President's Letter

Dr. Padraic E. Carr, President, Alberta Medical Association

The "voice of the AMA" – The President's Letter informs you about Alberta Medical Association (AMA) 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 participate in members-only commenting.

You may also contact the AMA President by email at

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

Reconciliation Process and Retention Benefit

July 17, 2017

PRESIDENT'S LETTER: I am writing to update you about the status of the 2016-17 Retention Benefit. As you may recall, this was one of three at-risk payments under the two-year Amending Agreement.

Physician supply regulations

July 7, 2017

PRESIDENT'S LETTER: I have good news with respect to the efforts to develop a needs-based physician resource plan as established by our Amending Agreement with government. Some significant progress has been made and entrenched in new regulations approved by government this week.

Income equity and the Special RF

July 6, 2017

PRESIDENT'S LETTER: I am sending this letter to update you regarding the results of the Special Representative Forum (RF) regarding income equity. I am pleased to say this was a very productive meeting for the Alberta Medical Association (AMA) that provided greater clarity on a very complex initiative. The direction given to the Board of Directors going forward is crucial to the success of this endeavor.

Members ratify PCN Governance Framework

June 14, 2017

PRESIDENT'S LETTER: On May 15, voting began for the Primary Care Network (PCN) Governance Framework, a provision of our Amending Agreement with government. I am writing to tell you the results of the vote that was just tallied this morning: The framework was ratified with a double majority: 88% of voting physicians and 98% of PCNs (47% of eligible physicians cast ballots).

About the Special RF

June 8, 2017

PRESIDENT'S LETTER: The Representative Forum (RF) meets on Saturday, June 10 in Calgary to further address the topic of income equity. This special RF will build on the direction that the Spring RF meeting provided. At the Spring RF, the Alberta Medical Association (AMA) was charged to proceed with work toward income equity. The RF approved using an Adjusted Net Daily Income (ANDI) model and reallocation as tools to meet a five-year timeline which was set by the RF.

Voting begins: PCN Framework – a major step towards integrated health care

May 12, 2017

PRESIDENT'S LETTER: Voting begins: PCN Framework – a major step towards integrated health care

More from the Spring RF - and plans for a Special RF

March 29, 2017

PRESIDENT'S LETTER: In my last letter I promised you more information about what occurred at the March 10-11 meeting of the Representative Forum. It was a particularly influential meeting in many ways.

RF’s direction to Board and work with sections ahead

March 22, 2017

PRESIDENT'S LETTER: The Representative Forum recently held its spring meeting on March 10-11 in Edmonton. A number of important subjects were addressed including an interactive session on future directions of the AMA, an update on Physician Resource Planning, a session on Health Information Exchange, and a session on Negotiations 2018 among others.

Preparing for Representative Forum

March 1, 2017

PRESIDENT'S LETTER: The upcoming spring Representative Forum (RF) will address many important activities under the Amending Agreement. Members may review information provided with this letter and contact their delegates to provide input for the forum, particularly with respect to a major session regarding relativity and equity.

SOMB savings complete – Results and next steps

February 2, 2017

PRESIDENT'S LETTER: As outlined by our Amending Agreement, we have been working with government to identify $100 million in savings via changes to Schedule of Medical Benefits (SOMB) rules. Guided by consultation with sections and also considering input from individual physicians, a joint Alberta Medical Association (AMA)/Alberta Health (AH) working group developed a list of SOMB rule changes which were based on the following principles...

No decisions made on physician supply mechanisms

January 13, 2017

PRESIDENT'S LETTER: As noted in my last President’s Letter, the AMA Amending Agreement commits the parties to establishing a needs-based physician resource plan. Using best evidence, the plan will be developed by a multi-stakeholder Physician Resource Planning Committee (PRPC). I am pleased to announce that Dr. Ruth Collins-Nakai, past AMA and CMA President, will be our representative to this important committee.

