Highlights from Spring 2018 Representative Forum

March 29, 2018

Hello Members:

My last President’s Letter updated membership on the Spring 2018 Representative Forum discussion on the Income Equity Initiative as part of the overall Physician Compensation Strategy. I would now like to touch on some of the other topics and themes that were discussed at the RF meeting March 16-17 in Edmonton.

Here is a topic summary. Scroll down to the "Highlights" section to see more details on each topic.

• Peer Review: An update on work of the Peer Review Committee was provided to the RF. The forum was asked for guidance on the extent of the AMA’s role when promoting appropriate billing by physicians.
• Physician Resource Planning: The AMA and other stakeholders continue to meet at the Physician Resource Planning Advisory Committee to develop a needs-based physician resource plan. The RF received an update. We also discussed the profession’s role in managing supply toward what the needs-based plan identifies, using the tools currently available to the various parties.
• Negotiations 2018: An overview of the current negotiations and activities to date expanded on discussions, opportunities and challenges in achieving a new master agreement with Alberta Health.
• New section established: The RF voted to establish a new Section of Medical Oncology within AMA. Congratulations to our newest section. The RF looks forward to your contributions.
• Professionalism, Diversity and Gender Equity: Our own Dr. Kim Kelly, AMA Board member, told her story and the next day Dr. Nancy Baxter from the University of Toronto led a thought-provoking session about how diversity and gender issues manifest themselves for physicians, residents and medical students. The RF voted to establish a working group to explore the topics further with other stakeholders.

As usual, the RF worked hard and collegially on this wide range of challenging topics. I never fail to be impressed by the RF’s thoughtful input and informed discussions that lead to wise decisions.

All RF resolutions have been posted to the AMA website and are available here (member login required). If you have any questions or comments on any of the topics covered at RF, you can reach me in the usual three ways:

• Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org.
• Comment publicly on this President’s Letter.
• Share your perspectives with colleagues in our Discussion Board for members only (member login required).

At your service,

Neil D.J. Cooper, MD, FRCPC, Dip. Sport Med.
President

P.S. My last letter regarding the Income Equity Initiative noted that all physicians would soon be asked to participate in a survey regarding overhead costs. That survey has now been released by Deloitte on behalf of AMA and Alberta Health. I encourage all members to take advantage of the opportunity to participate in this very important study. If you did not receive the link, please email equity@albertadoctors.org. The survey closes April 20.

Highlights from Spring 2018 Representative Forum

Peer Review

The AMA Peer Review Committee has been meeting regularly since spring 2017. The peer review program was officially launched December 15, 2017, on the AMA website. This area includes information about the peer review process, links to a member website/portal for submitting ideas, a Billing Matters newsletter offering case study examples of how to bill correctly, along with links to the Fee Navigator^®.

The Fall 2017 RF directed that the peer review process should be educational and non-punitive, and that Alberta Health involvement should occur only when AMA processes have failed to remedy a “confirmed recalcitrant problem.”

The Spring RF provided further guidance for these rare situations where usual process may not be effective. Delegates passed a motion to pursue, with Alberta Health, the utilization of a third party to distribute targeted information directly to and from a physician on the Peer Review Committee’s behalf.

The PRC will continue to focus on an educational approach to encourage appropriate billing.

Physician Resource Planning

The RF received an update on the discussions and work underway related to physician resource planning.

Future work of the Physician Resource Planning Advisory Committee will include determining how to evolve its model to be an actual needs-based plan that includes mechanisms/processes for implementation. Work will include developing both short- and long-term recommendations to achieve supply and distribution goals that meet the needs of all Albertans.

The Board recognizes that a human resource plan is clearly a fundamental component of the AMA’s vision for a high performing system and we will continue to seek guidance from RF as we move forward in this process with our partners.

Negotiations 2018

The AMA Negotiating Committee members gave RF delegates an update on negotiations activities to date.

The AMA has been negotiating with government since December 2017. Both parties have expressed a desire to achieve a negotiated agreement. The AMA is seeking a deal that meets the needs of patients, physicians and government. This includes elements that are bigger than payments and rates, such as issues of representation, issues of system improvement and creating value for patients.

While there is no certainty in any negotiation, we continue to work for the best agreement possible. As things stand today, we expect government to live up to its commitments to negotiate a fair deal, to recognize the contributions physicians have already made and, if necessary, give us the access our contract provides to dispute resolution mechanisms.

For a review of the themes incorporated in the AMA’s negotiating position, please see my January 17 President’s Letter.

Professionalism, Diversity and Gender Equity

Physician health involves many aspects, including healthy workplaces, work-life balance, diversity and gender equity.

Instances of harassment, lack of respect and lack of diversity continue to occur in the medical profession. While these issues are certainly not unique to medicine, they do require our focus and attention in order to be appropriately addressed.

Led by a motion from the Fall 2016 RF, the Board identified the need to address diversity and gender equity in its own appointments. We are also improving our monitoring of the issue and are reviewing our appointment processes.

To help us begin to explore these issues in earnest, Dr. Nancy Baxter delivered a very engaging and eye-opening presentation to RF around issues of diversity and inclusion in medicine. I have received many comments from delegates who expressed how much they appreciated and were challenged by Dr. Baxter’s presentation. She certainly got us thinking and helped us start this important dialog among Alberta physicians. An update on what has happened with the working group that the RF established will be brought back to the Fall 2018 RF.