COVID-19 response: We need to stand together

March 18, 2020

Dear Member

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.

COVID-19 AND VIRTUAL CARE

The presence of COVID-19 does not mean that all the health issues, for which our patients normally see us, disappear. The majority of other provinces are finding a way to support new types of physician arrangements that are tailored specifically to this time when usual methods of interaction are impossible. The 03.01AD code has been established for COVID-19 patients, but that is not enough. It is important that we develop and communicate some practical solutions in Alberta.

For the Alberta environment, we need to:

• Establish fee codes for physicians providing virtual care services:
  • Valued similarly to face-to-face visits without the current weekly limits on patient telephone and e-communication codes. These arrangements should cover a broad range of medical services:
  • Psychotherapy, psychiatric or primary mental health care, counselling or interview conducted by telephone or video per half-hour
  • Intermediate assessment of a patient by telephone or video, or advice or information by telephone or video to a patient’s representative regarding health maintenance, diagnosis, treatment and/or prognosis greater than 10 minutes
  • Minor assessment
• Establish differing types of arrangements (such as a sessional rate) for physicians working in designated assessment centres – these sessional rates should be valued at the same level as other sessional models.
• Clarify the technology that is available to physicians, especially for those working in the community.
• Provide support for physicians who become sick or are otherwise quarantined – this includes both helping to ensure patients are able to access necessary medical services as well as providing temporary or interim business continuity support for clinics that are compromised as a result of the COVID-19 pandemic

The clock is ticking as Alberta races to flatten the curve on COVID-19. It’s important to note that if Alberta is somewhat behind other provinces in terms of virtual care, we are also at the front of the pack in other areas such as rates of testing and early implementation of public health measures like social distancing.

We are in as good a position as any jurisdiction can be, provided that there is swift movement on making virtual care available to Albertans. It is the only way that physicians can safely and effectively look after the pandemic and other health needs of their patients. We can’t tell patients not to show up, not to get sick, not to want a Medical Home. We need to be able to care for them, safely and effectively and virtual care codes are will allow this to happen.

SUSPENDING IMPLEMENTATION OF PHYSICIAN FUNDING FRAMEWORK

As also mentioned yesterday, although it is good news that the Complex (Time) Modifier change will not go into effect on March 31, 2020, the remaining elements of government’s Physician Funding Framework are still slated to go ahead on that date.

We will continue to seek resolution, but for the profession right now there is another health care battle that requires our urgent attention. We are entering the upward curve of the COVID-19 response and it will consume us. We need to remove distractions. That’s why I’ve called for the framework implementation to be suspended, at least until the pandemic has passed.

I will be giving you frequent updates on these and other matters. In the interim, for COVID-19 response, please visit the AMA’s resource center: www.albertadoctors.org/about/COVID-19

In the last day we have added a page on preparing your practice and yourself to deliver virtual care. There is relevant information from the College of Physicians & Surgeons of Alberta, Canadian Medical Protective Association, Government of Canada and more. We will continue to add to this resource center.

Finally, look after yourselves. These days are immensely stressful physically and mentally. Don’t hesitate to reach out to the Physician and Family Support Program if you need assistance. By the way, they are offering e-visits.

In your service

Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association