The big picture, SOMB savings and physician supply

December 16, 2016

PRESIDENT'S LETTER: It has been two months since ratification of the Amending Agreement. While the total percentage of members casting ballots was less than ideal, turnouts are typically low and those who voted did so strongly in favour. Due process was followed, and the results are binding. With this direction, the Board has endeavoured to carry out the commitments of the association. • Amending Agreement initiatives: We must keep our eyes on the big picture and long-term goals. • SOMB Rules Savings Initiative: The board is considering how to recognize the contributions of sections. • Physician supply: Any decisions that are made to manage Alberta’s physician supply must consider the evolving needs-based physician resource plan from the Physician Resource Planning Committee. No decisions regarding conditions on billing numbers have been made.

Needs-based physician resource planning

November 29, 2016

The AMA (Alberta Medical Association) commends government for its commitment to fund any new physicians that Alberta needs while working with the AMA toward a needs-based physician resource plan. Principles will guide the Board of Directors. The timing is good to develop an evidence-based plan without being driven by a crisis in physician supply.

SOMB savings: Keeping you informed

November 15, 2016

We have had an impressive response from physicians to our call for suggestions toward the Schedule of Medical Benefits (SOMB) Rules Savings Initiative.

Implementing the Amending Agreement

November 10, 2016

You may have seen a feature article in Postmedia Network publications yesterday regarding the details of our newly ratified Alberta Medical Association (AMA) Amending Agreement. This was the first media coverage concerning details of the agreement’s provisions and there have been more media interviews since. These are key opportunities to emphasize some important points as we move into implementation. I thought I would share some of the messaging we have been relating to the media.

Ratified: AMA Amending Agreement

October 17, 2016

I am writing to let you know the results of the ratification vote by Alberta physicians on the package of amendments to the 2011-18 AMA Agreement. I am pleased to advise that the amendments were ratified, receiving a “Yes” vote from 74% of responding physicians. (Voter turnout was 29%, a bit lower than the average 38% for votes since 2003.)

Appreciating achievement

September 30, 2016

In my letter yesterday, I recounted the topics and discussions at the recent Representative Forum and annual general meeting. I thought you would also be interested to learn about some of the ceremonial moments of the event when we recognized the achievements of some outstanding Albertans.

First AMA President’s Letter:

September 29, 2016

This is my first opportunity to write to you since becoming president of the Alberta Medical Association (AMA) on Saturday, September 24, during the fall Representative Forum (RF) and annual general meeting. It is truly an honor to serve as your president, and I look forward to working for you in 2016-17.

Thoughts at the end of the year

September 23, 2016

In closing my term as president, I have selected a couple of topics that have had particular relevance this year.

Integrated care: What you told me

September 21, 2016

I am very excited about some of the proposals in the tentative Amending Agreement relating to the new Integrated Care Consultation Agreement and the existing Primary Medical Care/Primary Care Networks (PCNs) Consultation Agreement.

A ratification vote will be held

September 9, 2016

Last night the Alberta Medical Association (AMA) Representative Forum (RF) met in Edmonton and Calgary. The sites were linked by videoconference and delegates who were unable to attend in person joined by webcast.

Tentative Amending Agreement Next Steps

September 2, 2016

My President’s Letter on Tuesday, August 30 advised that the Alberta Medical Association (AMA) had reached agreement with government on a tentative package of amendments to the ongoing 2011-18 AMA Agreement. Here is what happens next.

Government discussions concluded – Tentative amendments to AMA Agreement reached

August 30, 2016

I have written to you previously about the issues of stewardship and professionalism and their linkage to the ongoing discussions with government. Our current negotiations began in February under a Memorandum of Agreement that laid out the terms and objectives.

Integrated care: what it really means

August 3, 2016

Last week I wrote to you about our ongoing discussions with government around stewardship of the health care system. I have written several times this year on the subject of stewardship, but in the context of negotiations, members might ask: Why does it matter? Why should we try? What will we achieve?

