Dear Members,
I am writing to update you on the latest developments regarding physician stipends and the transition to Clinical Alternative Relationship Plans (cARPS). Recent communications from Primary and Preventative Health Services (PPHS) and Alberta Health Services are understandably causing concern and confusion amongst 1000+ members who are currently receiving stipends for services that are not otherwise remunerated. These stipends have long supported hospital-based services — such as trauma, palliative care, mental health, acute care surgery, obstetrics and hospital medicine — that are vital for patient care and are not fully compensated through the physician services budget alone.
Over time, the stipend system has become less consistent and has lacked transparency, resulting in major inequities in how physicians are compensated across the province. The AMA supports the need to end stipends in favor of a fair, modern and consistent approach — provided that approach follows due process, with reasonable alternatives in place.
What’s driving the change
As per the terms of the AMA Agreement, the AMA and AHS established the Stipend Working Group (SWG) to review the wide range of clinical stipends paid to physicians, particularly those supporting hospital-based services. This review was performed by a jointly appointed independent chair, and his recommendations are final and binding on all parties. Most importantly, the SWG’s report recommends transitioning all current stipend programs to more equitable, modern and reasonable alternatives, with reasonable notice and compensation options for physicians. Click to access the full Report of the Stipend Working Group (member login required), including key recommendations that are binding on the Minister.
Recent communications and AMA’s collaborative efforts
The MED 288 Bulletin issued on December 29 confirms the government’s intention to finalize the SWG recommendations and provide reasonable compensation alternatives. I have also received a letter from the Minister reiterating this commitment, outlining plans to implement the SWG report and proposing January 2026 meeting dates to address outstanding cARP rates. However, it is essential for members to know that the AMA has consistently advocated for reasonable alternatives — including updated rates and terms for cARPs/Academic Medicine and Health Services Programs, Fee-For-Service (FFS) and the Physician On-Call Program (POCP) — to be in place before stipends end, as contemplated by the SWG report. Our concern is that due process cannot be achieved if these reasonable alternatives are not available at least three months prior to the end of stipends. This concern is heightened by the fact that PPHS has delayed the finalization of these terms since the SWG report was completed last May.
Member concerns
We have heard — and share — serious concerns about real-world impacts if stipends end before viable alternatives are in place. In particular:
- Scope of “reasonable alternatives”: The SWG’s intent was not cARP only. It includes updated cARP terms, FFS with Schedule of Medical Benefits changes (e.g., a transfer of care solution for family medicine) and improvements to POCP rates and eligibility criteria. These must be implemented as a package consistent with the binding report.
- Family medicine MRP programs: Physician leaders have reiterated that many family medicine MRP programs will not accept a cARP as the sole alternative and have requested 03.03AO transfer of care and POCP inclusion as the practical, provincial solution to retain family physicians in hospital medicine.
- Program definitions and equity: We are pressing for equitable and modernized terms, developed through contractual arrangements, that are applied consistently to physicians providing similar services and are in alignment with quality care delivery. The practice of making certain benefits exclusively available to certain groups will only further the inequity that exists today and undermine consistency — which is needed by all specialties for retention and recruitment.
- Afterhours incentives: AMA has previously proposed strengthening 03.01AA as part of a coherent alternative for programs remaining in FFS; we are also advocating for improved recognition for physician on-site availability and expect this to be addressed alongside SWG report implementation.
We are hearing from physicians who have received letters indicating that their stipend contracts will terminate by March 31, 2026. AMA legal counsel has previously confirmed that once such contracts end, physicians are not obligated to continue providing services that were previously compensated by stipends. In addition, according to CPSA guidance, physicians are not required to accept or take on a non-emergent patient with whom they have no pre-existing relationship. In many sites, this could mean a lack of physician availability to see new patients — particularly during after-hours — which would materially slow emergency department throughput and further risk acute care flow. This is precisely why reasonable alternatives must be in place before stipends end.
What the AMA is doing
We are coordinating dates now to reconvene the Stipend/ARP Resolution Working Group and finalize remaining cARP rates and associated FFS/SOMB and POCP changes, consistent with the SWG report. We will share meeting details with sections and site leads.
We will insist on an implementation plan that prevents service gaps — including reasonable notice, practical transition supports and choice of model with fair terms. We will continue to provide guidance and advocacy as options are finalized.
For questions about the Med Bulletin or stipend notices, the government has directed physicians to email [email protected]. Please cc [email protected] so we have full visibility of the issues and impact and can intervene where needed.
We recognize the uncertainty these changes create and will keep you informed every step of the way. The AMA will continue to collaborate with government, but our goal is clear: full implementation of the SWG recommendations so that critical services are sustained and physicians are afforded due process.
Regards,
Brian Wirzba, MD, FRCPC
President, Alberta Medical Association