Dear Members,
I am writing to provide an update on three important areas of work underway at the AMA:
- ending of family medicine hospitalist stipends with some physicians transitioning to clinical Alternative Relationship Plans (cARPs)
- early stages of negotiations for a new Master Agreement
- release of results from our latest AMA Pulse Survey
Update on clinical ARPs and hospitalist programs
As members are aware, many hospitalist programs across Alberta have historically relied on stipends, paid in addition to fee for service billings, to retain physicians and support work that is not well captured in the current fee schedule. There are approximately 30 hospitalist programs across the province that have been receiving these stipends, which ended April 1, 2026.
The AMA has been consistently advocating for physician choice following the ending of stipends, specifically as it relates to decisions around continuing work in a fee-for-service model, moving to a modernized clinical ARP, or moving on to completely different work elsewhere. For those physicians looking to transition away from stipends and onto a modernized cARP, we have been working with Primary and Preventative Health Services (PPHS) to ensure the recommendations from both the 2025 cARP Working Group and the Stipend Working Group are implemented.
To date, five hospitalist programs have successfully implemented new cARPs, and we are working closely with seven additional groups that have expressed interest in developing a cARP as a viable alternative. Currently, approximately 17 hospitalist programs have significant concerns about entering a cARP under the current conditions. Many of these groups are questioning whether their practices can remain viable now that stipends have ended, and several have sought legal advice on how to restructure their services while still meeting medical staff bylaws, CPSA requirements and patient care obligations.
The AMA’s position is that government has not yet fully implemented the complete set of changes required under the SWG report in a way that supports a safe and sustainable transition away from stipends. PPHS has not been consistently working with the AMA and physicians during the development and implementation of new cARPs, which is critical at this stage in the transition.
Without meaningful involvement of the AMA and physicians, we are seeing unnecessary confusion regarding process, what is being offered, whether proposals are reasonable, what supports are available and how implementation will work. This lack of coordination has already contributed to service disruptions, including the loss of consistent in-house night coverage for medical, surgical and psychiatric services, care of surgical patients on the ward, negative impacts on certain OR slates, further pressure on emergency departments and delays in patient care. We are actively raising these concerns with PPHS and continue to press for a collaborative cARP implementation process, as directed by the SWG report. We are also encouraging physicians considering cARPs — or starting an application — to contact the AMA for support. cARPs are not for everyone but when structured correctly, they can lead to a stable and sustainable patient care delivery model.
Negotiations update
Since the end of March, the AMA Negotiating Committee has met twice with government to begin formal bargaining for a new Master Agreement. We have outlined our key interests and, this week, tabled several proposals for consideration — including two foundational proposals on dispute resolution and physician representation within Alberta’s evolving health care system.
These interests and proposals reflect what we have heard from members, and they are aimed at today’s realities: system pressures, recruitment and retention challenges and rising practice costs and inflation.
While we are still early in the process, we have already identified several areas of shared interest with government. We will not align on every issue, but the tone to date has been collaborative — an important foundation in a complex negotiating environment.
Negotiation sessions will continue later this month and throughout May. Under the current agreement, either party may request mediation after 90 days of negotiations. The earliest mediation could begin is in June and, if required, is expected to conclude in July. Mediation provides a structured process to help both parties reach a mutually acceptable outcome should discussions stall.
We will continue to keep members updated as bargaining progresses and will seek member input along the way, while respecting the confidentiality of the negotiating table.
AMA Pulse Survey: MAID and Bill 18
Finally, I would like to thank the many members who recently participated in our AMA Pulse Survey focused on medical assistance in dying (MAID) and Alberta’s proposed Bill 18, including those across a wide range of perspectives who took the time to write thoughtful — and thought-provoking — letters that clearly demonstrated their deep care for patients in Alberta. We launched this survey to better understand the perspectives, experiences and concerns of physicians across the province on an issue that is ethically complex, clinically challenging and of significant public interest.
As with all AMA Pulse Surveys, the purpose was not to arrive at a single position, but to ensure the AMA has a clear, evidence informed understanding of where physicians stand, where views diverge and where there is common ground. This insight helps guide our advocacy, supports informed dialogue with government and ensures physician voices are reflected in policy discussions that directly affect patient care and professional practice.
An executive summary of the survey findings is now available on the AMA website. This summary was released on an expedited basis to ensure physician perspectives could inform timely discussions and advocacy with government. A more fulsome and contextualized report will be released in the coming month.
Thank you for your continued engagement. Please reach out to me any time.
Regards,
Brian Wirzba, MD, FRCPC
President, Alberta Medical Association