Dear Members,
The AMA continues to emphasize the need for informed reform. It is our firm belief that changes to Alberta’s health care system, especially major shifts like dual practice, must be evidence-informed and physician guided.
Put another way, any move toward dual practice must be carefully designed and safeguarded to avoid foreseeable harms. That starts with a commitment to ensure that access to necessary medical care is based on need, not on ability to pay.
Last week the AMA submitted to government a proposed safeguards report developed by the AMA’s Dual Practice Task Force. This is a substantial body of work encompassing 70 proposed safeguards designed to protect equitable access, patient safety, workforce sustainability, accountability and the integrity of the public system should Alberta proceed with any form of dual practice.
Development of these safeguards directly reflects what we heard from members through an AMA Pulse Survey (member login required) in November. At that time, members held a range of opinions on dual practice itself but shared a clear agreement that robust, enforceable safeguards are critical if it proceeds. I suspect that is still the case.
I want to recognize — and sincerely thank — the physicians who stepped forward to form the task force and deliver these proposed safeguards that we have provided to the government. Since it was formed, the task force has invested significant time building on evidence from an earlier environmental scan, testing assumptions and working through real-world scenarios to identify where risks could emerge and how to prevent them. Canadian evidence, including documented studies on cataract surgery right here in Alberta, confirms that these risks are not theoretical. They have already been measured in our own province.
Intentionally, the task force brought together physicians who represent a wide range of perspectives, training and experience across Alberta’s health care system. Including physicians from diverse practice types and settings, such as urban and rural, surgical, family practice and specialist care, as well as individuals with direct experience in dual practice-style models in other jurisdictions. Importantly, task force members held differing views on dual practice itself.
Despite these differences, there was clear consensus that if dual practice is pursued in Alberta, strong safeguards are essential.
This is not the first time an expanded role for private practice has been raised and it may not be the last. For many years the AMA has said that before considering any expanded role for private care, Alberta’s publicly funded system must be clearly defined and strengthened.
We continue to seek out all opportunities to work collaboratively with government and other partners to help ensure policy design is workable in the real world and that it protects patients and the public system. As this work continues, we will keep emphasizing a simple principle: informed reform must guide any changes to Alberta’s health care system. Solutions must strengthen, not destabilize, publicly funded care. If robust, evidence-informed safeguards are not part of the foundation of Alberta's dual practice approach, then patients and the public system bear the consequences.
And that is a price none of us can afford.
Regards,
Brian Wirzba, MD, FRCPC
President, Alberta Medical Association