President's Letter

Dr. Christine Molnar, President, Alberta Medical Association

The "voice of the AMA" – The President's Letter informs you about Alberta Medical Association positions on key issues in Alberta’s health care.  

Comments on the President's Letter are welcome. Go to the most recent President's Letter (see the link below) to post a public comment.

You may also contact the AMA President by email at president@albertadoctors.org

For older issues of the President's Letter (and issues on other topics), visit the President's Letter archive.

President's Letters and news releasesRSS

Top of Mind: Government Relations and Supporting Members and Albertans in COVID-19

April 7, 2020

PRSIDENT'S LETTER: This is a very stressful time as we enter the COVID-19 surge environment. Our normal life and work patterns are disrupted and anxiety-laden. We enter this time without the confidence that we are valued by our government, having endured their inequitable treatment as they now call on us to serve. But we do not serve a government, we serve Albertans. And serve we will as we march into battle to support Albertans, facing the biggest challenge of our lifetime.

Supporting each other through the storm

April 3, 2020

PRESIDENT'S LETTER: We find ourselves in the midst of a perfect storm. Physicians are working hard in the face of the COVID-19 pandemic. They are preparing to give the all-out effort required to save lives and will be there when it counts. Albertans can rely on that. This is despite the fact that for months, we’ve notified the Provincial Government that their planned changes in health funding would be damaging and destabilizing to medical practices across the province.

Government rejects call for delayed implementation of framework

March 30, 2020

PRESIDENT'S LETTER: Today, we received the Minister's response stating that the government intends to proceed with the remaining elements of the framework on March 31. I share your extreme frustration and disappointment with this decision. Adding further disruption and uncertainty to a health care system already under unprecedented pressure from COVID-19 is simply irresponsible and not in the best interests of the health care system and our patients.

Virtual care codes now available

March 23, 2020

PRESIDENT'S LETTER: Good News today! Following discussions between the Alberta Medical Association and government, I’m very happy to let you know that three new categories of virtual care codes have been established so that family physicians and specialists can provide more telemedicine, such as teleconferencing and video, for an expanded scope of patient needs during the pandemic.

Babylon: setting the record straight

March 21, 2020

PRESIDENT'S LETTER: In my letter yesterday, I spent too little space on fully explaining the facts and issues around the new Telus Babylon product and the AMA’s concerns. Thank you for sending your concerns through to me. It is a complex problem and I need to address it further. Please be aware that AMA is currently working on a complete virtual care schedule with Alberta Health. It is imperative that this is operational as soon as possible. From my perspective, it is overdue. Let’s start with what we know about Babylon.

Cyber-bullying, government discussion on virtual care and stipends

March 20, 2020

PRESIDENT'S LETTER: It has come to my attention that things were said yesterday on social media and outside of it that are deeply troubling. Whether you agree with public officials or not, making personal attacks and threats on them and their families is never acceptable. It’s cyber-bullying, plain and simple; it’s not who we are as physicians, and it must stop. The comments, which I will not dignify by repeating or referencing here, did not originate from an AMA member, though some members may have shared or liked them.

COVID-19 response: We need to stand together

March 18, 2020

PRESIDENT'S LETTER: In my President’s Letter yesterday I mentioned there are issues with enabling the profession to respond to the COVID-19 pandemic. I wanted to share with you what I believe is needed in order to provide patients with the care they need.

Complex modifier change paused; other proposals remain to be implemented

March 17, 2020

PRESIDENT'S LETTER: This afternoon, government announced that the proposed changes to physicians’ payments for the Complex (Time) Modifier will not go ahead as planned on April 1, 2020. This is great news. The development came out of discussions last week between the working group of Alberta Medical Association and government. The AMA’s objective continues to be an agreement that will provide fairness for physicians and value for patients. An agreement would provide stability for physicians and support ongoing collaboration in development of a sustainable health care system for Albertans. Please be aware that I have written to the Minister today with two concerns:

Government discussions; COVID-19 and AMA support

March 16, 2020

PRESIDENT'S LETTER: The COVID-19 pandemic represents an unprecedented public health challenge. During these times of crisis, adhering to the public health direction as a single source of truth is imperative.

Representative Forum cancelled

March 11, 2020

PRESIDENT'S LETTER: The AMA has been consulting with public health leaders with respect to holding the Representative Forum in person this weekend during the current COVID 19 pandemic. (Just this morning, the World Health Organization officially announced that COVID-19 can be characterized as a pandemic.)

