President's Letter
Dear Members,
Earlier today, the Minister of Health released Modernizing Alberta’s Primary Health Care System (MAPS): Strategic Advisory Panel Final Report.
Many of you were involved in extensive consultations that formed the basis of this report, and we have been waiting anxiously for its release as family medicine and primary care have continued to erode in Alberta. Each week we hear of more physicians retiring or relocating their practice, including to British Columbia where recent significant changes have substantially improved the foundation for family practice. Changes in BC, as well as Manitoba and Nova Scotia, have brought new urgency to addressing family medicine in Alberta and changed many of the assumptions that informed the MAPS report.
An important part of the minister’s announcement today was the release of Honouring our roots: growing together towards a culturally safe, wholistic primary health care system for Indigenous peoples - Indigenous Primary Health Care Advisory Panel final report, along with the implementation of some of its recommendations. At its very outset, that report acknowledges, “health outcomes for Indigenous peoples are moving in the wrong direction.” We all share an accountability for addressing that shameful legacy and we are committed to continuing to work closely with Indigenous leaders and government.
As I wrote to you last week, government has been closely analyzing the proposal on longitudinal family practice (LFP) submitted by the AMA and its family medicine leaders. The proposal will address significant gaps in government support for family physicians and incentivize longitudinal or comprehensive family practice. As part of that proposal, we have also advocated for substantial stabilization funding necessary to help retain our family physicians.
We know the announcement was not what members expected. Even the minister said this, and she acknowledged the need for a new funding model and adequate stabilization. While these comments are promising, physicians whose practices are on the brink will be particularly disappointed. We need rapid and substantial measures, and while it is unfortunate they were not announced today, we will not rest.
The minister’s announcement included a commitment to a Memorandum of Understanding with the AMA that promises to include an LFP proposal in Budget 2024. The minister’s announcement also includes funding to support panel growth which, while modest, is expected to be supplemented by further stabilization funding per the commitment in the MOU.
Government has said that MAPS recommendations will be implemented through a phased approach, with several moving forward immediately, followed by medium- and longer-term improvements. MAPS speaks to potential new governance structures for primary care in Alberta. New governance, along with potential new accountabilities, have been cause for debate amongst our membership. Members have also told us they want to preserve elements of our system that work well now. Alberta has some of the best approaches to team-based care in the country, even while the overall structure and supports for primary care have been ignored by government for too long.
We will work with government to ensure the MOU includes provisions to work on all of these elements in a cooperative manner – including a specific provision about engaging with the AMA on modernized governance structures. In this context and elsewhere, we will reinforce the importance of a medical home. Nothing can replace the comprehensive, high-value care provided by family medicine specialists who have years of training in understanding the needs of patients through the whole life journey. The best approach is an integrated team that includes allied health professionals and physicians working together to address a patient’s medical concerns.
I have heard from many members that you are burned out; your practices lack financial viability and the departure of doctors from your communities has created unreasonable expectations and workload. Now we face several weeks of intense work and I ask you to be patient. We will work with family physician leaders to support the work with government, to finalize details for the LFP model, inform appropriate stabilization and discuss governance. We cannot guarantee the outcomes, but we must do all we can to influence and guide policy so that all Albertans can benefit from an appropriately resourced medical home.
Family medicine is the foundation and heart of primary care. Without it, effective primary care is impossible. I am committed to keeping members up to date and will ensure our work is transparent and that we engage widely to capture the views of members whose practices are diverse. We will be particularly focused on ensuring that government’s next budget addresses urgent needs in the health care system.
You can reach me anytime at president@albertadoctors.org. You can also comment on this letter on the AMA website.
Regards,
Paul Parks
President, Alberta Medical Association