Dear Members,
I am writing to provide clarification on upcoming changes to the Physician On-Call Program (POCP). Many of you have raised important questions – especially as these revisions land alongside changes to stipend programs. To be clear, the POCP is distinct and separate from stipends.
As government has outlined in Bulletin 290, POCP revisions include updated categories, payment rates, eligibility requirements and defined on-call hours. Under these revisions are several noteworthy differences that may impact physician practice:
- New call categories replace the previous structure:
- On-site (must remain on site)
- Level 1 (immediately reachable by phone when off-site and able to be on site within 15–30 minutes)
- Level 2 (reachable by phone within 15 minutes; may not require presentation to site)
- Level 3 (generally support services that do not admit patients under their service; primarily off-site, available by phone or virtually as needed)
- Program reclassification under the new categories means some programs will be paid at lower rates, and some have been deemed ineligible for POCP.
- Where a stipend is ending and POCP becomes a potential alternative payment approach, POCP will recognize only one on-call program per service per site (consistent with the existing POCP but not some stipend models).
- Weekday daytime coverage is removed for all categories.
- Funding is limited to afterhours only – defined as 5 p.m. to 7 a.m. on weekdays and 24/7 on weekends and statutory holidays.
For years, the AMA has advocated for changes to the POCP. We have proposed its modernization through our involvement in various provincial committees and working groups, in our Acute Care Stabilization Proposal (member login required) and through direct conversations and advocacy with government.
At every stage, we have asked that physician on call availability be remunerated at pre 2019 levels plus 3%, applied 24/7, along with an expansion of eligibility criteria.
We are pleased to see the rates increase, and welcome eligibility expansion as this will give more than 200 new programs access to POCP funding. At the same time, I need to be clear: the AMA does not support moving away from 24/7 compensation. We are also concerned about the lack of transparency around reclassification decisions and program eligibility. It remains unclear which programs applied and were rejected, and on what basis. The AMA is seeking clarification from government and AHS, and we encourage affected members and groups to share specifics with us so we can advocate effectively on your behalf.
Limiting what “counts” as on-call by the hour of day does not reflect clinical reality. Patient needs and the professional burden and disruption to other clinical tasks do not disappear during daytime hours. In fact, for many physicians, non-acute or community clinical activities will now become a priority. Narrowing the eligibility window by 42% while offering a slight increase to hourly rates does not resolve the longstanding issue of fair compensation for physician availability and responsiveness.
This matters for patients and for physicians. The literature consistently shows that increases in uncompensated call burden and workload are associated with higher rates of physician burnout. On-call responsibilities are already identified as one of the most taxing aspects of practice, contributing significantly to physical and mental exhaustion. Government’s decision reflects a limited appreciation of the clinical realities facing physicians, where continuous patient responsibility and admission duties must be managed alongside irregular, disrupted sleep cycles that do not align with conventional work hours. This creates unsustainable work-sleep cycles that impair performance and increase the risk of fatigue-related errors. Evidence also shows that insufficient staffing and high call burdens undermine recruitment and retention, risking gaps in coverage. In turn, inadequate coverage has been associated with delays in care, reduced access and potential declines in quality and safety, as fewer physicians are available or able to provide consistent, well-rested care.
Most concerning to me is the moral injury these changes are causing. I’ve heard that some physicians are feeling pressured to continue to provide their availability without remuneration, even though they may not be on-site or may be occupied with other scheduled work. Others have told me they are feeling pressured to set boundaries and not provide services during non-funded hours, even though they may be willing to do so. These are challenging times and we need to support each other as colleagues. Physicians should have choice around what services they provide based on what remuneration is offered.
It has been well understood that physicians must be available for their own patients and that the POCP was put in place to compensate physicians to be available for unattached patients. It is the AMA’s position that there is value in having physicians available to take on unattached patients. It is disappointing to see that our province is moving away from these well-established principles.
Any group or member considering changes to on-call availability is encouraged to seek legal advice, particularly where privileging may be involved.
The AMA remains committed to securing fair compensation that supports patient care across Alberta – and reflects the real burden of physician availability regardless of time of day. We will continue to press these outstanding issues at the negotiating table and in ongoing discussions for the next agreement.
Sincerely,
Brian Wirzba, MD, FRCPC
President, Alberta Medical Association