Diagnosis and treatment for acute care

January 4, 2024

Dear Members,

As you know, we’ve been advocating intensely and continuously to stabilize family and rural generalist practices in Alberta. I also promised you that there would be more information coming about AMA proposals to government to address the parallel crisis in acute care. We know acute care relies on a strong, comprehensive primary care system, and we are taking immediate action to stabilize this area. At the same time, we also need significant changes in acute and hospital-based care where the current, dire situation has been years (and one pandemic) in the making.

With so many moving parts and priorities, the complexities of acute care can be difficult to assess and understand. Even without a complete reorganization of the system in the next few years, it’s understandable to ask: How do we know where to start?

That’s where the AMA can bring something unique to the table. Our physician leaders have expertise in every area of acute and hospital care, and they know what can work and why. For years we have been advocating for solutions to the major issues. Although we haven’t had the response we hoped for, we have never given up and we continue to evolve and refine the solutions we are bringing forward.

We now have a unique opportunity to combine and catalyze all those solutions into a comprehensive proposal to stabilize access to acute care for our growing and aging population by retaining physicians, attracting new talent and improving the flow of patients through the system.

Here are the elements that we believe need to go into the mix:

• Modernizing Alternative Relationship Plans (rate review), including after-hours for ARPs, AMHSPs, capitation and blended capitation models.
• Improving incentives for the provision of after-hours care.
• Addressing physician availability through improvements made to the physician on-call program.
• De-escalation of the stipend crisis.
• Removal of further compensation reductions (such as AHS overhead and Z-code policies).

Combining solutions for these issues has the potential to address the most complex problems we face (before, during or after a reorganization of the health care system). We could measurably improve:

• ER waiting times
• surgical waits
• patient flow
• admissions/discharge process
• patient outcomes
• surgical recovery
• after-hours care
• specialist availability

This looks worthwhile to me, and physicians are ready to contribute.

A recent President’s Letter described our first action to advance specifics of our proposal and an update from the AMA’s ARP Working Group (member login required). We will share more about the elements of the acute care stabilization proposal in the weeks ahead. 
 
Regards, 
Paul Parks
 
P.S. We continue to work with the AMA Strike Team, government and through public advocacy to stabilize family and rural generalist medicine. In the weeks ahead we will be seeking next steps on AMA proposals that the Minister has promised to act on in Budget 2024.
 
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