Supporting each other through the storm

April 3, 2020

Dear Members:

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. We warned them that the planned changes would put many physicians in the untenable position of choosing between being financially viable and offering the best care they can to patients. We alerted them that patient care would be impacted as a result of what they were planning.

Our messages went unheeded. We are now confronting the consequences in the midst of a pandemic.

Having assessed the financial impacts of the Physician Funding Framework put in place March 31, 2020, physicians across the province are having to restructure their practices. The Minister of Health has created a set of conditions that result in physicians being forced to make very difficult decisions. These decisions will vary according to the individual circumstances of every physician.

We’ve seen members withdraw from some services that they can no longer afford to offer. Doctors should not have to choose between caring for patients and bankruptcy, yet this is the choice that many are facing due to government’s actions.

The AMA respects the right of all physicians to make such choices, in accordance with professional ethics and the standards and advice of the College of Physicians & Surgeons of Alberta.

In this context, the AMA fully supports Alberta physicians in the changes they are forced to make to their individual and group medical and surgical practices: not only in their offices, but in their emergency coverage, in-hospital coverage and in extended care in the community.

I fully appreciate how difficult it is to make these decisions. They are heart-wrenching.

It is very important that as a profession, and as colleagues, we support one another as best we can. We need to be able to discuss the stress our practices are under today, the measures we are taking to sustain our practices and support and learn from one another.

Sustainability of patient care is also being affected by COVID-19. In particular, there is a need to maintain safety for health providers and patients in the community, where the frontline battle with the pandemic will be fought, won or lost. We have established a Community Support Group of the AMA, Alberta Health, Alberta Health Services and the College of Physicians & Surgeons of Alberta to discuss and elevate issues around personal protective equipment availability, communication, payments, business continuity matters, use of technology and workforce plans. This work will need to be aligned with similar efforts in the acute care sector.

The AMA fully supports its physician membership in requiring the highest level of safety for health care workers in the COVID-19 pandemic environment. Full access to personal protective equipment such a masks, face shields, gloves and gowns must be available to protect health care workers at all times during the COVID-19 crisis in the community, hospitals or any other health care facilities, such as extended care or long term care facilities. This is not only for their protection, but also for the safety of their families, other health care workers and patients.

The Section of Rural Medicine has requested that we set up a secure online discussion board to share ideas and needs. We will be reaching out through Section Services to see if other sections would welcome a similar opportunity.

I will write again soon. Please keep safe.

In your service

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