Report from the Board of Directors

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Questions about the Report from the Board of Directors? Please email president@albertadoctors.org.

The Board invites all members to participate in the virtual AGM at 6:30 p.m. on Tuesday, October 3, 2023. 

The AGM is an opportunity for members to engage with the president and officers of the Alberta Medical Association regarding matters affecting the profession and our patients in the year ahead. This report is the account of the Board of Directors to the membership for the year October 1, 2022 to September 30, 2023. Any significant updates after time of writing will be reported at the AGM.

There are three parts to this report:

  1. YEAR IN REVIEW is a recounting of the events of the year around two key themes:
  2. AMA ADVOCACY provides an overview of the issues and strategies applied to remain united and support members to help Albertans understand what is happening in the health care system.
  3. PERFORMANCE AND BUSINESS PLAN REPORTING provides highlights of what we did – and how well we did – under the business plan that articulates the direction, dollars and staff made available for members throughout the year and all related activities.

A YEAR IN REVIEW: How the AMA supported members in 2022-23

The following section details multiple events and challenges over the past year – in chronological order – and demonstrates how the AMA consistently supported members through:

The AMA President’s Letter is our foundation communication tactic. It serves to inform members about what is being done on their behalf, but at various times also serves as a news release and MLA backgrounder. Anything significant that the AMA has to say in the public eye will typically be shared via a President’s Letter. A chronology of letters for the business year presents a detailed timeline of activities and issues.

Agreement implementation and representing member interests:

October 6, 2022: AMA engages with UCP leadership candidates.

November 4, 2022: AMA seeks reps for new committees as per AMA-AH Agreement.

November 17, 2022: Calling for system stability as administrator replaces AHS Board.

November 21, 2022: Daily cap temporarily removed, details about lump-sum payment (as per AMA-AH Agreement).

November 24, 2022: Details on lump-sum payment, MLR and CME.

December 5, 2022: Government tables legislation to repeal Section 40.2 of the Alberta Health Care Insurance Act, which allowed government to terminate its agreement with the AMA.

December 15, 2022: Increase to the Business Costs Program implemented as per AMA-AH Agreement.

December 19, 2022: Thanking the CMA for their unwavering financial, political and moral support.

December 20, 2022: Section 40.2 of the Alberta Health Care Insurance Act officially struck down, as per AMA-AH agreement the AMA discontinues its lawsuit against government.

January 5, 2023: Announcement regarding first retroactive fee-for-service payments.

February 24, 2023: News on retroactive payments for physicians in clinical ARPs, AMHSP, sessional clinical ARPs and the Blended Capitation Model.

March 23, 2023: AMA-administered Continuing Medical Education Program opens for 2022-23 claims.

March 27, 2023: Update on top-up payments for 2022 Medical Liability Reimbursement.

April 3, 2023: Year one allocation complete and new SOMB posted as per AMA-AH Agreement.

April 6, 2023: AMA calls for consistency and structure in all AHS payments.

April 24, 2023: $12 million in funding available to physicians through AMA-AH Agreement to help increase adoption of CII/CPAR.

May 19, 2023: Update on key result areas, achievements and short-term solutions.

May 31, 2023: Lab physicians need due process after five years without AHS contract.

July 25, 2023: Physicians appointed to AMA-AH Alternative Relationship Plan Working Group to address alternative compensation models issues.

August 17, 2023: AMA representatives aligned and clear on the need for urgent action to address the family medicine crisis.

August 21, 2023: Lab physicians hope for stability as government announces transition of all lab services from DynaLIFE to Alberta Precision Laboratories.

September 18, 2023: Top-up to one-time recognition payments issued.

Responding to System Issues, Opportunities and the Care Deficit

October 21, 2022: Responding to Airdrie urgent care crisis.

November 15, 2022: Advocacy for virus season precautions.

January 3, 2023: Independent pharmacist clinics weaken comprehensive care.

January 13, 2023: AMA releases tracking data on the care deficit and pandemic disruptions to patient care.

January 24, 2023: Update on Modernizing Alberta's Primary Health Care System (MAPS) Innovation Forum.

February 8, 2023: Federal government announces $46 billion in new funds for health care.

February 10, 2023: Joint Physician Advocacy Committee (JPAC) focuses on family medicine and acute/hospital care.

February 20, 2023: AMA submits proposals to MAPS to improve Alberta’s primary care system.

February 21, 2023: Short-term recommendations from MAPS show promise but immediate action is needed.

February 27, 2023: AMA shares system priorities as provincial budget and election focus largely on health care.

March 1, 2023: AMA asks where new health care dollars will go as provincial budget is released.

March 3, 2023: Health care system still in crisis as Premier, Minister of Health and Alberta Health Services Official Administrator announce improvements.

March 6, 2023: AMA President releases statement regarding a study identifying explicit anti-Indigenous bias among some Alberta physicians.

March 17, 2023: Government moving forward with MAPS, holds virtual discussion on rural and remote primary health care.

March 24, 2023: AMA launches Handle With Care information program to keep health care top of mind for Albertans during the election: Issue 1 – Care of the Elderly.

March 27, 2023: First round CaRMS numbers alarming as 42 family medicine residency positions in Alberta go unmatched.

March 30, 2023: AMA shares additional information about first-round CaRMS results.

March 31, 2023: Handle With Care Issue 2: Human Health Resources.

April 11, 2023: Handle With Care Issue 3: Pediatric Mental Health.

April 20, 2023: JPAC Gratitude Program invites physicians to thank their colleagues.

April 21, 2023: Handle With Care Issue 4: Rural Health Care.

April 27, 2023: Twenty-two Alberta family medicine spots remain unfilled after second round CaRMS match.

April 28, 2023: Handle With Care Issue 5: Indigenous Health.

May 1, 2023: AMA stresses importance of proper implementation as government makes statement on final reports from MAPS.

May 5, 2023:  Handle With Care Issue 6: Drug Poisoning Crisis.

May 11, 2023: Handle With Care Issue 7: Primary Care.

May 19, 2023: President responds to frustrated members; stresses importance of unity in times of extreme difficulty.

May 23, 2023: AMA hosts virtual patient town hall about health care with Alberta New Democrat Party and United Conservative Party leaders.

May 24, 2023: UCP and NDP respond to AMA questions about the health care system.

May 30, 2023: AMA reaches out to Premier Smith immediately following provincial election win.

June 13, 2023: AMA President meets with new Minister of Health Adriana LaGrange to lay out the critical issues facing the profession.

June 28, 2023: Specialty Care Alliance conducts a survey to assess the impact of Connect Care implementation on members.

June 30, 2023: AMA's Indigenous Health Committee provides statement on the resignation of Dr. Esther Tailfeathers from her AHS role.

July 11, 2023: Urgent discussions with government focus on stabilizing family medicine clinics at risk of collapse.

July 19, 2023: AMA and physician leaders continue to push for urgent action to stabilize practices across the system.

August 1, 2023: Athana Mentzelopoulos announced as new Executive Director as Mike Gormley prepares to retire October 1.

August 4, 2023: AMA continues to push government to take urgent action to stabilize family medicine.

August 11, 2023: Members encouraged to stay informed as final report on AMA’s Income Equity Initiative will be presented to Fall 2023 Representative Forum.

August 31, 2023: Some membership dues increased to allow the AMA to continue supporting members in increasingly challenging times.

