News on programs and other matters

July 24, 2020

Dear Members:

On Wednesday, July 22, we received an update on government’s decision-making regarding the future of the programs under the AMA grant agreement. As you are aware, since the spring and end of negotiations, the grant agreement has been unsigned, leaving all involved in limbo. Given the importance of these programs to physicians and the health care system, we have ceaselessly pushed for clarity on their future and underscored the value of retaining them within the AMA. We have now been advised of the following:

• Physician Locum Program – A service to family physicians and specialists who access the program for weekend, short-term or seniors’ coverage and locum physicians who provide rural/regional locum coverage either part-time or full-time.
  
  The grant to the AMA will fund activity for the period April 1, 2020 - August 30, 2020. The services will be moved to Alberta Health Services effective September 1, 2020.
   
• Alternate Relationship Plan Physician Support Services – Supports physicians in the exploration, development and implementation of Alternative Relationship Plans. This includes clinical ARPs and Academic Medicine and Health Services Plan arrangements.
  
  The grant to the AMA will fund activity for the period April 1, 2020 - August 30, 2020, after which the program will end.
   
• Physician Learning Program - A physician-driven program supported by the AMA that helps physicians self-assess their current clinical needs and access high-value learning resources to meet those needs.
  
  The grant to the AMA will fund activity for the period April 1, 2020 - August 30, 2020. After that date, Alberta Health will grant with the universities directly.
   
• Accelerating Change Transformation Team – Enables system transformation in four ways: content to understand transformative change; capacity and building skills for change; support for Primary Care Networks and partners to lead and implement change; influence policy, practice funding and services of other groups to promote successful change.
  
  The grant to the AMA will fund activity for the period April 1, 2020 - March 31, 2021. During the year, Alberta Health will issue a Request for Proposal for the services that are currently provided by ACTT. The AMA will have the ability to submit a proposal to the RFP.
   
• Physician and Family Support Program, Compassionate Assistance and Parental Leave – Important physician-led programs to support physician health and provide guidance through crisis, life and career stages.
  
  The grant to the AMA will fund activity for the period April 1, 2020 - March 31, 2021. During the year, the department will review options for future delivery of these programs.
   
• Wind down – The grant to the AMA will include provisions for reasonable wind down costs for the programs that are scheduled to end August 30 as well as a wind down provision for the remaining programs if those programs end or delivery is moved to other organizations after March 31, 2021.

While we can work with some aspects of the above, others diminish the AMA’s role and have significant implications for physicians and patients.

For example, termination of the ARP Physician Support Services does not line up well with the goal of supporting physicians already in ARPs, or those who wish to enter into one. From our own work and surveys we know this support, from a trusted and knowledgeable source, is key to ensuring these efforts are successful and sustainable. The AMA will continue to support those physicians, but it is unfortunate that the Minister does not appear to realize that disabling a primary support service provided through a trusted source, will not be helpful in advancing what we had believed was an important policy direction.

The movement of the Rural Locum Program to Alberta Health Services also strikes me as unnecessary and disruptive. The AMA has successfully administered this program for many years and has established relationships with physician practices that are necessary to make this work. Other than its destabilizing effect, it is not clear to me what this move is intended to achieve and it simply adds more instability into our system.

Finally, it is positive that the Physician Learning Program remains in place, although the AMA’s involvement has ended. The Physician Learning Program uses health system data, expertise in the facilitation of audit and feedback and human-centered design, to co-create tools and resources that support meaningful change and sustainable solutions to advance practice. The reason for having AMA involvement was to ensure a strong linkage between these important programs and those physicians operating outside our academic institutions. It is unfortunate that the Minister does not appear to support this notion.

The Board held a special meeting last night to provide initial direction on work to be done. I will have more to say about the Board’s thoughts and plans as a result. I very much welcome thoughts from members regarding how you will be affected.

Also on the topic of programs, and in case you missed the email on this topic earlier this week, the Canadian Medical Protective Association has generously responded to advocacy from the AMA. For physicians participating in the Medical Liability Reimbursement early reimbursement process, the CMPA will be deferring the withdrawal of annual dues to September 1, 2020. As you are aware, there have been significant implementation issues since this program was bureaucratized to Alberta Health.

In other news, I recently wrote to you that we had received a media release and letter from the Eye Physicians and Surgeons Association of Alberta regarding their wish to negotiate directly with the Minister. I have heard from many physicians on this topic and can tell you that we are working with members to identify the issues and support solutions. Regarding certain statements made by EPSAA, the Section of Family Medicine has asked that I share their latest SFM Bulletin with the entire membership, which links to a letter from the Section of Rural Medicine to the signatories of the EPSAA letter.

Finally, our Confidence Vote Referendum on the Minister of Health is still underway. Since the outcome of the referendum will guide the Board in taking next steps to seek a negotiated agreement, I believe this is one of the most important votes in which you will be asked to participate for years to come.

In response to member’s questions, your anonymity in voting is assured. It’s incredibly important that you vote according to your conscience and encourage your colleagues to do the same. Please note that resident physician and medical student members are eligible to vote. A reminder notice will be sent from the voting platform today, including the secure link (member login required and anonymity guaranteed).

You will hear from me again soon.

In your service,

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