Dear Members,
As we step into 2026, I have been reflecting on two of the many roles we hold as physicians: experts in medical care and leaders in health care delivery. The past year brought not only challenges to our expertise but also relentless change to our system. From the introduction of Bill 11 and ongoing restructuring, to increasing pressures in acute care, ever-expanding waitlists and the evolution of primary care payment models, the landscape is shifting rapidly.
While these changes bring uncertainty, they also offer opportunities for renewal. The challenge, however, is that without a clear target, these initiatives may fail to achieve intended results; policies enacted to address short-term issues may become long-term liabilities. As leaders, we must continue to put forward a vision of an "optimal" system for every Albertan — one that moves beyond reactive "sick-care" toward a model of high-value investment. This requires us to be disciplined, focused on evidence-based initiatives that work and courageous enough to move away from those that do not.
Our vision must ensure that the system is adequately resourced to support patients sustainably, safely and with accountability.
Building on a foundation of value
To achieve sustainability, physician leaders must continue to state that health care is not a mounting expense to be managed, but a strategic investment requiring a "smart" approach. An optimal system focuses relentlessly on high-value care — interventions with clear, evidence-based benefits. We must also reinforce that complex illnesses require equally complex care; these are not candidates for the "efficiency" initiatives that might work in simpler clinical situations.
Research consistently demonstrates that a strong primary care foundation, complemented by sound public health, is our most effective tool for reducing all-cause mortality and lowering total system costs. Essential to this foundation is the deliberate support of our longitudinal family medicine specialists in close coordination with community non-FM generalists and other specialties. Because our patients increasingly present with more than one complex health issue, this seamless integration of expertise is the only way to ensure the coordination of care required for optimal outcomes.
By prioritizing a patient journey that is based in the "medical home” and travels seamless through an integrated “medical neighbourhood," we can better address issues of public health and social factors such as housing, economic stability and community support (that often outweigh clinical intervention in long-term health outcomes). Integrating these determinants and specialty perspectives with our foundation allows us to create wellness rather than just managing illness.
Stabilizing the system and reducing wait times
An optimized system must address the "pressure valves" of our acute care settings. Our emergency rooms and medical/psychiatry wards currently bear the weight of system-wide misalignments. Safety and stabilization require building capacity within our acute care bed base while strengthening the non-acute system so patients can transition out of hospital seamlessly.
Wait times for surgeries and diagnostics remain indefensible. A true centralized intake system, protected capacity for essential services and the reduction of low-value tests and procedures are critical. Ultimately, Alberta needs a comprehensive, long-term capital and workforce plan. We must ensure we have the right spaces — from EDs to homecare slots — and a sustainable, engaged workforce of physicians and allied health professionals to staff them.
Universality and equity: our shared target
Universality means that all Albertans get the care they need, when they need it, regardless of their background or the payment model used. Accountability for making that happen, therefore, is a requirement. Currently, factors such as geography, education, socioeconomic status and race create significant hurdles to this goal.
As we navigate new dual-payment models, we must insist on "guardrails" — unified professional standards and shared data systems — that protect the integrity of the public system and ensure that ability to pay never dictates the quality of care received. This digital infrastructure must support data portability, empowering patients with secure, seamless access to their own records to reduce errors and ensure continuity of care no matter where they seek it in the province.
True equity also means ensuring that the next generation of breakthroughs — from AI-assisted diagnostics to gene-based therapies like CRISPR and CAR-T — are not reserved for a select few. These technologies are shifting the very definition of care from "treatment" to "precision." As leaders, we must ensure these tools are integrated into our clinical pathways with the physician voice at the helm. We must plan for the "readiness" these technologies demand — investing in the infrastructure and specialized training needed to ensure they enhance, rather than displace, the expert clinical judgment that guides the patient journey.
Leading through evidence and stewardship
The AMA has a long legacy of leading through times of change and challenge. I have presented some of my thoughts on the target we might strive for, but this vision must be shaped by the collective expertise of our membership.
As we proceed, I want to hear your vision for this system. What specific high-value interventions in your specialty need support? Are there low-value or “wasteful” practices that need to be avoided? Where do you see additional technological opportunities? Your insights will be the blueprint for the AMA’s advocacy as we push for the smart, evidence-based changes Albertans deserve.
Regards,
Brian Wirzba, MD, FRCPC
President, Alberta Medical Association
P.S. Advocacy for patient care to government is more important than ever. To provide physician perspectives to the Board, we are establishing a Government Affairs Advisory Committee. If you have a passion for government relations and political advocacy, you may wish to apply (member login required). Applications close Friday, January 23.