September 8, 2023: AMA president updates members on the pressing issues and critical topics that the Board and Representative Forum were focused on going into the Fall 2023 RF meeting.

September 14, 2023: AMA president calls for lab physicians to be treated fairly and with due process.

AMA ADVOCACY

With an agreement in place, in 2022-23 the AMA focused on seeking to collaborate with government to improve the system, while still holding them accountable. The AMA created opportunities for members to find a balance to engage in government relations and advocacy in several areas, including:

  • Agreement and implementation: Members who engage to advance physician financial viability (their own and that of their colleagues) and support patient care.
  • Governance and leadership: Members who engage to be part of building up the profession and their roles in society.
  • Advocacy: Members who engage and are motivated by active advocacy for patient care.
  • Government relations: Members who engage because they want to affect their local environments and communities.

Government relations

Prior to the May provincial election and guided by the Joint Physician Advocacy Committee plus expert external advisors, AMA advocacy and government relations programming focused heavily on making Albertans and government aware of priority issues and pressure points in the system. Our Care Deficit Assessment series provided much of the core content along with health human resources shortage and the urgent need to support community family medicine (as demonstrated by our President’s Letters elsewhere in this report).

After the election, attention was focused on activities related to rebuilding relationships. The AMA President and Board had multiple meetings with the Minister of Health and AMA senior staff actively engaged with the senior civil service. Whether in direct meetings with government officials and staff, or through public communication including media interviews and AMA communications channels, the AMA continued to stress the need: for immediate and long-term action toward stabilizing primary care and family medicine; and for engaging with the AMA on primary care reform, AHS payment issues, governance changes at Alberta Health Services, etc.

Joint Physician Advocacy Committee (JPAC)

Advocacy, public and government relations activities were ongoing throughout 2022-23.

As the Board and senior staff worked to repair our relationship with government, the Joint Physician Advocacy Committee helped the AMA prioritize topics for advocacy by feeding in concerns from grassroots members and letting us know what they were seeing on the ground in their own practices and specialties. Throughout 2022-23 JPAC brought specialists and primary care physicians together to support and advise on AMA advocacy activities.

At the end of March 2023, under the guidance of JPAC, the AMA launched a public information program to help ensure that health care remained front and centre for Albertans in the lead-up to the provincial election on May 29.

Election Information Program

Handle With Care was an election information program designed to inform Albertans about what was happening in the system and help them consider their own expectations around health care. They described key issues and presented questions that candidates and parties should be prepared to answer or address.

Handle With Care focused on seven key themes drawn from patient research in our online patient communities, as well as the 2022 Care Deficit Assessment Series. Themes were vetted with the Joint Physician Advocacy Committee and the Representative Forum and were as follows:

In the final component of our election information program, the AMA publicly posted responses from the two major parties to the questions we posed about each of the seven topics covered through Handle With Care.

On May 22, 2023, the Handle With Care information program culminated in a virtual town hall event and members of our 48,000 PatientsFirst.ca online community were invited. The town hall featured NDP Leader Rachel Notley and UCP Leader Danielle Smith speaking to important health care issues.

Over 2,000 Albertans showed up on a holiday Monday evening to engage with the candidates in what was the only additional event during the election window at which Danielle Smith and Rachel Notley appeared together. A recording of the PatientsFirst.ca Election Town Hall was posted on the AMA website.

JPAC Shine On Gratitude Program
In April of 2023, JPAC members began an initiative that allows physician colleagues to easily recognize and thank one other. JPAC members recognized that while there are many things that physicians need as professionals, they also have needs as individuals who are working hard every day.

The JPAC Shine On Gratitude Program gives physicians the opportunity to thank their colleagues for their acts of kindness – big and small – and was designed to help lift the spirits of physicians and learners through the simple expression of gratitude.

Value of Family Medicine
In follow-up to covering the topics of rural and primary health care in the election information program, JPAC continued to focus heavily on informing the public and government about the value of family medicine.

Working closely with members of JPAC, a web page was created to share important information about the crisis facing family physicians: Understanding Alberta's family medicine crisis. Information was updated and added throughout the remainder of the year.

Hospital and Acute Care Working Group
In early 2023 JPAC invited physicians from various specialties to take part in a Hospital and Acute Care Working Group. The intent of the working group was to help focus JPAC advocacy efforts by zeroing in on issues and challenges facing hospital and acute care physicians and patients.

Meetings were held to prioritize external advocacy issues. The Specialty Care Alliance assisted by identifying groups for a cross section of issues including internal medicine, general psychiatry, gastroenterology, emergency medicine, pediatrics, cardiology and obstetrics and gynecology.

Over several meetings of sharing experiences, the group arrived at three themes: (1) Burnout/healthy working environments and lack of engagement in AHS; (2) Incapacity and need for a physician supply and clinical resource plans with a need for more access to data to inform decision making and planning; and (3) Incentives and need for infusion to fee for services.

PatientsFirst.ca
The 48,000 member PatientsFirst.ca online community is an activist group, interested in supporting physicians and lending their voices to advocacy. They played an important role this past year in the AMA’s Handle With Care pre-election information program. The activists contributed questions and issues that they believed politicians should be able to answer. Their input provided the content for the virtual town hall, hosted by the community and the AMA, with Danielle Smith and Rachel Notley. On the holiday Monday of the Victoria Day weekend, more than 2,000 participated – the largest online event of which we are aware during the election, and the only event (other than the official debate) that the two party leaders participated in together during the election.

Albertapatients.ca
Since 2015, the AMA has maintained the unique albertapatients.ca community in which 14,000 patient members explore perspectives on health care. The results are brought forward as the patient voice in our advocacy and discussions with system partners.

We have fielded frequent surveys on topics relating to AMA advocacy activities and shared the results with the profession and the public through President’s Letters, social media and earned media.

Surveys have gathered patient perspectives on a range of topics including pediatric mental health, the primary care experience, patient attitudes with respect to care provided by allied health professionals, virtual care from their own physicians versus corporate offerings and attitudes and experiences in the emergency department.

Social and earned media
Over the course of the last year the AMA continued to grow its social media presence.

In June of 2023 the Public Affairs team expanded to include a Social Media Coordinator to help streamline, focus and coordinate social media activities, including exploring new opportunities and possibilities in the social media space.

The AMA had a very busy year on social media sharing information and amplifying important conversations.

NB: The following hyperlinks are intended to provide a small sampling of the breadth and depth of the AMA’s social media posts in 2022-23. The list is not exhaustive.
We continued the discussion about:

We provided a significant amount of public health advice on:

During Alberta’s election period (end of March to mid-May), we produced and shared our Handle with Care election program, in which we offered much information and questions regarding the care of the elderly; health care human resources; pediatric mental health; rural health care; Indigenous health; primary care; and the drug poisoning crisis.

We promoted and reminded our followers about our programs and their initiatives, including:

We shared:

We amplified our communications:

As well as helped to amplify partners' messages, including:

We added our voice to many trending topics such as:

We gave kudos and recognized members:

We circulated messages from physicians such as:

And we participated in many special campaigns including but limited to:

PERFORMANCE AND BUSINESS PLAN REPORTING

The 2022-23 AMA Business Plan, approved in September, was developed with a continued focus on essential deliverables, while working toward a new agreement with government. The ratification of the AMA Agreement in October 2022 introduced several new deliverables and created new policy opportunities, which were not part of the original business plan.

