Physicians need `immediate action' on primary care pay model: AMA
System `never recovered' from Shandro's move to tear up agreement, doctor says
All the millions and zeros from Thursday's budget debut have yet to translate to a new primary-care pay model, leaving Alberta's family doctors poised on the brink of either a solution or a catastrophe.
Many members of the Alberta Medical Association were upset the new model wasn't a line item in the budget, a done deal amid clumps of cash in an already complicated document, said Alberta Medical Association (AMA) president Dr. Paul Parks.
“I share their frustration with that,” Parks said.
Meetings are imminent in an “I'm slammed today with all the budget buzz” kind of way, with the Alberta Medical Association hoping to finally get a new pay model in place within days to replace Alberta's current fee-for-service-only model, which has been updated by provinces from Ontario to B.C. in a country where a growing number of Canadians find themselves without a primary care doctor and recruiting competition is fierce, if not overt.
Amid the hubbub that is the rotunda of the Alberta legislature following the budget drop, Parks and Health Minister Adriana Lagrange touched base Thursday, Parks said.
“The minister has repeatedly said she gave her word to get us to move to this model,” he said.
“This is what she said to me clearly after the budget: that they are fully committed to the new funding model and to making sure that once we like finalize those last little details ... she is committed that it will be competitive with B.C., Saskatchewan, Manitoba,” he said. “That was the commitment I got directly from the minister after the budget so I hope that that's the way it goes.”
The AMA'S economics team is giving the document a going-over for specifics, but “it's mostly big lump sums of money,” Parks said.
“So it's all going to be around the specifics, and the devil will honestly be in the details around how they're going to spend some of that money that they're dedicating, because it's difficult to say, even combing through that budget, exactly what they're planning with it,” he said.
“I spent a lot of time with the minister after (the budget dropped), saying `Listen, we need action out of this — it can't be just promises. I've said this a bunch, but it's really true.'”
The AMA and the UCP government's longitudinal funding plan are in agreement on the big major components, while little details need to be hashed out, he said, noting family physicians can't run a business on promises.
He's still getting messages from doctors around the province: “I'm contemplating not renewing my lease,” or “I'm going to go into a different type of practice,” or “I'm going to leave Alberta completely.”
A qualified family physician has choices: they can work in ER, as a hospitalist, or assist in surgeries.
“We need immediate action — concrete, objective evidence that the government is moving forward on this new funding model like ASAP,” he said.
“We will not have anything left to build on in primary-care, family medicine in this province. If we delay it for another year, it will be devastating.”
The AMA is not just blowing smoke, Parks said.
Within Alberta's medical school ranks, students are turning away from family practices long-developed by a corps of beloved family doctors, he said, citing dinners with students in recent weeks, where just one in 19 students was even remotely intrigued by the family-practice option.
He points to internal medicine unable to recruit, the Grey Nuns Hospital releasing a letter saying they'll stop admitting patients, and 650 postings for physician positions that can't be filled.
“It's insane. It doesn't need to be this way. We can change the narrative to `Alberta's an amazing place to work,' and we have to,” he said.
Like the provincial government and Albertans themselves, familycare practices have been hit hard by inflation — but history itself looms large.
Parks points to then-health minister Tyler Shandro in the previous UCP government tearing up the province's master agreement with physicians in February 2021.
“It's the first time in history that physicians have had a negotiated contract just totally torn up, and we had no recourse (of strike or Supreme Court challenge),” he said.
Shandro later walked back some of his sentiments, Postmedia reported, but the damage was done.
“They made a couple of unilateral cuts to family medicine, the fee-for-service funding ... that actually amounted to about a 20 to 30 per cent pay cut for family medicine, and they've never recovered,” Parks said.
“All that's the legacy from the last government and we have not recovered from it.”
Lagrange posted Friday morning on X, the social media platform formerly known as Twitter, saying the 2024-25 budget contains the largest physician compensation package in Alberta history.