other provinces. While I believe the simple answer is to expand the budget for the POCP, I am open to alternatives and will be working closely with the Minister at our next opportunity.

Sincerely,

Shelley Duggan, MD, FRCPC
President, Alberta Medical Association