As a result, the Board undertook a review and produced a 2022-23 Business Plan Update, which highlighted new activities and provided an updated financial forecast. New activities were as follows:

  • Implementing the agreement.
  • Policy initiatives and opportunities.
  • Government relations and advocacy.
  • Rebuild and reconnect.

Note that updates on the work done in these four areas are provided below through reporting on one or more of the goals within our three Key Result Areas.

In addition to the above new activities, the Board also established goals for the organization that cascaded from the AMA mission. These were categorized in three broad Key Result Areas:

  1. Financial health for physicians and their practices.
  2. Well being (personal, workplace, community).
  3. System partnership and leadership.

There were nine overarching goals (three under each Key Result Area) with related activities. The purpose of the goals was two-fold: they expressed how the Board wanted to deliver value to physician members and also what was felt to be most important in moving toward the association’s vision. Connected to each goal were the related activities that were planned for the 2022-23 fiscal year. These were developed by staff with Board oversight.

Achieving the goals under the three Key Result Areas requires a healthy, vibrant and sustainable AMA. The Healthy AMA section of the business plan focuses on core organizational capabilities in the areas of governance, workforce, financial, relationships and knowledge.

Activity continued toward achieving each of the AMA’s goals. The following content provides a summary of the activities under each goal within the Key Result Areas, including highlights, progress and challenges.

Key Result Area 1 – Financial Health

The goals under Financial Health were:

  1. Physicians are fairly compensated for their skills and training in comparison to other professionals.
  2. Physicians’ practice management decisions are based on sound management advice and best practice.
  3. Reliable and best-in-class financial products are available to all members.

Goal 1: Physicians are fairly compensated for their skills and training in comparison to other professionals.

On September 28, 2022 voting closed for the 2022-26 agreement package the AMA had negotiated with government.

Members ratified the agreement with a “Yes” vote from 70.2% of responding physicians. Voter turnout was 45.8%. On September 29, past-president Dr. Michelle Warren and then health minister, Jason Copping held a joint news conference to announce that an agreement had been reached.

Agreement implementation

Implementation activities continued throughout 2022-23. At a staff level, the Joint AH/AMA Agreement Implementation Working Group met weekly to discuss the status of implementation activities and regular updates were provided to the AMA Board.

At time of writing, work continued on implementation of many agreement deliverables:

  • Management and Rates Committee representatives: After a membership-wide callout process, the AMA Board selected Dr. Paul Boucher and Dr. Alison Clarke as AMA physician representatives for the Management Committee. Dr. Heidi Fell, Dr. Jeff Way and Dr. Brian Wirzba were selected as AMA physician representatives for the Rates Committee.
  • Daily visit caps: The parties agreed to lift the daily visit cap policy pending a review of the impact of the previous policy and its impact on patient access. A Ministerial Order was signed with change effective December 1, 2022. The results of the review, expected in late 2023-24, will inform any future policies beyond the current fiscal year.
  • Business Cost Program: This work was completed. Rates were increased December 15, 2022, and retroactive payments for 2022/23 services prior to the rate increase on December 15 were deposited on April 28, 2023.
  • Recruitment and Retention Funding: The agreement provided funding of $15M per year to support recruitment and retention of physicians who practice in underserviced areas. The AMA formed a Recruitment and Retention Working Group to consider objectives, eligibility criteria and conditions for payment. The group included leaders from the Section of Family Medicine, Section of Rural Medicine, Specialist Care Alliance and an AMA PRP Working Group representative.
  • RRNP Funding: The agreement included funding of $12M per year to support improvements to the RRNP program. A retroactive payment for the 2022-23 RRNP year is currently being discussed with Alberta Health. The RRNP review is expected to begin in Fall/Winter 2023. The Recruitment and Retention Working Group will help guide this work.
  • Secure access to benefits for medical examiners: Both parties reviewed this issue and provided input for consideration by the Management Committee at its September 2023 meeting.
  • Virtual Care: Under the terms of the new AMA Agreement, AH and AMA committed to a joint review of virtual care to be completed by March 31, 2023. As part of this, a review was to be undertaken of mental health virtual care codes by November 30, 2022, with a ministerial decision by January 1, 2023. This work was delayed by the slower than anticipated formation of the Rates Committee. In early April 2023, the Rates Committee and Management Committee recommended implementation of virtual care priorities for mental health services put forward by the AMA during negotiations. While the changes were approved at the joint AMA/AH Rates Committee and Management Committee, the health minister at the time, Jason Copping, did not have an opportunity to sign off on the changes before the 2023 provincial election was called. At time of writing, the request was still being considered by government. The wider virtual care review is still outstanding, including implementation of some other virtual care improvements previously identified by the AMA and Virtual Care Working Group.
  • IM/IT Funding: The IM/IT Working Group achieved consensus on recommended parameters in January 2023. The parameters were approved by the Management Committee in early March and the grant was executed on March 31, 2023.
  • One-Time Payment (COVID): This work was completed. The grant was executed December 15, 2022, with funding provided December 20 and payments issued to physicians on December 23.
  • Physician Support Program Grant Agreements: The 2022/23 PSP grants have been executed (PFSP-CAP, PLP, CME, Locum) and first payments were provided. At time of writing, AH was initiating a process for 23/24 to 25/26 combined PSP grant, including PFSP-CAP, Parental Leave, CME and one-time computer system development grant (locum and ACTT to remain separate grants).
  • MLR Program: AH made top-up payments to physicians who paid a higher deductible for the 2022 Canadian Medical Protective Association year (the deductible was reduced to $1,000 for all physicians under the AMA Agreement).
  • GP Special Skills Locum Program: Locum grants were finalized and the program formally launched in March 2023.
AMA lawsuit

In December of 2022, the government tabled legislation to repeal Section 40.2 of the Alberta Health Care Insurance Act. This regulation enabled termination of the AMA agreement and its repeal was a commitment by government under the new agreement. Government issued a news release about repealing the legislation as a commitment to rebuilding the relationship with physicians.

In late December 2022, AMA legal counsel advised the Board that Bill 4 received Royal Assent, meaning it was a law in full effect. The AMA met its corresponding commitment and began to prepare and forward a Discontinuance of Legal Action without costs. The lawsuit was officially discontinued.

Other negotiations and payment discussions

Stipends
The new AMA Agreement saw stipends extended to March 31, 2025. Schedule 6 (page 46) of the agreement provides for a Stipend Working Group to develop a process to review current stipends paid by AHS to physicians and allows for an independent chair to make a decision, should the parties fail to reach consensus. Recommendations are made by the working group to the Management Committee and then to the minister.

The AMA worked with AHS (with AH in an observing capacity) toward developing the scope and process for decision-making with respect to AHS-paid stipends. The AMA provided a draft Terms of Reference for the Stipend Working Group as defined in Schedule 6. At time of writing, AMA and AH were scheduled to discuss the TOR and other matters at an upcoming Management Committee meeting.

A Memorandum of Understanding was signed between AMA and AHS outlining an AHS-AMA Engagement Framework on physician compensation related matters within AHS Facilities. The MOU addressed issues through a process of engagement (negotiating, renewing, extending) within the best interests of patients and the health system. The parties could, through mutual agreement, appoint mediation and/or arbitration to help resolve issues.