Discussions continue with government

March 7, 2020

PRESIDENT'S LETTER: I am pleased to advise you that discussions continue next week with the Alberta government in an attempt toward a physician agreement that provides value for patients, fairness for physicians and affordability for the system.

Update on AMA’s response to government actions

March 2, 2020

PRESIDENT'S LETTER: Government has unilaterally terminated our agreement and imposed their dictates on the profession. My February 26 President’s Letter provided a list of actions and activities that the AMA is undertaking in response. Today, I provide an update on a number of those items.I want to acknowledge the sheer amount of information that we have been sending to members. You may be feeling like there is a fire-hose of information coming at you. Government has purposely created an environment where their decisions and actions have so many implications and unintended consequences that no matter where you look - there is chaos.

Provincial budget

February 27, 2020

PRESIDENT'S LETTER: Government has tabled its second provincial budget. The budget reflects the devastating cuts to physician payments that were announced last week and the hostile action of this ministry in tearing up our Alberta Medical Association contract. The budget gives the impression that “there’s nothing to see here” and physician compensation is portrayed as frozen. Physician compensation is anything but frozen. Once again, government is misleading Albertans about what they are doing.

First do no harm. We Must Act for Patients’ Safety and Access

February 26, 2020

PRESIDENT'S LETTER: Tomorrow government tables its latest budget in the Legislature. This event will generate a lot of noise in the media and spark further public debate. We do not expect a significant change to our situation. Government has torn up the agreement with the profession and continues with some ill-conceived changes that will be destructive to your practices and to our health care system.

Master agreement terminated

February 21, 2020

PRESIDENT'S LETTER: The termination of our master agreement is an outrageous action that must be challenged. Government is putting physicians and patients at risk. The AMA Board met last night and will meet again Sunday. We are reaching out to all sections and zone medical staff associations to discuss: legal options; plans for engaging the public; the results of our surveys (“Yes” patients overwhelmingly value their time with their doctor and feel that sometimes more is needed; “No” patients don’t agree with the tearing up of contracts); and next steps needed to get government’s attention.

Response to government announcement

February 20, 2020

PRESIDENT'S LETTER: I write to you today with great concern for our public health care system in Alberta. Today, the Minister of Health announced that government is ending its master agreement with physicians and enacting the 11 consultation proposals they tabled in November of last year. I wanted to share with you the following statement that we have issued in response:

Negotiations update – mediation unsuccessful

February 15, 2020

PRESIDENT'S LETTER: On January 31, I wrote to inform members that our negotiations with government were moving to mediation. Unfortunately, that voluntary mediation process was not successful. There are a few possibilities for next steps. Some of which the parties can do together, others that would be done separately. We are actively exploring our options and will be reaching out to the Health Minister to discuss a way forward that will satisfy the needs of Albertans and treat physicians fairly.

Flawed data equals flawed decision-making

February 14, 2020

PRESIDENT'S LETTER: In my President’s Letter last Friday, I shared our negotiations objectives and what we consider to be key requirements for reaching a deal with government: Better information – government is using misleading physician payment figures Clear vision required – a lot of ideas out there, they need to be brought into focus; Provincial physician compensation strategy – essential for true system improvement; A way to deal fairly with physician supply and control practitioner ID numbers. Today I would like to focus on the first requirement: better information.

Negotiations update and AMA's key requirements for an agreement

February 7, 2020

PRESIDENT'S LETTER: As reported last week, Alberta Health and the AMA have brought in a mediator to assist with negotiations. There is still a long way to go, but I believe it is positive that both parties are doing what they can to reach an agreement.

Alberta Health Services Review: Concern for health care in Alberta

February 5, 2020

PRESIDENT'S LETTER: The 57 recommendations in the Alberta Health Services Performance Review are a compendium of cost-cutting opportunities that purport to improve value in health care by either reducing cost with no impact on quality of care, or by reducing cost and improving quality. It’s an interesting concept. We can understand the exercise of looking at the current state and seeking efficiencies; the report provides many ideas to consider. The picture is still incomplete, though, if we don’t also look at what the health care system needs to deliver for patients today and in the future.

AHS Review: Initial reaction

February 3, 2020

PRESIDENT'S LETTER: Today government released the long-awaited Ernst & Young summary report of Alberta Health Services Performance Review. We have had a little time to review it, but much more time will be required given the scope and the potential implications.

