Exercise your right of representation

May 15, 2020

Dear Members:

In the absence of an agreement, through our members the AMA continues to assert our representative role to effectively support you with respect to the Schedule of Medical Benefits, Alberta Health Services payments, clinical alternative relationship plans (ARPs) and all matters relating to physician compensation. Thank you for so actively supporting our profession to speak with one voice! 

While appearing to value physicians in some ways, government’s actions have sought to undermine the value and role of the AMA as our representative organization. Physicians remain strongly united behind the AMA against this approach, as demonstrated in several recent President’s Letters. 

Physician representation in ARPs is a critical issue facing the profession. As you have noted over the past months, government is actively promoting clinical ARPs, at least in part, by attempting to make fee-for-service unsustainable. 

The AMA strongly supports alternative relationship plans as an important component of our Physician Compensation Strategy. ARPs can provide a payment plan that effectively supports the relationship between physicians and their patients where, in some circumstances, fee-for-service does not suffice.
 
While we continue to press for a negotiated agreement, the best way for us to move forward in the development of ARPs in Alberta is through a collaborative approach with government. AMA input will support new contractual arrangements that are designed to provide value for patients and fairness for physicians. 

Government has made expansion of ARPs a priority and is planning to roll out a new model(s) for primary care. While there are many positive aspects to providing care through the ARP payment model, no physician should be forced into making the move without careful consideration. This is particularly true in this time of such uncertainty that we find ourselves in with respect to Bill 21 and COVID-19. 

Government’s expectations for increased ARP uptake are directly linked to the impact of its imposed Physician Funding Framework that has made fee-for-service less sustainable for many. The magnitude of the change required to shift business and cultural practice from a fee-for-service model to an ARP model cannot be understated. No physician should feel pressured into making the move to an ARP while under financial duress or with incomplete information. Physicians need to make an informed choice. Importantly, physicians need to be supported in change management as well as represented by their association in exploring or entering into ARPs. The AMA “has your back.”

I encourage you to exercise your right to be represented by the AMA when considering and/or entering into an ARP. 

Please make contacting the AMA your first step. Your experienced AMA staff are always ready to assist. Please contact us for information or advice:

• For annualized and sessional clinical ARP models, contact the AMA’s ARP Physician Support Services (ARP PSS) team at arpinquiries@albertadoctors.org or visit their website. 
• For the Blended Capitation Model (BCM), contact Christine.deMontigny@albertadoctors.org.
• For AMA representation or advocacy on ARPs in general, contact Didi.Wimmer-Frank@albertadoctors.org. 

The AMA has advised government that we intend to be involved and will comment on the planning of any new ARP models. We are assembling a working group/task force of physicians to inform us; a call for ARP representatives to submit applications for serving on the working group was issued May 9.

When changing payment models, good information is as important as representation. Members will receive further support via future President’s Letters, webinars and other learning opportunities. Some proposed topics include: how the AMA can assist individual members through contract processes; the impact of the Ministerial Order approach that currently governs ARPs; improvements we have proposed to Alberta Health’s process to implement ARPs; our thoughts on the future of ARPs within a broader compensation strategy; features of different models such as capitation, the Blended Capitation Model in primary care, etc. Through these activities we will seek your input and feedback. 

Since my last letter, hundreds more physicians joined our campaign calling on government to get back to the negotiating table. Nearly 2,500 members have already participated. Let’s get those numbers higher! While physicians have our own link to sign up for the campaign, the public can now also participate at patientsfirst.ca. In the coming weeks there will be further opportunities for the public to participate.
In your service,

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