The AMA and AHS disagreed about the interpretation of the scope of Schedule 6, and a letter was sent to the Management Committee to seek resolution. AMA’s view was that all physician groups receiving AHS payments are to be included in the process described in Schedule 6. This included new AHS payments to physicians that were created after the agreement was signed. In the interest of consistency and fairness, the AMA felt it was important to deal with all payments under Schedule 6.

Throughout 2022-23, AMA staff and the Stipend Action Committee continued to exchange information with physicians receiving stipends, often regarding the AMA Agreement, the Engagement Framework and the due process that is available to them.

Market Rate Review
In 2023-24 the AMA began developing and moving forward with a strategy to properly prepare for and undertake inter-provincial review of SOMB, ARP and AMHSP rates in preparation for the rate review beginning in 2024/25. Rates Committee discussions of the market rate review are expected to begin in Fall 2023.

The AMA began development of a framework to ensure there is alignment between the various aspects of the AMA Agreement like market/rate review, global reopener negotiation, Income Equity Initiative, ARP/AMHSP rate review/rate setting methodology and other system initiatives. The framework included the following:

  • Development of a set of principles to guide the strategy (e.g., various components should work together to support system goals and not work against each other).
  • Description of the alignment between various components of the agreement and initiatives underway. As an example, how do results of the fee review and Income Equity Initiative feed into allocation?
  • Determination of how the AMA will support sections in the market rate review (fee and ARP/AMHSP comparisons, overhead differences, differences in service delivery, etc.).
  • Development of a common information strategy with government. What sources of information will be used to inform the market rate review, reopener negotiation and allocation? Where are the gaps and how will they be addressed?
  • Plan to advance these concepts with AH at the Rates Committee and Management Committee.
  • Plan to socialize concepts among sections, RF, AMA membership.

At time of writing, immediate priorities were to implement the 2023-24 and 2024-25 allocations, working with sections to implement their allocation priorities in advance of the market rate review.

Supporting laboratory physicians
Negotiations between AMA-ASLP and AHS-APL came to an impasse and at time of writing, mediation/arbitration was scheduled for November 2023. The president wrote to members about laboratory medicine issues to draw attention to the important work that lab physicians do in the system and the fact that they had been without an agreement with AHS for five years: 
 
Lab physicians: Fair treatment and due process 
Lab physicians hope for stability in latest changes to lab services
Lab physicians: Essential services deserving attention
Opinion: Physicians seeking fairness, stability in Alberta’s lab services (published in the Edmonton Journal, September 18, 2023)

On August 18, government announced that DynaLIFE would be transferring its staff, operations and physical locations in the province to the government-owned Alberta Precision Labs by the end of 2023. The AMA supported impacted physicians in the transition and advocated to ensure lab physicians were treated fairly and with respect and due process.

Supporting cancer care physicians
Collaborative Advisory Committee (CAC) meetings between AMA-CCA physicians and AHS commenced in 2022-23. Discussions included a high-level summary of activities undertaken by the previous Joint Workforce Planning Committee, identification of challenges in workforce planning and workload management and next steps. The goal was to address retention and recruitment issues for CCA physicians and AHS. A Workload Standards Working Group was struck under the CAC to engage in this work. 

Supporting alternative relationship plan physicians
The AMA continued to support and represent the interests of physicians considering a clinical ARP and/or already participating in clinical ARPs. The Management Committee was tasked with reviewing the application and approval process for alternatives to FFS payments, including ARPs. The goal was to increase transparency and efficiency and reduce red tape. AMA staff and the Clinical ARP Working Group continued to exchange information with physicians participating in clinical ARPs to identify key issues and priorities. Clinical ARP rates and associated FTE definitions will be reviewed by the Rates Committee as per the new AMA Agreement.

Supporting academic medicine physicians
The AMA also continued to support and represent the interests of AMHSP (Academic Medicine and Health Services Program) physicians at various provincial tables and in discussions with Alberta Health, AHS and the faculties of medicine.

The release of the draft AMHSP Master Agreement by Alberta Health was delayed and the current AMHSP Master Agreement and individual physician services agreements were extended for one year to allow time to complete the draft and the consultation process.

The AMHSP Council met in June to discuss expected changes and impact to AMHSP physicians related to the clinical rates funded through the Physician Services Budget; ongoing communications with participating physicians; engagement with AMHSP participating physicians; and Council direction to the AMHSP Negotiating Committee as it prepares for further engagement with AH once the AMHSP Master Agreement is released.

At time of writing, an expansion total of 72 FTEs to the existing AMHSP was in process. Three new programs will see a total of 12 FTEs each (anesthesia, obstetrics and gynecology, and general surgery); 12 new FTEs will be added in psychiatry focusing on pediatric and adolescent care and 24 FTEs will be added in family medicine. These positions focus on increasing the number of Alberta-trained physicians, as well as supporting generalist care in rural and regional centers. Grid rates for the new expansion groups are being discussed at a provincial subcommittee, and with discussions focused on existing provincial payment rate methodologies.

AHS sent a formal letter in early May 2023 acknowledging the AMA’s representation of AMHSP physicians and confirming they will honour the 2019 opt-in process. At time of writing, preparations were underway to confirm all participating AMHSP physicians working in the province. 

Goal 2: Physicians’ practice management decisions are based on sound management advice and best practice.

Schedule modernization

Allocation provisions under the new AMA Agreement allow for some section and AMA-driven fee modernization:

  • Allocation year 1: Fee-only adjustments. The Rates and Management Committees approved section-submitted changes which were implemented on April 1, 2023.
  • Allocation year 2: Fee adjustments and some limited SOMB amendments (new and amended codes, wording and rule changes). Activities are currently underway, with sections having submitted priorities by November 30, and the AMA Fees Advisory Committee having assessed requests by the end of February 2023. Discussions are underway with government, with Rates Committee approval scheduled for fall 2023.
  • Allocation year 3: Sections are recommending fee adjustments and more significant structural changes over summer 2023. The AMA Fees Advisory Committee to assess proposals beginning in September. Discussions with government will follow sometime in the fall period.
Peer Review

Informal peer review for billing appropriateness occurred within various sections of the AMA and within the AMA’s billing education services. Re-establishment of a formal AMA Peer Review Committee is dependent on future government support to establish a trusted third party to distribute confidential peer review information to physicians.

Collaborative Learning

The “Vital Clinics” program was launched in May 2023. The first facilitated learning session was conducted, followed by a session for practice facilitators and a workshop addressing key clinic processes and efficiencies. An evaluation was conducted to understand how well the target audience for the program was reached and modifications to the program are under way prior to offering a second round of the sessions. Another set of sessions is scheduled for late September 2023 and current access materials are being reviewed.

Goal 3: Reliable and best-in-class financial products are available to all members.

The AMA continued to operationalize the MD Financial/Bank of Nova Scotia alliance with Alberta-based MD Financial teams to ensure members benefit from our respective offerings. 

A process was developed with MD Management’s regional management team to ensure that members received coordinated advice on their insurance and wealth management needs regardless of the members’ entry point (i.e., ADIUM Insurance or MD Management).

The Alliance Management Committee, which includes representatives from BC, AB, SK, MB and Yukon medical associations, along with MD Management and Scotiabank representatives, met regularly to review insights, trends and best practices to improve offerings to members.

