Family medicine crisis
August 17, 2023
Dear Members,
This is another brief update on activity.
There has been daily contact with government and AMA senior staff. There have been meetings between primary care physician leaders (Section of Family Medicine, Section of Rural Medicine, Primary Care Networks Physician Leads Executive) and the minister. All our representatives are aligned and clear on our commitment to membership and the need for urgent action to address the sustainability crisis in family medicine.
No commitments have been made but we are being heard and there is necessary activity underway toward any meaningful solutions.
According to July data from the albertafindadoctor.ca website, the number of family physicians accepting new patients keeps dropping. Family physicians are leaving comprehensive practice or moving away because their current practices are not viable. We received a brief message from a medical billing clerk that tells a now commonplace story. We need action soon to keep the physicians we have, and we must get started on years of work it will take to recruit and build back in a worldwide health human resource competition.
You are always welcome to share your thoughts with me. You can email me via president@albertadoctors.org. You can also comment on this letter on the AMA website.
Regards,
fred Rinaldi, MD, CCFP, FCFP, LLB, MBA, MPA(HSA), BCom
President, Alberta Medical Association
"Fate whispers to the warrior, 'You can not withstand the storm.' The warrior whispers back, 'I am the storm.'"
6 comments
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Riyaan Hassen
1:34 PM on August 17, 2023
It’s just not viable owning a practice anymore. You have to offer doctors less than 30% office fees just to attract them but at that rate, you lose money on wages/rent and all other expenses.
For family practices to survive in their current form office fees will need to be closer to 35-40%.
Even with low office fees, many new doctors do not want to be family docs. They prefer specialty clinics and better work life balance. Who can blame them too.
But I expect many family medical clinic closures in the next 1-2 years. Where many other specialities can charge 45-50% office fees and still the associates make more money than a family doctor that works 5 or even 6 days a week.
Grant Erickson
1:49 PM on August 17, 2023
Problem is all about money. We have been losing 5-7% per year compounded for the last 7-10 years.
Government wants to fix the problem? 20% raise + 5% per year increase. Problem solved
Grant
Jim Dickinson
1:50 PM on August 17, 2023
I am currently visiting Sweden. Here the government has recognized that economic incentives work to counterbalance the status and other benefits of being a hospital specialist. So they pay family physicians more than hospital specialists. The only ones who get more are psychiatrists. And rural doctors of any type get more than in the cities for the standard day's work, let alone the extras for on-call.
Why does this government, wedded as it is to rampant capitalism, not follow the obvious incentives? And why does the AMA not support such actions?
Dan Botha
2:02 PM on August 17, 2023
It's intriguing how the AMA is currently rushing to collaborate with the government to address an issue they've been aware of for years - the deterioration of the profession. For sustaining a family practice, which involves covering expenses like office space, staff, equipment, and education, a rate of $500-$600 per hour seems necessary. This parallels the billing standards of professionals such as accountants and lawyers. Comparatively, veterinarians charge approximately $112 for initial consultations, with additional costs, while our charges remain notably lower at $38.03 in 2009 and a mere $38.76 in 2023.
There seems to have been a lapse in proper action or oversight, and even the introduction of PCN (Primary Care Network) has added a costly layer to healthcare without substantial benefits. Given the substantial funds within the healthcare system, it should be feasible to both cater to the needs of over 4 million citizens and provide fair compensation to medical practitioners.
Lorraine Liesemer
6:30 PM on August 17, 2023
The Docs need to present to the AMA and government what they want. What will make a viable practice for them. They may have signed a deal last Fall but these are new times and time to rework it.
David Lardner
8:23 PM on August 17, 2023
This is not just an Alberta/Canada problem. A relative of mine in Australia is having some mental health issues. Wait time to see a GP is 6 weeks.
We need fundamental changes to make General practice a much more attractive proposition.
Too much administrative time/red tape to deal with, hourly rates that are likely less than an NP working for AHS.
Overhead fees linked to CPI and a pension structure may help.