Physician funding model still just elevated fee for service, AMA react

Article content

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 AMA president Dr. Paul Parks.

Article content

Article content

“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 BC 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.”

Article content

Article content

The AMA’s economics team is giving Thursday’s 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 is at 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.

Article content

“We need immediate action — concrete, objective evidence that the government is moving forward on this 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 docs, 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, family-care practices have been hit hard by inflation — but history itself looms large.

Article content

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),” Parks recalled.

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.

“There wasn’t a physician in Canada that wanted to look at Alberta to come and work when the government is acting like that.

“All that’s the legacy from the last government and we have not recovered from it.”

The light at the end of the tunnel may not be a train.

LaGrange posted Friday morning on X, the social media platform formerly known as Twitter, saying the 2024-2025 budget contains the largest physician compensation budget in Alberta history.

Article content

She thanked the AMA and Parks for “collaboration and continued advocacy.”

“Budget 2024 reinforces our commitment to address issues in primary-care family medicine,” she wrote.

“We are committed to working with @PfParks and the @Albertadoctors on a new physician compensation model to support comprehensive family medicine, in a way that continues to align with other provinces and will keep retaining and attracting the best and brightest family physicians to Alberta,” LaGrange posted.

Getting the primary-care pay model done will enable everyone to address other fires in the Alberta health-care system, Parks said.

“We have to be able to secure the family medicine piece so that we can actually start to put some of our energy and focus on the other big issues,” he said.

Article content