A market study and analysis of the Disability and Professional Overhead Expense plans with Manulife was completed to ensure coverage and premiums were competitive and that the plans would remain viable over the long-term. A 9% rate increase was implemented (the first in many years), effective January 1, 2023. These changes will stabilize the plan, while continuing to offer competitive products to members.

Key Result Area 2 – Well being (personal, workplace, community)

The goals under Well being were:

  1. Physicians are supported in maintaining their own health and that of their families.
  2. The AMA is a broker in bringing together physicians, patients and families toward healthy communities. Physician and community contributions are supported and celebrated.
  3. The AMA is committed to working with and for physicians to address system issues which impede attaining a safe, healthy and equitable working environment.

Goal 1: Physicians are supported in maintaining their own health and that of their families.

Physician and Family Support Program

During the reporting period of January 1, 2023 – July 31, 2023, the PFSP received 2,168 calls to the Assistance Line, which is an 18% increase over the same period in 2022. This increase is in line with the growth the program has been experiencing over the past four years. To address the impact of this growth on the PFSP, the service delivery model for the Assistance Line will move toward two assessment physicians on first call each week.

There were 6,092 therapy hours provided to eligible physicians and their families who called the Assistance Line. There were 2,066 hours of administrative time spent providing this counselling service by the third-party service provider, Unify Consulting Group. For both therapy hours and administrative time there was a 13% increase over the same period in 2022.

Assessment physicians provided 5,088 hours of coverage to the Assistance Line and spent 784 of these hours talking with individual callers, providing support and assistance.

Case Coordination

From January 1, 2023 – July 31, 2023, the PFSP’s Case Coordination service experienced an increase of 15% in new accesses over the same period in 2022. The number of physicians accessing this service on a yearly basis is typically small (approximately 30-35 in a year). Percentage fluctuations are expected and not necessarily indicative of trends or issues. There were 399 therapy hours provided to clients participating in Case Coordination and 61 hours of administrative time spent providing this counselling service by the third-party service provider, Unify Consulting Group.

Education, Prevention and Promotion

In 2022-23, 11 formalized activities were held that focused on prevention with some of those also providing an element of education and/or program promotion. Of the 11 events, eight were targeted to residents, three to students and six to physicians. Topics included physician suicide, substance use, career transitions and peer support team training.

The PFSP staff promoted the program and the Assistance Line at five different events that together encompassed physicians in all career stages and three locations (Edmonton, Calgary and Red Deer).

The PFSP continues to experience a surge in requests for family physicians through the Physicians 4 Physicians (P4P) service.

  • 360 requests for family physicians were received from January to July 2023, an 83% increase over this same time last year.
  • Of these requests, 335 (93%) were for providers in either Calgary or Edmonton while only 35 physician providers are located in the two urban centres.
  • June and July of 2023 saw a record number of requests at 63 and 74 respectively. 

In an effort to bolster the P4P service and meet the demand, the PFSP reached out to collaborate with leaders from both Alberta Health Services and Primary Care Networks. However, the reality of the family physician shortage at the time led to a mismatch between supply and demand. At time of writing, the sustainability of the service was uncertain.

Well Doc Alberta

Well Doc continues its excellent work helping physicians to remain resilient and well. Well Doc Alberta’s initial three-year funding was secured with active support and assistance from the AMA. The AMA remains open to opportunities to help support activities related to securing funding.

Affinity funding

The AMA continued to operationalize funding from the Affinity Collaboration (Bank of Nova Scotia, the Canadian Medical Association and MD Financial Management Inc.) to help address the health and wellness needs of physicians and medical learners, including implementing psychiatry services as an additional offering.

Service provision to physicians who fell outside of the eligibility criteria listed in the grant agreement was in place to ensure retired physicians and those who may have been too ill to work were able to receive support. From January to June 2023, 130 hours of therapy and administration time were provided to this group of physicians. A psychiatrist has been hired to support the Psychiatric Assessment program and they began working with the PFSP clinical team in June. The psychiatrist worked with clients and supported the PFSP team in further developing the program.

Goal 2: The AMA is a broker in bringing together physicians, patients and families toward healthy communities. Physician and community contributions are supported and celebrated.

Shine A Light

Shine A Light recognizes and profiles AMA member physicians who are making a difference every day in big and small ways. The program was revitalized in 2022-23 in an effort to profile more physicians more frequently.

The following physicians were nominated for Shine A Light in 2022-23:

Honourees were also recognized across AMA’s social media platforms and featured in Alberta Doctors’ Digest. 

Emerging Leaders in Health Promotion (ELiHP) grant program

Due to declining applications and resourcing pressures, a decision was made in 2022-23 to cancel this program.

AMA Youth Run Club

Youth Run Club had a busy 2022-23 school year with 22,000 students participating at 300 schools across Alberta.

In 2022-23 there were 46 Walking Champion Clubs, 24 Girls Only Clubs and 17 Rainbow Run Clubs at various schools. There were also run clubs at 19 Indigenous schools.

Key events throughout the year included a Track and Field Day held in Airdrie with students from nine schools participating in track and field and traditional Indigenous games, 75 fun runs, and a Medicine Hat Run Day with 1,100 student participants. Click to view the AMA Youth Run Club - Annual Report 2022/2023.

At time of writing, the Board was considering the future of this program. The AMA has one more year of funding committed to this program for the 2023/24 school year. 

Goal 3: The AMA is committed to working with and for physicians to address system issues which impede attaining a safe, healthy and equitable working environment.

Healthy Working Environments

The AMA, the College of Physicians & Surgeons of Alberta and Alberta Health Services collaborated on a new online training course for Alberta’s physicians on race-based micro-aggressions. The course launched on June 14 and is available to all regulated members through the myCPSA virtual learning platform. Early results from post-training survey respondents are excellent and indicate that the VITALS tool and scenario-based learning are very useful. CME accreditation is expected in October 2023.

Results of the environmental scan were discussed with the HWEAC. There was discussion on how to share this information with membership.

Physician Leadership Institute courses on Crucial Conversations and Trauma-Informed Leadership were offered in the Spring of 2023. Approximately 39 physicians have met the criteria to participate in group coaching, which will be scheduled at a future date.

The CMA National Physician Health Survey 2021 was released in August 2022 and stated:

“The key findings from the national study reveal that numerous subgroups are experiencing more negative wellness outcomes, including medical residents; those under 35 years of age; those identifying as women; those practicing six to ten years; caregivers of a child and/or parent or family member in the home; those living with disabilities; and those working in small town/rural or isolated/remote areas. Still, not all the results are discouraging: there are signs of a culture shift toward prioritizing wellness. That is, medical residents and younger physicians report accessing support for their mental health challenges more frequently than practicing physicians who are at a later career stage. While some of those who need wellness supports are accessing them, there are still significant barriers to overcome, such as stigma, availability and concerns around confidentiality."

Alberta-specific findings, from this CMA survey, were released in January 2023:

“Respondents from AB are significantly less likely to have been experiencing burnout at the time of the survey (49% vs. 53% national total). Across other key psychological measures, there are no significant differences: half test positively for depression, and a quarter experience moderate to severe anxiety levels; 38% report having had thoughts of suicide at some point in their life and 14% have had thoughts in the past 12 months.” 

PFSP continued to advocate and collaborate on these important issues.

