Not a good time to butt heads with doctors
Kenney should calm his combative instinct and prepare for potential health emergency
The Kenney government is not known for gracious retreat. Faced with criticism, it hunkers down and fights.
But this battle against the doctors must stop. With the new coronavirus likely to hit the province, it’s the worst possible moment for changes to physician pay and governance rules that could seriously affect service.
Dr. Christine Molnar, president of the Alberta Medical Association, says the government should cancel its measures until next year and reinstate the master agreement it abruptly cancelled.
That’s the best short-term solution. It would give everyone time to work out a new, arbitrated pay agreement, which many physicians believe would be a good thing if it’s properly done.
But any compromise has to overcome the fighting instinct of the UCP, including Premier Jason Kenney.
Asked about the dispute this week, Kenney denied there’s any pay problem at all. He implied that the doctors must be making up their claims of lower incomes.
Kenney pointed out that the overall budget for physician pay, $5.4 billion, won’t change.
Then he said: “Some physicians, primary-care physicians apparently believe that this implies a 30 per cent reduction in their compensation.
“How could that be possible when there’s a zero per cent reduction in the overall budget for physician compensation?
“It’s just mathematically impossible … I just don’t understand how somebody could come to that conclusion.”
Hundreds of doctors have swamped Twitter and signed statements explaining exactly how it’s possible.
One problem is stipends for on-call doctors. The government wants them eliminated. But for some key specialists, these stipends are a significant part of their income and a crucial component of public health.
Across Alberta, 63 of 274 stipend programs had been reviewed for cuts by December.
That affects 967 doctors, including on-call obstetricians, pediatric specialists, surgeons and emergency doctors. We definitely want those people ready to spring into action.
The government would also cut subsidies for malpractice insurance. For some “low-risk” doctors, this may not be significant. For surgeons, however, insurance can run well over $50,000 a year.
Family doctors are still unsure whether they’ll continue to be paid the complex modifier that allows them to charge more for seeing patients beyond 15 minutes.
One surgeon, who doesn’t want to be named publicly, said in a letter: “Because I am paid partly by stipend, because I do on-call work, because I have malpractice insurance, and because I do work that takes more than 15 minutes, I estimate my practice income will drop by approximately 38 per cent after April 1.”
He’s ready to leave Alberta and deeply regrets moving his family here three years ago.
But Kenney says he can’t imagine why a doctor would move to another province with a higher cost of living, higher taxes and lower physician pay.
One big reason is unpredictability. Doctors don’t like it any more than the rest of us.
The government has already shown it will tear up a signed contract.
Doctors have every right to suspect the imposed fee regime, to come April 1, could be altered again at any time.
The government’s fiscal goals aren’t in question here. The UCP wants to keep pay from rising. It plans to direct savings to frontline medicine.
On Wednesday, the UCP announced $100 million for improvements to surgical facilities in Edmonton, Calgary, Lethbridge and Grande Prairie.
This is expected to add more than 17,000 surgeries this fiscal year — a very positive improvement.
But the same day, 36 emergency doctors from Lethbridge and Medicine Hat sent a long letter to Kenney and Health Minister Tyler Shandro, expressing deep concern “that as early as April 2020 our emergency departments will begin to be overwhelmed due to reductions in local primary and specialist care.”
Overwhelmed emergency departments are the last thing Alberta needs right now.
The government needs to calm this dispute right now, even if that means a rare admission that it messed up.