Negotiations move to mediation

January 31, 2020

PRESIDENT'S LETTER: Our negotiations with government are moving to a new stage. We have been at the negotiating table since November 2019. While we have seen some advances in recent weeks, both sides have agreed that discussions would benefit from mediation. A mutually agreed upon mediator has been appointed this week with the first mediated discussion occurring today. Meetings are currently scheduled to the end of February.

Update on AHS stipends

January 24, 2020

PRESIDENT'S LETTER: Within the set of 11 insured services consultation proposals that Alberta Health provided to the AMA on November 14, proposal 8 plans to eliminate some stipends that are currently paid to physicians practicing in AHS programs.

First update of 2020: Many things underway

January 13, 2020

PRESIDENT'S LETTER: I will provide you with updates on discussions with government and negotiations frequently in the weeks ahead.

Plans in place for 2020

December 24, 2019

PRESIDENT'S LETTER: Last Friday you will have received a copy of the AMA’s final response document for government’s Insured Services Consultation. The December 20, 2019 President’s Letter is on our website if you missed it. It contains our perspective on the consultation items.

AMA response to government consultation proposals

December 20, 2019

PRESIDENT'S LETTER: On November 14, the Alberta government tabled several proposals, which they considered to be outside of negotiations, and gave the AMA until today (December 20) to formally respond. We received feedback from over 1500 physicians and I am writing today to provide members with the AMA’s response to the Alberta Health and Alberta Health Services Insured Services Consultation proposals.

Government consultation proposals: action to date

December 16, 2019

PRESIDENT'S LETTER: I am writing today to provide a brief update of the work and activities that have taken place since the Special RF on December 7.

HQCA Evaluation: Crowfoot and Taber Clinics

December 11, 2019

PRESIDENT'S LETTER: On December 9, the Health Quality Council of Alberta (HQCA) released its Final Report of the Crowfoot and Taber clinics case study evaluation.

Special RF Response to Government, Pushing Back

December 9, 2019

PRESIDENT'S LETTER: The special meeting of the Representative Forum took place on Saturday, December 7 in Calgary. Delegates received a full update on the current negotiations with government for a new financial agreement. There was a presentation on the evolving AMA response to the 11 consultation proposal items that government has released and that were the subject of my November 29 President’s Letter. The RF also endorsed the Board of Directors’ proposed plan to respond to these challenges and ensure that government hears our concerns.

Deep Concerns re Government Consultation

November 29, 2019

PRESIDENT'S LETTER: This is in regard to recent developments in our negotiations with government that are deeply concerning for the profession. I want to provide you with information regarding what government has proposed, what work the AMA is doing to review these proposals and how you can contribute. On November 14, government tabled several proposals which, in their view, were outside the negotiations. They asked the AMA to respond by November 20 as to how we would like to be consulted.

On conscience rights legislation

November 13, 2019

PRESIDENT'S LETTER: On November 7, a United Conservative Party MLA tabled a private members bill: Bill 207, Conscience Rights (Health Care Providers) Protection Act. I wanted you to know that I have written to Minister of Health Tyler Shandro to express the opinion that this legislation is unnecessary and inappropriate. You can review my letter here.

On-call deserves our support

November 5, 2019

PRESIDENT'S LETTER: Our rural physician colleagues have recently been in the media with concerns related to reductions in on-call payments by Alberta Health Services. Our rural members, who are already stressed by a heavy burden of service, know that reducing on-call support will make it even more difficult to recruit and retain physicians to rural areas.

New Legislation – AMA Agreement and Physician Supply

October 30, 2019

PRESIDENT'S LETTER: Government has tabled legislation: Bill 21 Ensuring Fiscal Sustainability Act. This omnibus bill amends a number of statutes. Having received it late Monday afternoon, we have been exploring its implications. There are important provisions relating to the Alberta Health Care Insurance Act.

Connect Care Launch: Must-read information

October 16, 2019

PRESIDENT'S LETTER: On November 3, Alberta Health Services will launch the first wave of Connect Care in the Edmonton Zone. Supported by a fully integrated clinical information system, Connect Care will consolidate the patient’s story, including goals, problems, plans, investigations, treatments and all prior AHS health records. Connect Care is the AHS record of care.

Physician On-Call What's Happening; What's Next

October 9, 2019

PRESIDENT's LETTER: Many of you will have received an Alberta Health Services bulletin last week: Physician On-Call Program Changes Effective October 1, 2019, that highlighted changes in the number of on-call categories from five to three, and a reduction of stipends paid for those services.