AHS updated the AMA Healthy Working Environments committee on safe reporting, trauma-informed leadership training and other related initiatives at their spring meeting. AHS established a Bilateral Complaint Resolution group in October 2021. Its purpose is to focus on improving processes for worker-to-worker concerns, including harassment and violence complaints. The work is ongoing with an anticipated end date of June 30, 2025.

Key Result Area 3 – System Partnership and Leadership

The goals of System Partnership and Leadership were:

  1. Working with Alberta Health, AHS and other partners, lead and influence positive change in the delivery of services.
  2. Key incentives and supports for physicians are aligned with the delivery of care and toward overall system objectives of timely access for patients to quality care.
  3. Physicians and the AMA, in partnership with patients, play a leadership role in advocating and promoting a system characterized by Patients First®.

There are several different streams of activity under KRA 3, and various strategies were undertaken to promote physician leadership in a high-performing health care system. The business plan lists these things separately for purposes of reporting, but in practice, the Board found that we need to treat them as being dynamically and closely intertwined. Success in any one dimension is not possible without support from the others.

Goal 1: Working with Alberta Health, AHS and other partners, lead and influence positive change in the delivery of services.

Modernizing Alberta’s Primary Health Care System (MAPS)

Since September 2022, the AMA has participated in MAPS. MAPS was initiated by the minister and supported by Alberta Health. The Board approved budget and staff resources to support physician leader participation, including support for research and a coordinating group chaired by Dr. Brad Bahler and the Assistant Executive Director of ACTT. Input into MAPS was provided by AMA’s sections of Family and Rural Medicine and the Speciality Care Alliance. The PCN Physician Leads Executive; Provincial PCN Committee (PPCNC) and medical student representatives also provided input.

AMA’s input and collaboration was largely reflected in four MAPS proposals:

  • Seven short-term proposals submitted by various members of the coordination group set up within AMA.
  • A Section of Family Medicine/Section of Rural Medicine/PCN Leads Executive proposal, “Team-Based Funding.”
  • A Specialty Care Alliance proposal, “Linkages Between Primary Care and Specialty Care in the Health Neighbourhood.”
  • Provincial PCN Committee Proposal.

Physicians have been well-served by the physician leaders involved. The review process that was conducted included significant physician leader input.

Short-term recommendations were announced by government in February 2023 from both the Strategic Advisory Panel and the Indigenous Panel. The final report on the long-term recommendations was submitted on March 31, 2023.

There were many commonalities in the AMA-led proposals with respect to assessing challenges and recommending improvements to the primary health care system. Differences related mostly to the priority and timing of some of the steps or the degree to which they should implemented.

At time of writing there was an urgent need to provide additional support to physician practices given the financial and service delivery challenges they were facing. The AMA was advocating for prioritization of the PCN one-time funding and the funding review. The AMA was also seeking ways to strengthen the relationship between the primary medical home and PCNs. The AMA recognized that primary care governance would need to evolve and mature and that steps needed to be taken immediately to strengthen individual players and partnerships with an eye to developing a new model of overall governance.

Strengthening the Patient’s Medical Home

ACTT continues to support physician leaders, including the PCN physician leads executive, Inter-Zone Implementation Coordination Committee, PCN zonal physician groups, ASI working groups, physician champion network, Specialty Care Alliance and Primary Care Alliance in their work toward advancing the Patient’s Medical Home and the Medical Neighbourhood.

Notable progress at time of writing included:

  • Over 1.4M Albertans paneled through the Community Information Integration & Central Patient Attachment Registry (CII/CPAR).
  • $4.1M was paid out to physicians for the CII/CPAR Acceleration Grant payments in September 2023.
  • Over 2,200 providers are live on CII/CPAR (a 63% increase in 1 year).
  • Five clinics are on the Blended Capitation Clinic (BCM). One clinic has committed, three clinics are in financial evaluation and 64 clinics are in orientation. ACTT collaborated with three PCNs to deliver two zone BCM webinars in the Edmonton and Calgary Zones. ACTT also hosted two BCM Community of Practice meetings, supported facilitation and development of Practice Agreements for three BCM clinics and created peer-to-peer video vignettes.
  • A Home to Hospital to Home (H2H2H) Change Package was launched in January 2023 with supplemental online training in progress.
Alberta Surgical Initiative (ASI)

Discussion was ongoing with AH and AHS regarding evolving the ASI governance structure, as well as the operational oversight model for some of the program services. AMA continued to advocate to ensure physician input was provided at all levels of the governance structure.

The ASI 3.0 Governance Structure was proposed and the AMA has been asked review the Terms of Reference and to identify representatives for four committees, three of which are new (*): 

  • Provincial Surgery Steering Committee (PSSC)
  • Alberta Surgical Initiative Stakeholder Advisory Committee* (ASI-SAC)
  • Alberta Surgical Initiative Physician Expert Advisory Committee* (ASI-PEAC)
  • Provincial Specialty Access Steering Committee* (PSASC)

The other new addition to the ASI 3.0 Governance Structure is a Specialty Access Shared Services Executive Oversight Committee (PCSS_EOC) which will be a joint committee with AH, AHS and AMA.

Primary Care Network Funding Review

As per the AMA Agreement commitment letters, there were two groups that were active on PCN funding. The short-term group was set up to review and provide recommendations with respect to the $40 million in funding for PCNs in the next two years.

The short-term group recommended that the first $20 million be allocated for the April 1, 2023 – March 31, 2024 fiscal year to allow the PCNs to use the money right away. This group is reporting to the Provincial Primary Care Network Committee (PPCNC).

At time of writing, the AMA had asked for an extension for the additional $20M in year two (so that it could be allocated in the April 1, 2024 - March 31, 2025 fiscal year.

The long-term working group submitted recommendations to the minister on March 31, 2023. Physicians from the PCN Physician Leads Executive and the Section of Family Medicine were representative members of this group.

Goal 2: Key incentives and supports for physicians are aligned with the delivery of care and toward overall system objectives of timely access for patients to quality care.

The AMA’s Physician Compensation Strategy (login required) emphasizes value for patients and fairness to physicians, while identifying physician compensation objectives of equity, quality, access and productivity. The strategy also considers how other factors (such as informatics, peer review, modernization, relativity, etc.) have a role to play.

The AMA Board remains committed to the principles and aims of the Income Equity Initiative (login required), as contained within the compensation strategy. The goal of the initiative is to achieve a fair and justifiable distribution of earning capacity among sections. The measure looks at adjusted net daily/hourly income after considering each section’s compensation, overhead costs, training and career length, and hours of work.

Members may recall that in 2022 the interim IEI measure was used for year-one allocation of the agreement. Five sections that were ranked low according to the interim income equity measure were prioritized, including: family medicine, neurology, obstetrics and gynecology, pediatrics and psychiatry.

IEI work continued throughout the year, including expanding the interim model to incorporate additional compensation elements and the Hours of Work study results, as well as ensuring that the compensation, overhead, hours of work, and training and career length factors were aligned. The AMA Compensation Committee engaged with the Section Panel, individual sections (on request) and the AMHSP Council as the proposed measure was being completed.

The AMACC presented the IEI approach and measure, and proposed timelines for dispute resolution and member ratification to delegates at the Fall 2023 Representative Forum.

Physician supply

The AMA Agreement provides for the re-establishment of a Physician Resource Planning (PRP) Advisory Committee. The terms of reference that include the composition of this committee will be developed and recommended to the minister. Physician supply will be part of the implementation activities of the AMA Agreement.

