Call to action
October 12, 2023
Dear Members,
Last week I met with Minister of Health Adriana LaGrange to discuss the ongoing crisis in family medicine and the Longitudinal Family Practice proposal the Alberta Medical Association has submitted to address it. I was joined by the presidents of the Section of Family Medicine and Section of Rural Medicine. These leaders have done a lot of heavy lifting behind our proposal to make family medicine stable and sustainable.
As you know, the minister has acknowledged that the family medicine crisis is real. The question for government is how, and how quickly, they will respond with meaningful, physician-led reform.
When we met, I found the minister well-informed about our proposal. She clearly shares our solutions-oriented approach. I believe she understands that we are no longer competitive in Canada, and that we are losing doctors while also failing to effectively recruit new ones. I think she understands that without meaningful measures to retain the doctors we have in the province, reforms to family medicine will become more and more difficult to achieve. There was also recognition that even in the time since the Modernizing Alberta’s Primary Health Care System (MAPS) process was undertaken, a shortage of doctors and lack of financial viability have continued to erode family medicine.
When she spoke at the Representative Forum, Minister LaGrange said that the release of MAPS would be accompanied by “short, medium and long-term initiatives.” For family physicians, the short-term initiatives must include stabilization funding that will help to retain the physicians we have and secure our family and rural medicine practices. A stabilized sector can then be engaged in medium and long-term reforms that include a fair and more effective funding model that supports team-based care. We want a system that provides a medical home for every patient who wants one, in an integrated health neighborhood where all specialties work together as seamlessly as possible. We have outlined a framework to start this work in our LFP proposal, and we must preserve and build on the elements of primary care that are working well right now in Alberta.
Beyond stabilization, our LFP proposal includes solutions to address various issues, such as payment for time – indirect, direct and add on, as well as complexity payments to recognize how chronic diseases are managed at different levels, affected by the mental health and age of the patient.
Your family medicine leaders continue to represent you very well as we push for reform toward comprehensive, longitudinal family practice and fair compensation. When I met with them yesterday, they were clear in their support for immediate stabilization and eager to participate in ongoing discussions with government. They will continue their advocacy, and, on their behalf, I am appealing to all members to continue to raise awareness with elected officials: family medicine is in crisis and requires immediate stabilization and reform.
I encourage you to share this President’s Letter with your network and your local elected officials. There is a link at the bottom if you would like to send the President’s Letter directly to your MLA. Ask them to read and consider it and, if you can, tell them about the circumstances you are dealing with in your own practice. Too many Albertans do not have access to a family physician. Doctors are leaving Alberta. This must change.
The minister’s mandate letter from Alberta’s premier is clear: Support primary care as the foundation of our health care system by assessing alternative models of care and leveraging all health care professions.
After a year of consultation and many months of waiting, we are beyond ready for action.
If you would like to forward this President’s Letter to your MLA, please click the appropriate link below:
Practicing physician: www.patientsfirst.ca/md-mla-program
Resident physician: www.patientsfirst.ca/md-mla-program-residents
Medical student: www.patientsfirst.ca/md-mla-program-medical-students
Please lend your support. I will write again soon to keep you updated. You can reach me anytime at president@albertadoctors.org. You can also comment on this letter on the AMA website.
Regards,
Paul Parks
President, Alberta Medical Association
4 comments
Commenting on this page is closed.
John Fernandes
3:21 PM on October 12, 2023
Hi Paul,
I appreciate the note - but the prose in your communication seems to deliberately avoid the very words that need to be said…..pay the Family Physicians better - a lot better.
There is a lot of alternative language full of buzzwords and all kinds of statements that do everything EXCEPT address the fact that Family Physicians need to be paid way better.
The statement from the Minister to the AMA:
"The minister’s mandate letter from Alberta’s premier is clear: Support primary care as the foundation of our health care system by assessing alternative models of care and leveraging all health care professions."
- seems to ignore the fact that Physicians need to be paid better or they will leave. “Alternative models of care” have been explored and implemented with variable success for the past 15 years without any helpful conclusions.
“Leveraging all health care Professions” does absolutely NOTHING to help Family Physicians that cannot pay the bills of their operational costs. These approaches are usually inefficient and have been proven to overall increase costs while decreasing quality of care.
I don’t think that allowing the Minister of Health to get away with flowery “non-languague” and meaningless buzzwords is an effective way forward for the Profession through its AMA representation.
This approach has been a spectactular failure for the past 25 years of my membership in the AMA and I believe that a much more aggressive and blunt approach is needed.
For example - the “tray fee” implicit in a 98.12H procedure fee pays $38.78 for a Family Physician and has not changed significantly since 1991 - while inflation has pushed the costs of surgical trays north of $450 per tray.
In the past 33 years, the tray fees should now be a minimum of $78.83, based on a 3% inflation rate.
This still does not account for the new Infection Prevention and Control (IPAC) protocols that the CPSA requires Physicians to undertake in order to keep up with the new Professional Standards.
These IPAC protocols are very expensive to maintain and typically cost about $480 per surgical tray at the very least.
I can easily provide an audit report in MS Excel format for you that details every penny of the cost of a $480 procedure tray that is reimbursed at a rate of $38.78.
Many of the other billing codes for Family Physicians have also not increased appreciably in 33 years, and they have certainly not even approached inflationary increases in operational costs.
I think that the time for overly polite and avoidant language has come to an end, and a sharper and more targeted and uncomfortable approach is indicated.
The Nurses union seems to have this figured out and perhaps the AMA can take some inspiration from their approach.
I hope that this helps.
John Fernandes
Family Physician.
N/A
1:29 AM on October 13, 2023
What is the government and adriana lagrange doing to address the highly skilled number of canadian IMG (international medical graduates) who are willing and able to enter into residency training? the canadian matching service is extremely unfair and biased towards canadian medical graduates. They are begging for family doctors and there is an infinite pool of applicants willing to train, even in the most rural areas.
Aalo Duha
3:54 PM on October 14, 2023
In response to John Fernandes [comment #1]
Thank you for this, Dr. Fernandes.
John Julyan-Gudgeon
5:57 PM on October 16, 2023
To those family doctors reading this, ask me about job action.