Some new discussions with Alberta Health

May 15, 2015

Dear Member:

Last week I wrote about Alberta’s election and the New Democratic Party government. I believe that we have an opportunity to work together to make the system better for patients and that physicians can bring leadership, accountability and innovative ideas to the table.

In recent months, I’ve written about the balancing game we all face when we attempt to control health care costs (sustainability) yet still provide timely access to quality care. This can be difficult. When it’s not done well, it can result in undesirable tradeoffs. As Alberta’s health care system considers how to meet its financial challenges, there are some important factors to help us succeed:

1. We must set clear and measurable objectives for what we want to do.
2. We must be open to innovation and to allocating resources toward what matters most for patients.
3. Physicians and other health care professionals have to be engaged as full participants in system change.
4. Patients need to be included in planning and making this journey.

I have mentioned before that, in addition to our existing agreement, I believe we require a related arrangement that will allow the Alberta Medical Association (AMA) and the government to focus our energies on what is really important. I believe this should apply not just with respect to physician payments, but also across the system to improve sustainability and effectiveness (which includes productivity, quality and patient satisfaction).

Some new discussions

The AMA and the government are entering into discussions to explore some ideas to achieve these things. To ensure that both parties’ interests are protected, we have agreed to a memorandum of understanding (MOU) to guide discussions. There are several key features of this MOU that I wish to highlight:

1. Discussions will be undertaken without prejudice to each party’s rights and interests as provided for in the AMA Agreement.
2. We will not make any changes to the AMA Agreement without the express approval of both parties; this would be subject to an AMA member ratification vote.
3. There will be bilateral representation from AMA and Alberta Health, with Alberta Health Services attending in an advisory capacity.
4. The parties reserve the right to call in a facilitator to assist with discussions.
5. A rapid timetable is envisioned, with discussions to commence May 20.

The MOU identifies four top priority issues:

• Immediate financial viability of the health care system.
• Shared stewardship of limited health care system resources.
• Enhanced opportunities for physician participation in health care system decision making.
• Governance issues.

We will then focus on some longer-term issues, working together to improve access and quality care for Albertans.

The AMA Board of Directors has agreed on some “first principles” that will guide any initiatives that are proposed. Specifically, new arrangements must:

• Improve patient care.
• Improve access.
• Enhance efficiency.
• Decrease costs to the system.
• Drive behavior by incenting better care and avoid duplication.
• Keep practice viable for physicians.

These discussions represent an opportunity for the physicians of Alberta and Alberta Health to demonstrate joint leadership in the management and stewardship of system resources. I look forward to reporting on our progress.

As always, I want to know what you think. Please email president@albertadoctors.org or leave a comment below.

Regards,

Richard G.R. Johnston, MD, MBA, FRCPC
President