An AMA PRP Working Group was established to support the association’s involvement in the multi-stakeholder PRP Advisory Committee and to help with other issues that deal with human health resources. In late-December 2023, a call went out for AMA PRP Working Group representatives. Representatives are Dr. Eric Wasylenko (Chair); Dr. Michael Auld; Dr. Scott Beach; Dr. Nicholas Monfries; Dr. Ankur Sharma; Dr. Suzanne Squires; Dr. Parker Vandermeer; Dr. Nathan Rider/Dr. Tamara Rider (PARA representatives: these residents will alternate their attendance); and Mr. Gareth Jones (Medical Student Rep).

The first meeting of the AMA PRPWG was held on May 24. The group discussed its role and how it can assist with solutions to address short-, mid- and long-term health resource needs for the province. The Working Group will partly focus on preparing the AMA for the anticipated revival of a minister’s Physician Resource Planning Advisory Committee.

e-Health modernization

AMA continued to co-chair the eHealth Modernization Working Group in 2022-23. Requirements sessions that focused on health system opportunities took place over the course of 2023 across stakeholder groups including patients, physicians and other health care professionals. AMA Informatics Advisory Committee (IAC) members and other physicians continued to be heavily involved.

Informatics updates
  • AMA continued to work closely with AH on the expansion of results and information made available to patients through MyHealth Records. The release of referral information is expected in the fall of 2023.
  • The Informatics Advisory Committee intends to meet with Alberta Health Services in September to discuss short- and long-term digital health priorities.
  • The IAC welcomed additional members to expand the expertise and breadth of experience within the committee.
  • IAC members and AMA staff continue to monitor and adjust the informatics dashboard as the landscape and provincial priorities change.
  • IAC members and AMA staff participated in Alberta Virtual Care Coordinating Body subcommittees to do a deep dive on all aspects of virtual care. Detailed reports and next steps are expected in the fall.
  • At the request of the Physicians Lead Executive, and with the support of the IAC, AMA informatics staff worked with ThinkHQ to develop an EMR survey for primary care physicians. The results will be used to identify opportunities and establish priorities.
  • AMA staff worked with University of Calgary in support of research on access to patient records and the limitations of the Health Information Act.
Connect Care

The rollout of Connect Care impacted the flow of information to community and mixed context providers and caused many workflow challenges within AHS facilities.

The Non-AHS Community Provider Advisory Group was created in 2019, prior to wave-1, as a place where stakeholders could work collaboratively to identify and explore challenges and work toward short- and long-term solutions. While progress was made and high priority work continued to improve the flow of information, there were still challenges.

The motions raised at the Fall 2022 and Spring 2023 RFs brought several priority issues to the forefront. They supported the AMA’s work in this area and reinforced the need for additional advocacy for challenges facing members who used Connect Care within an AHS facility.

AMA physician leaders and staff continued to work with AHS to support and facilitate solutions to address the Connect Care-related challenges faced by community, mixed-context and AHS providers. Early in 2023, surveys were sent to Connect Care users – one from the Specialty Care Alliance and one from AHS. Links to the survey results and the June 28, 2023 AMA-AHS joint letter sent to AHS physicians can be found in the June 28, 2023 President’s Letter.

AHS and the AMA held a joint virtual session on September 19 to talk about work and actions undertaken as a result of survey feedback. The shared goal was to understand what was working and what required prioritization for Connect Care improvements.

The AMA continued to use its strong advocacy role to identify system issues with the delivery of patient information. We worked with AHS on short- and long-term resolutions. A development plan for Connect Care changes is expected in the Fall of 2023.

Goal 3: Physicians and the AMA, in partnership with patients, play a leadership role in advocating and promoting a system characterized by Patients First®.

Albertapatients

This activity is covered above under AMA ADVOCACY.

Indigenous health

The AMA continued to support and advocate for improved health care delivery for the Indigenous community.

Infographics and a list of resources and recommended actions were developed to support community physicians in finding ways to recognize the 2023 National Day for Truth and Reconciliation on September 30.

The Indigenous Health Committee hosted a group viewing of The Unforgotten at the Fall Representative Forum. This was followed by an Indigenous lunch with invited Indigenous leaders from across the province. After lunch, a panel of Indigenous leaders addressed questions from the audience related to the movie and the health inequities that Indigenous peoples face.

Healthy AMA

In 2022-23 the AMA continued to undertake activities to promote efficiency, reduce costs and improve member value.

Governance
  • The Board has approved a social media policy to guide activity.
  • The Board undertook a comprehensive review and update of the business plan for 2023-24, including a revision to the AMA mission statement and adjustments to the Well Being and System Partnership and Leadership goals. These adjustments highlighted the importance of the AMA’s role in advocating for and supporting members, and strengthening physician leadership of the system.
  • The Governance Oversight Group undertook a survey of section executive members to establish a baseline for section governance practices and better understand the needs of sections. Based on the results, at time of writing the GOG was developing a set of recommendations to improve governance practices (e.g., templates for code of conduct, conflict of interest, equity/diversity training, etc.), and making improvements to the welcome and orientation material for incoming section executives.
  • The Transparency Working Group completed a review of the level of transparency with members from all levels of governance. This included a review of current practices, policies and accountability mechanisms, practices in other jurisdictions, as well as any limits that may exist. The Transparency Working Group provided a gap assessment and preliminary set of recommendations to the Fall 2023 RF.
  • The Annual General Meeting Working Group undertook a review of the format and agenda for the Annual General Meeting and put forward several recommendations that were accepted by the Board. The bylaw amendments needed to action the recommendations are being put forward at the 2024 AGM for consideration by the membership.
  • The equity, diversity and inclusion training provided to the Nominating Committee is now mandatory for all hiring committees.
  • A quota pilot was put in place and outreach to underrepresented groups was occurring as needed to reach the aspirational goal of 50%.
Workforce
  • A hybrid working group reviewed the effectiveness of the hybrid environment that was launched in May 2022 and put forward several recommendations that supported continued connection and information sharing amongst staff and between staff, physician leaders and members.
  • Staff responsibilities have shifted to support agreement deliverables and capacity has been added, particularly in the areas of advocacy and physician representation.
  • A comprehensive review of the AMA’s employee benefits package by Mercers showed that the total plan value is competitive and that some plan design adjustments are needed to better align the AMA plan with others. Design changes are expected to be implemented for 2024.
Financial
  • The steps taken to ensure organizational stability following the termination of the AMA Agreement have ensured we remained in a strong financial position throughout the year.
  • The Committee on Financial Audit (COFA) completed a review of the AMA’s investment beliefs and principles, as well as the asset mix for the various portfolios (e.g., contingency and insurance reserves).
  • At time of writing, grant agreements to fund the physician support programs were being finalized with government, after which, the required financial reporting will be prepared.
  • The Board felt additional resources were needed to meet the growing needs and expectations of members. The ratified agreement with Alberta Health crated additional demands, such as preparing for the inter-provincial fee review and completing the AHS payment reviews (stipends, on-call, overhead). There were also a growing number of members asking for support as they considered alternate compensation models to better support their practices. There was also a growing demand for the AMA to more actively advocate for improvements to Connect Care, sustainability of primary care practices and solutions to help address the health human resource shortage. After five years of frozen AMA membership dues, the Board decided to increase dues for some membership categories, effective October 1, 2023. In comparison to other jurisdictions across Canada, AMA dues were still middle of the pack and the Board did shelter both our learners (student and resident members) as well as our retired members from the dues increase.
Relationships

Relationship with Canadian Medical Association

Over the past few years, the CMA has provided unwavering financial, political and moral support to the AMA and throughout 2022-23 the relationship between the two organizations remained strong.