In your service: a new president’s thoughts

October 7, 2019

PRESIDENT'S LETTER: It is a great honor to represent our profession as AMA president. I have been a physician for 43 years. I have practiced my dual specialty in Calgary at the Foothills Medical Centre and in EFW Radiology’s community clinics for 34 years. I now come before you simply as a physician devoted to our profession.

Saying goodbye and wishing you well!

September 28, 2019

PRESIDENT'S LETTER: As my tenure as President comes to a close, I find myself reflecting on a challenging and rewarding year. Looking back, I am proud of what the Alberta Medical Association tackled this year.

Value for Patients, Fairness for Physicians

September 25, 2019

PRESIDENT'S LETTER: This week we will hold the 114th Annual General Meeting of the Alberta Medical Association, in conjunction with our Fall Representative Forum. We will have many discussions at both events about the challenges and opportunities facing physicians in caring for our patients.

Sunshine list legislation gets four-year review

September 16, 2019

PRESIDENT'S LETTER: The all-party Standing Committee on Resource Stewardship is conducting a review of the Public Sector Compensation Transparency Act, better known to physicians as the sunshine list legislation. The bill became law in 2015 and provided for regular legislative reviews. The committee has invited public submissions to inform its 2019 review and the AMA was asked to comment.

AMA & CMA Membership renewal: Offering members a choice

September 11, 2019

PRESIDENT'S LETTER: AMA/CMA renewal notices will be sent out later this week. AMA and CMA dues remain unchanged from last year and we want to remind members that, starting this year, membership in the CMA will be optional for Alberta physicians. Through our renewed partnership, the AMA and CMA are working together to advance our shared priorities and to advocate for physicians at the national and provincial levels, and that is why we want to encourage all AMA members to continue to support the CMA when they renew this year.

Initial thoughts on Blue Ribbon Panel report

September 4, 2019

PRESIDENT'S LETTER: Yesterday you will have heard about the release of the Report and Recommendations of the Blue Ribbon Panel on Alberta’s Finances. The report details government’s concerns over the growth and level of health expenditures, i.e., the issue of affordability. It conveys many of the same messages contained in the government’s election platform, although the focus there was more on value for patients and included creating a medical home for each Albertan, as well as issues related to seniors’ care, mental health and addiction.

Update on first months with a new government

August 19, 2019

PRESIDENT'S LETTER: The Alberta Medical Association advances patient-centered, quality care by advocating for and supporting physician leadership and wellness. Most of the time, this requires collaboration with others in the system. Relationships matter – and the one between the profession and the Government of Alberta is one of the most important. As I look back over the past few months with our new government in place, I wanted to share a few thoughts with you. My first observation is that the new government has been very active, including in health care where they have launched reviews of Alberta Health Services, laboratory services and Connect Care.

Overhead Working Group report and what comes next

August 6, 2019

PRESIDENT'S LETTER: I’m writing as promised in my July 9 President’s Letter to provide all members with a copy of the Overhead Working Group Assessment and Review Report regarding the overhead study commissioned by AMA and Alberta Health for the Income Equity Initiative. It is available here: https://www.albertadoctors.org/leaders-partners/income-equity/related-documents (member login required).

About laboratory services

July 26, 2019

PRESIDENT'S LETTER: In June, the government cancelled construction of the Edmonton laboratory hub lab project and is currently exploring the needs of the province for laboratory services. Yesterday, the Canadian Society for Medical Laboratory Science added its voice to support appropriate investment in this area. We wanted to update members with our own assessment of the situation and to let you know what the AMA and Section of Laboratory Physicians have been doing.

Overhead Working Group and Physician Compensation Committee

July 9, 2019

PRESIDENT'S LETTER: You may have seen an update bulletin from the Physician Compensation Committee today, including reference to the recent Deloitte overhead study and the committee’s discussion. As I wrote to you April 25 in a President’s Letter, the Board of Directors formed a small working group in response to concerns raised by the Representative Forum and sections about the results provided by Deloitte. The working group was asked to review what has been provided and then recommend (i) what, if any, elements of the study are usable and (ii) the next steps for ensuring usable overhead information in the Income Equity Initiative.

Board planning: Working with a new government and supporting members

May 15, 2019

PRESIDENT'S LETTER: At our annual planning retreat in a few weeks, the Board will be bringing together months of environmental scanning, analysis and discussion around the Board table. We will be planning for the year ahead in the interests of members and with a new government. Today I wanted to give you a sense of what that has involved.

