Supporting physicians impacted by changes to AHS-paid stipends

Update on representation surrounding the end of stipends in AHS

Effective representation of members in settings across the system is an AMA priority; we know that members look to us for this support. I’m writing today to update you on assistance we have been providing for the many physicians participating in the ongoing discussions about stipend payments within AHS.

To date, Alberta Health has offered cARPs to 38 physician groups whose stipend payments are ending by December 31, 2021. Physicians have raised the following common concerns related to these cARP proposals:

• If cARPs are insufficiently resourced, groups will not be able to meet patient needs.
• AH cARP timelines for consideration are creating a sense of pressure.
• AHS overhead charges, which will have direct implications for the viability of a cARP, have yet to be determined. 
• The cARP rate review is not yet complete, creating more uncertainty for the future of ARPs in Alberta.
• The value to Albertans of maintaining or improving access to essential medical services must be considered.
• Potential negative impacts on residency and training programs must be avoided.

In my May 26 President’s Letter, I mentioned that 47 groups of physicians had been invited by Alberta Health to 16 townhalls to discuss terms and conditions for movement to a cARP. We have been engaging with these members, and many others, since then. This table provides a current summary so you can get a sense of the level of activity involved.

AHS Stipend Physician Support - Weekly Status Update

As of June 21, staff have attended 14 out of 14 Town Hall events held so far (two were cancelled), plus several pre-and post-meetings with each respective physician group.

The table depicts only some of the large number of physician groups requiring support with respect to stipends, related contractual situations or possible cARP transitions. We know that members look to the AMA to guide them to the best decisions individually, but also collectively as a profession in the larger health care system.

Stipend Action Committee

In addition to the daily one-on-one level support provided by AMA Health Economics staff, the AMA has assembled a Stipend Action Committee to address, at a provincial level, the concerns expressed by various groups around changes in AHS stipend arrangements. This work complements and is informed by AMA staff efforts. The committee’s expertise is directed to where it can add the greatest value: identifying things that we need to do provincially for all members involved. This means identifying, defining or capturing:

• Principles that must apply for all cARPs.
• Concerns raised by physicians impacted by stipend changes.
• A provincial approach to address common themes across the physician sub-groups.
• Advocacy strategies to address concerns.

New cARP information source for members

We have created a dedicated space on the AMA website to provide information regarding AHS stipends and cARPs, including regular progress updates, common questions and answers, key concerns and more: albertadoctors.org/stipends-cARPs (member login required).

Our job is to ensure that members are well represented. The AMA will continue to provide impacted physician groups with expert advice on cARPs and assist in responding to Alberta Health’s cARP offers. The AMA Board, Stipend Action Committee, Joint Task Force and others will use a multi-pronged advocacy approach to support all members who are, or will be, impacted by changes to AHS stipend payments.

If you have questions or concerns about AHS-paid stipends and/or cARPS, please email [email protected].

As always, I will keep the membership updated as more information becomes available.

Your comments are welcome in the following ways:

• Communicate with me privately and directly by email if you would like a reply: [email protected]  
• Comment publicly on this President’s Letter on the AMA website (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member). 

Sincerely,

Paul E. Boucher, MD, FRCPC
President, Alberta Medical Association