It has been an honour to serve you

October 4, 2022

Dr. Vesta Michelle Warren, AMA President

Dear Members,

When I became president of the AMA in September 2021, I was told that the year would go by fast, yet I am still astonished at how quickly it has gone. Serving as AMA president has been altogether the most challenging, humbling experience of my life.

When I set out in this role, I had goals, both personally and for the association. Like previous presidents, I wanted to improve things for physicians in Alberta – to leave this role with our situation being better than when I entered it. Looking back at the events of the past year, I can honestly say that I have done my best to advance physicians’ interests in a challenging environment while following through with my mantra: speaking truth to power, as well as truth to AMA members.

My role began shortly after Jason Copping was appointed minister of health, and I viewed this as a true opportunity for a “new beginning”. Minister Copping’s attitude – and that of the people he brought to his team – was very different from what physicians had faced in the previous two years with government. Throughout my tenure, over the course of many meetings and conversations, the minister showed a genuine interest in rebuilding the damaged relationship as we sought to inform government about the realities facing our health care system.

Our tireless advocacy led to the AMA being included in decision-making again, initially with decisions around COVID 19, then around virtual care. While we were working on virtual care, AHS was rolling out changes to stipends and plans to initiate overhead in their facilities, and the AMA advocated to show the minister that these decisions would have significant unintended consequences on patient care. Our efforts led to the deadlines being pushed back again and again. We advocated for open and transparent processes with fair representation and access to dispute resolution. The government decided that while we were in negotiations there would be no further action taken as it was finally recognized that these issues were intertwined with the master agreement we were working on.

We advocated on other issues as well, including the Alberta Surgical Initiative. We knew it was imperative to include all impacted stakeholders and as a result of our advocacy, physician leaders were asked to sit at the table and engage in the planning and implementation of the project. Your physician leaders did not hold back, they spoke truth to power about the harsh realities that need to be addressed with ASI, and the ministry recognized they not only need to hear those truths, but also our solutions from the front lines.

Nine months after the failed ratification vote, we got back to the negotiations table working with a facilitator to undertake interest-based bargaining. This new approach allowed us to share what we had been hearing directly from physicians, including their need for certainty, for stabilization of community practices, for physicians not to be responsible for things outside their control, for the importance of income equity and much more. Many of our physician leaders were “tapped” to join in, as the process needed their expertise – the primary care table, the specialty care table and IT/informatics, just to name a few.

It was a slow process, but an important one. My role – as always – was to explain the reality facing physicians in Alberta, to shine a light on things not understood by government. To speak truth about physicians struggling to keep their offices open in the community, the impact that Z-codes, stipends and AHS overhead was having on specialty physicians and how all of that was impacting Albertans. To speak to how improvements to primary care and the medical home could result in lowered costs in our system. To counter the myth that “there are plenty of docs in Alberta,” to help AH understand that all physicians are unique and there were nuances in the numbers. Many “final offers” were laid on the table but your negotiating team – as directed by the RF and AMA Board – pushed back over and over again.

Throughout the year, Alberta’s physicians advocated about the growing crisis in primary care. As a result, we now have the Modernizing Alberta’s Primary Health Care System (MAPS) task force, which recognizes that the current way of funding primary care is insufficient, and the care Albertans need and deserve is lacking. This is where physician leadership will be crucial, at both the executive and strategic levels so we can stabilize community practices and offer physicians a choice. This is where we can look at how team-based care can work in our system and improve access for all Albertans immediately while working on the medium- and long-term solutions we know we need.

The newly ratified agreement is a beginning, but implementation is key. I know our new AMA president, Dr. Fredrykka Rinaldi, will be amazing as she continues to advocate for our profession and for Albertans. She has always been a role model to me and consistently speaks truth to power.

Thanks to the AMA staff who worked with me this year and figured out how to work around the schedule of a rural physician! The dedication of our AMA team is so inspiring.

I also want to thank Dr. Paul Boucher for his support and mentorship, and Mr. Mike Gormley whose knowledge and wisdom were invaluable to me. A special thanks to my fellow AMA Board members, who inspired me with their dedication and insights. Thank you for being engaged, for stepping up and into leadership roles for our profession and for always putting the needs of physicians and patients first in our decisions.

In connecting with so many physicians around the province this past year I was continually impressed by your focus on getting patients the care they need. It is what drives us, and we can never lose sight of the fact patients are counting on us.

In the face of a leadership race and an upcoming election, I know that our commitment to one another will stand us in good stead as we continue to advocate for ourselves, for our patients and for our health care system.

It has been an honour to serve you.

Sincerely,

Vesta Michelle Warren, MD, CCFP, FCFP, FRRMS
President, Alberta Medical Association

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