Doctors will work with province as government eyes physician pay
The president of the Alberta Medical Association says the province’s doctors are willing to work with the NDP government as it targets physician compensation in a bid to control escalating health- care costs in coming years.
But Dr. Carl Nohr, while encouraged by what he’s heard so far from the new government, acknowledged there is also some worry the province’s attempt to contain costs could translate into a hard- line in future contract talks.
“That is a concern. But what we’re hearing from patients is that they appreciate that their physicians are reasonably compensated for their work,” he said in a recent interview.
In the NDP’s first budget, released last week, the government pledged to get a grip on health- care spending that has grown by six per cent annually over the last decade and now makes up 40 per cent of provincial expenditures.
Health Minister Sarah Hoffman has been charged with cutting the rate of increase on health spending to two per cent annually by 2018, with a focus on three major expenses: hospitals, drugs and physician compensation.
Total health spending in the budget is $ 18.6 billion, with doctors’ compensation at $ 4.3 billion.
Hoffman said in a recent interview the government wants AMA at the table when it comes to finding savings.
“We look forward to working in partnership with them ... to make sure that they know what our pressures are and, hopefully, we’ll be able to do this in a respectful and collaborative way,” she said.
The AMA signed a seven- year contract with the former Progressive Conservative government in 2013 after years of an increasingly acrimonious relationship.
Retroactive to 2011 and running to 2018, the contract froze wages for the first three years of the agreement and then called for two years of 2.5 per cent increases and two years of cost- of- living adjustments.
Nohr said containing costs within the system is a major concern for doctors, second only to preserving access and quality of care. He said he’s found the new government “open to discussion” and doctors are ready to give input on potential savings in the system.
The AMA — which represents about 10,000 doctors — is also willing to talk about new compensation models for physicians, said Nohr.
About 80 per cent of Alberta doctors are paid on a fee- for- service basis while the remainder are on alternative academic or clinical compensation systems. The latter can see doctors paid based on an annual salary, hourly rate or roster of patients.
“There are ongoing talks between us and government on how best to compensate physicians,” said Nohr.
“We would take the position that all front- line workers looking after Albertans deserve to be compensated fairly and reasonably ... Whether or not that involves major model changes in the future, I think is something that is of real interest to both the government and the Alberta Medical Association.”
Liberal Leader David Swann said it’s critical for the government and AMA to work together on the issue. He said the compensation model must be adjusted to ensure it maximizes the sustainability of the health system and patient care.
“Is the fee- for- service system serving the public or not? What are the options?” said Swann, who is himself a physician. “There’s no question the fee- for- service system stimulates volume and doesn’t incent prevention and community care.”