First do no harm. We Must Act for Patients’ Safety and Access

February 26, 2020

Dear Members:

Tomorrow government tables its latest budget in the Legislature. This event will generate a lot of noise in the media and spark further public debate. We do not expect a significant change to our situation. Government has torn up the agreement with the profession and continues with some ill-conceived changes that will be destructive to your practices and to our health care system.
 
I am hearing from many members in response to last week’s termination of the AMA Agreement by government, particularly about the imminent harm for patients resulting from the 11 consultation proposals that government plans to implement this spring. Your distress and anxiety are palpable and my heart is with AMA members at this difficult time.
 
The Board of Directors met Monday night to receive updates and consider next steps. You can expect to be hearing from me frequently in the next few weeks about how we will support you to continue practicing in ways that work for you and your patients. 
 
We require significant resources to mount our support. Look at this as a “war chest.” 
 
The AMA has established a special fund for a variety of needs that we have identified. In the next few days, you will have the opportunity to contribute to the fund if you wish. Additionally, I am truly pleased to report that we have been offered support from all of Canada’s physicians through the Canadian Medical Association. You will learn more soon, but there are significant resources involved. This assistance is much appreciated. Thank You CMA! You can read the most recent CMA statement on the situation in Alberta: Alberta health care takes a step backward; CMA supports AMA’s call for a negotiated agreement.
 
The Board is overseeing a wide range of activities:

• A public information campaign to inform patients about what government’s tactics are doing to the health care system and how individuals can become involved. This will include a range of strategies from online advertising to office-based materials (talking points, posters, etc.).
• Staff have been hired to support members in their own advocacy across the province. We are working with the Sections of Family Medicine and Rural Medicine, as well as the Specialty Care Alliance, to identify what would be useful for respective sections and groups. This could include a range of activities such as local town halls (see below for a great example).
• The Physician Advocacy Group is meeting next week to explore other actions that the profession may take to influence government.
• We have engaged constitutional and other legal experts as we prepare to initiate the most-appropriate challenge in the courts.
• albertapatients.ca, our online community of more than 11,000 Albertans, just weighed in via a survey to tell us how they value time with their physicians. Here are some results. 85% of patient respondents gave positive ratings on the amount of time spent with their family doctor on their last visit. 89% say they require (at least occasionally) more time with their physician to discuss more than one health issue. When it comes to compensation, 61% say they approve of the current system, which may utilize complex modifiers for flexible patient time with their physician. Please encourage your patients to join this online community. Sign up is easy: albertapatients.ca.
• We’ve ramped up our social media presence and are actively engaging in Twitter and Facebook to correct misinformation and provide physician and patient perspectives.
• We are preparing for the Spring Representative Forum and determining what direction we will need from the leadership there.
• We are working to understand the confusing and inadequate information put out in recent Alberta Health bulletins. It’s not clear what has been or will be done, e.g., regarding the new codes for Alberta Health Services physicians, Medical Liability Reimbursement support and Continuing Medical Education earned entitlements. We are seeking clarity from AH and we will communicate information to physicians and the public. 

Government needs to fix what they have broken. Sadly, instead of directing our energy toward collaboration for an improved, patient-centered system, government’s actions mean that physicians are facing a fight. It is our honor and responsibility to first Do No Harm, and in that manner we will proceed to march forward and bring to light the consequences of government’s impositions. 
 
Our goal remains to have a meaningful dialogue and resolution of our current situation through negotiations toward a new agreement. This is what patients deserve and expect.
 
Based on conversations with the Minister, and your many interactions with him and other MLAs, I am sure you agree that the road back to a common sense approach will not be easy. It may be long. The Board is ensuring that the necessary resources are in place. You all have a role to play in this battle to keep quality health care in Alberta. We will stand with our patients in this struggle. Their voices must be heard. We are all, after all, the taxpayers that fund the system.
 
I mentioned the idea of physician-led town halls earlier in this letter. If you’d like to see a great example of the level and quality of advocacy that we would like to support members to do, have a look at this video from the Moose and Squirrel Medical Clinic in Sundre. Huge kudos to the physicians there, who organized a successful town hall last Sunday and posted the video to Facebook. We like this approach because it’s a member-led discussion with patients about what government has done and what patients and doctors can do in response.
 
Please keep an eye on your email. I will be in touch soon.
 
In your service,
 
Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association