Introducing Healthy Working Environments initiative

May 3, 2019

PRESIDENT'S LETTER: Like me, perhaps you have lately observed a surge of headlines, reports and journal articles like these: "Why focusing on professional burnout is not enough", "Task force launched to tackle sexual harassment", "Addressing gender equity and diversity in Canada’s medical profession", "Understanding how patients perceive physician wellness and its links to patient care", "Most doctors have little or no management training, and that’s a problem." Almost a year ago, the AMA Board sat down at our annual business planning retreat and considered the convergence of these issues – in both our profession and society at large. Respect. Diversity. Inclusion. Leadership. Wellness. All of these things are relevant to AMA members and absolutely necessary if we are to play a leadership role in the system.

An Update on Income Equity Initiative and Overhead Study

April 25, 2019

PRESIDENT'S LETTER: In the March 25 President’s Letter, I wrote to you about the overhead (office expenses) study under the Income Equity Initiative. Concerns have been raised by the Representative Forum and sections about the results provided by Deloitte. In response, the Board has formed a small working group with delegates from the Specialty Care Alliance and sections of General Practice and Rural Medicine. The working group will review what has been provided and then recommend (i) what, if any, elements of the study are usable and (ii) next steps for ensuring usable overhead information for use in the IEI.

RF Highlights

March 25, 2019

PRESIDENT'S LETTER: An excellent Representative Forum was held March 15-16 in Calgary. I’m writing to give you a brief summary of what happened. You’ll hear more on these topics in future letters.

MyHealth Records has launched

March 20, 2019

PRESIDENT'S LETTER: In December 2018 we wrote to you from the Alberta Medical Association and College of Physicians & Surgeons of Alberta to let you know that the Alberta government would soon be introducing MyHealth Records, a secure online portal that will enable Albertans to access some of their personal health information. We are pleased to tell you that the portal went live for all Albertans on Saturday, March 16.

Funds flowing to Alberta – Well Doc Alberta is first initiative under CMA-AMA MOU

March 12, 2019

PRESIDENT'S LETTER: In our February 21 joint President’s Letter, we announced that the Alberta Medical Association (AMA) and Canadian Medical Association (CMA) established a new collaboration – outlined in a Memorandum of Understanding – to align activities and partner on joint initiatives that advance our shared priorities.

Retro BCP payments and other physician compensation news

February 28, 2019

Just as physicians cannot help patients achieve their best health by focusing on only one aspect of being healthy, similarly, in overseeing the AMA’s work toward financial health, the Board must take a comprehensive approach.

AMA-CMA relationship

February 21, 2019

PRESIDENT'S LETTER: We’re pleased to announce that the Alberta Medical Association and the Canadian Medical Association are establishing a new partnership, which is outlined in a principle-based Memorandum of Understanding.

About retroactive payments to physicians

December 19, 2018

PRESIDENT'S LETTER: In my December 6 President’s Letter, I wrote that members would soon receive retroactive payments for the April 1, 2017 Schedule of Medical Benefits cost of living adjustments. These payments have now been issued by Alberta Health for the April 1, 2017 to October 31, 2018 claims period.

AMHSP physicians – a vote and a new council

December 12, 2018

PRESIDENT'S LETTER: Recent changes in Alberta Medical Association governance and the passage of legislation on the rights of physicians to representation provide important new vehicles for physicians to bring their issues forward. The focus of this President’s Letter is on those academic physicians who are or soon will be part of the Academic Medicine Health Services Plan, and who now have the ability to request direct support in negotiations from the AMA.

SOMB retroactive increases coming this week

December 6, 2018

PRESIDENT'S LETTER: This fall, we have been moving forward on making payments owed to physicians under our Amending Agreement. The AMA issued the 2017 Retention Benefit payments on Friday, November 2. Today I’m writing to provide you with some dates and details about the retroactive payments for the Schedule of Medical Benefits and Alternative Relationship Plans cost-of-living adjustment.

An Act to Protect Patients

November 16, 2018

PRESIDENT'S LETTER: You may have heard news reports last week that the Government of Alberta had tabled Bill 21, An Act to Protect Patients. The legislation guards patients against exposure to inappropriate or predatory sexual behavior from their care providers. It applies to all regulated health professions, including physicians. The bill passed at the end of last week and is expected to come into effect in April 2019.

The AMA advances patient-centered, quality care by advocating for and supporting physician leadership and wellness.