This is in regard to recent developments in our negotiations with government that are deeply concerning for the profession.
I want to provide you with information regarding what government has proposed, what work the AMA is doing to review these proposals and how you can contribute.
Consultation on Alberta Health and Alberta Health Services Proposals
On November 14, government tabled several proposals which, in their view, were outside the negotiations. They asked the AMA to respond by November 20 as to how we would like to be consulted.
In developing a response, the Board considered several factors. First, many of the proposals are in fact within scope of the AMA Agreement and would have to be dealt with as part of the current negotiations. Second, whether inside or outside negotiations, parties can always agree to consult. Third, given the severity of many of the proposals it was thought best to bring matters into the light of day for all members.
On November 20, the AMA informed government that it would consult with the entire profession. We also noted in our position that several of the proposals are within the scope of negotiations and have to be dealt with in our negotiations. We also noted that the December 20 timeline for final response would not be appropriate for all items.
The Proposals and Initial AMA Response
Please find below links to the following:
- Insured Services Consultation, November 14, 2019 (LOGIN REQUIRED)
- AMA Assessment of Government Proposed Initiatives on Physician Compensation, version 1, November 25, 2019 (LOGIN REQUIRED)
Note: There continues to be an exchange of information in response to our questions, the most recent response as late as last night. We will continue to incorporate this additional information and update the document as quickly as we can. - AMA Assessment of Government Proposed Initiatives on Physician Compensation, version 2.2, December 6, 2019 (LOGIN REQUIRED)
AMA Review Process
- Initial staff review, as per the AMA document noted above.
- The two documents noted above were provided to RF delegates, section presidents and section fee reps on November 25.
- The AMA Compensation Committee will review the proposals, as well as collate information from members, sections and others as needed. The committee had their first meeting November 27.
- The Physician Advocacy Group will consider what other steps may be undertaken. The group had their first meeting November 27.
- A special in-camera meeting of the Representative Forum has been scheduled for December 7 to consider this issue as well as others, such as implications of Bill 21.
Implications
While not wanting to pre-empt any comments from members or sections, I want to share some of the initial reactions so far:
- The focus of the overall proposed cuts – roughly 85% – is on comprehensive primary care. This is counter to sound health policy, the government’s health platform and the interest of patients, particularly elderly ones, those with chronic and complex conditions, and those living in rural or remote areas of the province. There will be a negative impact on care for thousands of patients. Not so long ago, many Albertans were unable to find adequate primary care and a family physician of their own. As a profession we worked hard and successfully to address this short-coming through the development of primary care networks and the Medical Home for patients. The government proposals threaten to reverse the progress we have made in primary care.
- While less severe at this time, other specialists will also be impacted. For one of the items – payments from Alberta Health Services – the impact is unclear and could affect many physicians.
- Combined with Bill 21 (Termination of Contracts; Practitioner ID Restriction), these proposals paint a grim picture of the kind of relationship government would like with physicians.
- Some have questioned whether the proposals are more about posturing. Possibly, but if so it seems irresponsible. The proposals would be devastating to rural family practice, for example, a group that government in other venues purports to support.
Share Your Thoughts
Once you have reviewed the documents, you may wish to comment on specific items. As mentioned, sections are already reviewing the proposals so you may wish to direct that input to your section executive. Alternatively:
- Visit the Consultation Feedback Tool to post your comments and view those of your colleagues on each of the proposals (LOGIN REQUIRED). This material will be collated and forwarded to the AMA Compensation Committee for review and presentation to the special RF.
- Email your input to [email protected].
As always, you can reach me with any comments via [email protected] or comment on the form below.
Concluding Comments
These activities by government are troubling and potentially divisive for the profession. Physicians have been through difficult times before. We have always come through on the strength of our commitment to patient care and our unity.
I want to acknowledge the hard work, excellence and innovation of all Alberta physicians. In particular this includes the role played by our primary care leaders. As groups such as the College of Family Physicians of Canada have recognized, they have made this province the national leader in implementing the Medical Home.
Our organization has endured for 114 years. With our firm commitment to our patients and to one another, we will continue to be a powerful force in the evolution of our health care system for many years to come.
I will let you know how you can help in the weeks ahead and into the new year.
In your service,
Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association