In December 2022, the AMA sent a letter of appreciation to the CMA. Their financial assistance and advocacy efforts helped the AMA to achieve a negotiated agreement with government.

Every year, the CMA holds nominations and election processes for the position of CMA president-elect. Last year, the president-elect was chosen from British Columbia. Dr. Kathleen Ross was elected and officially assumed her role as CMA president on August 16, 2023.

The 2023 CMA Annual General Meeting took place August 16. The following AMA representatives attended:

  • Dr. Rick Ward
  • Dr. Sadhana (Mindy Gautama
  • Dr. Shazma Mithani
  • Dr. Wayne Chang
  • Dr. Sidd Thakore
  • Dr. Scott Wilson
  • Dr. Gerry Prince
  • Dr. Vesta Michelle Warren
  • Dr. Paul Parks
  • Dr. Cathy Horsman
  • Dr. Jeff Way
  • Dr. Jon Hilner
  • Dr. Nadine Letwin
  • Dr. Olajide Durojaye
  • Dr. Sam Myhr
  • Dr. Sam Wong
  • Dr. Stephan Cassar
  • Dr. Troy Pederson
  • Dr. Linda Mrkonjic
  • Dr. John Bradley
  • Dr. Lloyd Maybaum
  • Dr. Brian Wirzba
  • Dr. Joshua Jones
  • Dr. Gareth Jones
  • Dr. Richard Leigh
  • Dr. Shirley Schipper
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  • AMA Deputy Speaker
  • AMA Immediate Past President
  • AMA President-Elect
  • Member delegate
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  • PARA Rep - Calgary
  • University of Alberta Student Rep
  • University of Calgary Senior Dean
  • University of Alberta Vice Dean of Education

Relationship with AHS

There are many issues on which we interact with AHS. The Provincial Physician Liaison Forum (PPLF) is a senior advisory forum between AHS administration and the AMA. Representation from AHS includes the Vice President Quality and Chief Medical Officer, Dr. Francois Belanger, and a number of senior medical and quality affairs staff.

In 2022-23, representatives from the AMA were:

  • Dr. Michelle Bailey, Representative Forum
  • Dr. Shelley Duggan, Board Appointee
  • Dr. Margot McLean, Committee Member, Council of Zonal Leaders Representative
  • Dr. Jeffrey Cao, Representative Forum
  • Dr. fred Rinaldi, Committee Member, President terms
  • Dr. Vesta Michelle Warren, Interim Board Representative
  • Dr. Stephen Cassar, Representative Forum
  • Michael Gormley, Executive Director and Co-Chair
  • Dr. Kim Kelly, AMA Staff Member, AED, Professional Affairs
  • Leona LaChance, AMA Staff Member, Senior Advisor, Professional Affairs

PPLF met four times throughout the year and topics covered included:

  • New Agreement; AMA/AHS
  • Physician recruitment/retention
  • Physician On-Call Program
  • Right Care Alberta and RCV
  • Physician wellness/burnout
  • Alberta Surgical Initiative [ASI]
  • Connect Care
  • AHS Medical Staff bylaws
  • AHS policy regarding out-of-province surgical patients
  • Processes for identifying and responding to physician concerns.
Knowledge

The AMA has returned to regular member opinion tracking surveys to monitor member perceptions of external and internal matters surrounding the association and how we are serving them. Each survey may include a flex topic, most recently support for healthy working environments. January 2023 results were reported to members via Alberta Doctors’ Digest. June 2023 results will be published this fall. Highlights depict a continued lack of confidence in the health care system and quality care, worsened by a lack of engagement in physician concerns by government or AHS.

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We continue our replacement of core information systems aimed at improving efficiency and integrating information so that we can better understand member needs and improve and enhance members services.

Phase one of the website redevelopment project was completed in 2022-23, including visioning work with members and key stakeholders as well as organizational, visual and interaction design. Phase two will focus on installation of the new system (Umbraco), implementation of the design and content migration. This work is expected to be completed in the third quarter of 2024. In coordination with this project, procurement of an enhanced search-engine for the website, as well development of enhanced user sign-on capability, has begun. In the fall of 2022, the ACTT website was moved to the new content management system.

Learn@AMA continued as the AMA's online learning platform. Over 2,000 unique external users logged in to take a course in the 2022-2023 business year, with over 250 of those being physician members and many others being physician support staff. Twenty-five separate curriculums were available through asynchronous or scheduled formats, including privacy training, CII/CPAR onboarding and management, board governance training, practice facilitator training and much more. Registration and user management continued to be refined to allow clinics and primary care networks to manage their own staff on the platform.

We are roughly halfway through the multi-year project to redevelop the aging AMA member information systems, which will ensure a common platform and consistent member experience for all AMA systems.

Board of Directors, Executive Committee and Representative Forum

During the 2023 AMA AGM, Dr. Paul Parks will be installed as president for the 2023-24 year. Dr. Parks is an emergency physician based in Medicine Hat.

2022-23 Board of Directors

  • Dr. Fredrykka Rinaldi, President
  • Dr. Paul Parks, President-Elect
  • Dr. Vesta Michelle Warren, Immediate Past President
  • Dr. B. Wayne Chang, Board member
  • Dr. Howard Evans, Board member
  • Dr. Sadhana (Mindy) Gautama, Board member
  • Dr. Robert Korbyl, Board member
  • Dr. Ling Ling, Board member
  • Dr. Usha Maharaj, Board member
  • Dr. Shazma Mithani, Board member
  • Dr. Sidd Thakore, Board member
  • Dr. Rick Ward, Board member
  • Dr. Scott Wilson, Board member
  • Dr. Joshua Jones, PARA representative
  • Daria Venkova, MSA observer

Note that Dr. Sarah Hall departed her AMA Board position effective January 23, 2023. The vacancy was filled at the Spring 2023 RF by Dr. Scott Wilson. Dr. Catherine Boutet, PARA representative, was replaced by Dr. Joshua Jones July 1, 2023.

AMA Bylaws require the Board to meet at least six times per year and at the call of the president. Throughout 2022-23, the AMA Board of Directors met 11 times (both in-person and virtually). Meeting dates are available upon request.

2022-23 Executive Committee Officers

  • Dr. Fredrykka Rinaldi, President
  • Dr. Paul Parks, President-elect
  • Dr. Vesta Michelle Warren, Immediate Past President

Executive Committee Board Representatives

  • Dr. Sadhana (Mindy) Gautama
  • Dr. Robert Korbyl, Board member

Throughout 2022-23, the AMA Executive Committee met seven times. Meeting dates are available upon request.

2022-23 Representative Forum Information

Spring 2023

  • March 10-11 (in-person, Calgary Airport Marriott In-Terminal Hotel)

Fall 2023

  • September 22-23 (in-person, The Westin Edmonton Hotel)

Alberta Medical Association Mission: Advocate for and support Alberta physicians. Strengthen their leadership in the provision of sustainable quality care.