Community access to PPE: physician concerns, principles

May 27, 2020

Dear Members:

The AMA sits on the Pandemic Community Supports Working Group, which is chaired by Alberta Health and also including Alberta Health Services and the College of Physicians & Surgeons of Alberta. This working group has been a successful space for advancing solutions to pandemic issues, from establishing virtual care codes, to streamlining and clarifying communication issues and more.

Access to personal protective equipment has been a constant agenda item. This morning’s meeting included discussion of the government’s May 25 announcement that very soon community physician practices will be responsible for the costs and procurement of PPE.

This change is a great concern to physicians, but there are also principles to consider here - for patients, our teams and the health care system at large. These include:

• Patient and provider safety
• Delivering care at the right place (versus redirecting patients to more expensive levels of care with less continuity)
• Sustainability of the health care system
• Equity

If community physicians are required to find and purchase their own PPE, they will not be able to sustainably continue providing services to all patients. Our estimates indicate that the costs of PPE for a COVID-suspected or COVID-positive patient in a community office would, in many cases, mean providing service at a loss.

Physician practices are key to health system infrastructure and must remain viable. For an excellent example, consider that the Calgary Zone has effectively dealt with about 96% of their COVID-positive patients in the community.

The AMA believes this matter is fundamental to Alberta’s reopening and to the well-being of Albertans. The AMA has proposed options through the Pandemic Community Supports Working Group and Alberta Health is reviewing them now. I will keep you informed regarding their response.

Before closing, I’d like to note that this is Alberta Rural Health Week. Let me take the opportunity to acknowledge rural health care providers and those who support rural hospitals or facilities. You are outstanding. Not only for your amazing service during COVID-19, but for always being there for our rural communities. Thanks to each and every one of you, including, of course, the remarkable and resilient rural physicians of Alberta. We could not be a province without you.

In your service,

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