More than 800 doctors object to pay changes

Physicians say ‘necessary resources’ needed to ‘put out fire’ of virus outbreak

EDMONTON More than 800 front line Alberta doctors have signed a letter to the UCP government decrying changes to their pay as of April 1 in the midst of the COVID-19 pandemic.

The letter, addressed to Premier Jason Kenney and Health Minister Tyler Shandro, states the pay changes will be detrimental to patients and the health-care system.

“Now is not the time to restructure the system that we understand and intrinsically know how to operate. COVID -19 is spreading like a wildfire in this province,” the letter states. “We are a strong and trusted team who require necessary resources to help us put out this fire.”

The province initially announced 11 changes to the physician funding network.

Two weeks ago, however, the government cancelled proposed changes to complex modifiers, the biggest bone of contention.

Changes to stipends paid to physicians were also later suspended, and new billing codes for virtual and phone consults were brought online at the same rate as an office visit. But Shazma Mithani, an emergency room physician at the Royal Alexandra Hospital, said while the base fees for virtual visits and face-to-face are the same, there are additional fees unavailable for virtual visits.

“There’s this overhead that’s associated with having these clinics where patients can see them and the effect of not being resourced in the same way as having faceto-face visits is that clinics are closing,” said Mithani, one of 846 physicians who signed the letter.

The letter states more than 400 community clinics in the province are closing or laying off staff, which will overwhelm and burden the community and in-patient physicians.

In a statement, Shandro said the province will provide any resources needed during the pandemic.

“We expect spending on physician services and health care overall to increase significantly this year. I continue to work with the AMA, the negotiating body formally representing physicians. In fact I spoke to (Alberta Medical Association president) Dr. Molnar

at length just a few days ago. My door is open to any concrete, specific proposal to support physicians and patients in the emergency and going forward,” he said.

Despite the modifications by the province, Mithani said there are still eight other concerning pay changes coming April 1. One includes the good faith claim, where the province would fund people — typically marginalized populations such as those experiencing homelessness — who have no health-care number or one that has become inactive.

“Starting April 1, that funding is stopped,” Mithani said. “We as physicians, of course, will always take care of our patients, we will continue to see them but the government has essentially said that we don’t deserve to be appropriately resourced for those patients.”

Another change is for physicians in hospitals, including specialists and family doctors with admitting privileges. Mithani said there will be a drastic change in resourcing, but doctors don’t know what those changes will be.

“The government has told us here are the new codes that we’re going to use, but they’ve assigned no kind of remuneration value to those codes. It’s going to cause a lot of instability during a time where we really need to just focus on our patients,” said Mithani.

The doctors’ letter warns against continuing to stress an already stressed health-care system. NDP health critic David Shepherd echoed that sentiment and said the province is not listening.

“They are not considering the real impact this is going to have on people that they would continue to force through these changes as part of such a problematic budget in the face of a massively transformed landscape and health crisis in the province,” Shepherd said.

Mithani said Alberta is reaching a potential crisis with increasing numbers of COVID-19 patients. The province has announced 690 cases and eight deaths to date.

“This next week or two is going to be quite telling in terms of whether we’ve been able to flatten the curve. And if not, that means that we’re going to be seeing huge volumes of patients come into the health-care system with COVID who are getting quite sick,” Mithani said.

“To make all of these changes right now, it just doesn’t make sense. We should be focusing on our patients and focusing on caring for those patients and we can talk about these changes after the pandemic is over.”