Update on government discussions

July 28, 2016

Discussions with government have been underway since the new year. As I have mentioned in previous President’s Letters, we have been working under a Memorandum of Agreement (MOA) for good faith negotiations “to explore issues of common interest during the term of the AMA Agreement, with the aim of managing the rate of growth with respect to the physician services budget, improving the effective provision of health care to Albertans and jointly ensuring the sustainability of the health care system.” The 2011-18 agreement remains in place; any proposed changes as a result of these negotiations would be subject to a ratification vote by physicians.

About the PCN review report

July 5, 2016

As you may have seen in media reports, yesterday government released a review of primary care networks (PCNs). The report is a review of some elements of PCN operations in a sample of PCNs. As might be expected, the review identified some things that need to be addressed. As always, we are open to ways to improve what we do as physicians and we will work with government to deal with these issues. At the same time, I would like to see this event as an opportunity to move forward and build the primary care system that patients want and deserve. I will say more about this at the conclusion of my letter.

Bill C-14 and assisted dying

May 6, 2016

I am writing to provide an update on assistance in dying. The newly released Bill C-14 has undergone first reading in the House of Commons. Whether there will be amendments is presently unknown, and my comments below reflect the current state of the bill.

Support for OMA

April 29, 2016

Discussions continue between the Alberta Medical Association (AMA) and the Alberta government, seeking to find ways in which the parties can reduce the rate of growth for health care expenditures while maintaining access and quality of care.

Response to Alberta budget

April 15, 2016

Yesterday afternoon, the provincial government released its first full budget. The budget is the government’s estimate of what it will require to meet its obligations and commitments while ensuring Albertans obtain the services they need.

Spring RF and accessing the PAD webcast

March 10, 2016

The spring meeting of the Representative Forum (RF) of the Alberta Medical Association (AMA) will be our usual two days of association business on behalf of the profession. In addition to “business as usual,” however, we will also take the opportunity to examine some larger topics. These subjects are about more than the AMA. In exploring them, we are facing not only issues that affect the profession and our patients, but also society at large.

Stewardship and Choosing Wisely

March 4, 2016

Recently (February 17 President’s Letter) I wrote to you about the need for effective stewardship of the health care system by physicians. Many of you kindly wrote back to share your thoughts on how we might be more effective in that role and some of you mentioned Alberta-based activities leading in that direction. I would like to update you on a major effort here to increase appropriateness in our clinical decision-making.

About the joint committee report on Physician-Assisted Dying

March 1, 2016

The Report of the Special Joint Committee on Physician-Assisted Dying was tabled last week, including a Dissenting Report and a Supplementary Opinion. I have some general remarks in response, and will then comment on some of the report’s specific recommendations.

Moving forward with PAD

February 24, 2016

I am writing to update you on Physician Assisted Death (PAD). You will recall that I wrote previously about this issue (January 14 President’s Letter).

A Memorandum of Agreement for government discussions

February 22, 2016

I wrote to you last week (February 17 President’s Letter) about the profession’s role as stewards of health care resources. Stewardship – and finding ways to manage the financial difficulties facing the province – are part and parcel of discussions over past months between the Alberta Medical Association (AMA) and the provincial government.

Physicians in society: the importance of professionalism

February 17, 2016

On Monday, February 8, the Alberta Medical Association (AMA) and Alberta Health participated in a policy forum called “Physicians as Stewards of Resources – Roles, Responsibilities and Remuneration.” The event was hosted by the Institute of Health Economics and the O’Brien Institute of Public Health at the University of Calgary. AMA Executive Director Michael A. Gormley and I both spoke at the event. I would like to share with you some of the things that Mr. Gormley and I said there.

Thoughts about Physician Assisted Death

January 14, 2016

I am writing today about Physician Assisted Death (PAD). The subject came up at the recent special meeting of the Representative Forum in December 2015 and is of great concern to members of the Alberta Medical Association.

The Alberta Medical Association stands as an advocate for its physician members, providing leadership & support for their role in the provision of quality health care.