On-call deserves our support

November 5, 2019

Dr. Christine P. Molnar, AMA President

Dear Members,

Our rural physician colleagues have recently been in the media with concerns related to reductions in on-call payments by Alberta Health Services. Here is one story from CBC. Our rural members, who are already stressed by a heavy burden of service, know that reducing on-call support will make it even more difficult to recruit and retain physicians to rural areas.

While this is unfolding, the government is planning to use Bill 21 to restrict access to billing numbers in the name of improving rural physician supply – a strategy that has failed in several other provinces. Billing restrictions have a poor history in Canada: they do not work. Bill 21 will not bring more care to rural Albertans. Perversely, it will reduce Alberta’s overall supply, including services in Edmonton and Calgary. Additionally, it introduces a new level of red tape to the billing number process.

It’s ironic that on one hand, we are witnessing reduction of proven, effective support for rural care through on-call. On the other, government is introducing restrictive policies that will undoubtedly inhibit rural access. This does not bode well.

In my October 9 President’s Letter, I wrote about the need for appropriate physician input into the design of on-call programs. This should include decision-making processes around program features, fair rates of pay and dispute resolution. A letter has been sent to AHS, jointly signed by the Specialty Care Alliance, Section of Family Medicine, Section of Rural Medicine and the AMA. We have asked AHS to work with us, on an urgent basis, to review on-call programs and issues. We have proposed that the review will include: principles and criteria for on-call; giving physicians access to AMA representation under the Strategic Agreement or another mutually acceptable mechanism; and transparent processes and communication.

We have proposed an immediate reinstatement of the POC rates that were in place prior to September, with the negotiated rate increases that were effective April 1, 2017, until such time as a program review is completed.

More updates will follow as we learn more.

Please let me know what you think in the following ways:

  • Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org
  • Comment publicly below on this President’s Letter (please be aware that comments are public, i.e. not members-only, even if you are logged in as a member).

In your service,

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

P.S. On the topic of Bill 21, some of you will have seen an article yesterday in the Globe and Mail by well-known health writer, André Picard. I thought it was worth sharing with members and we have obtained license to do so. Please read Alberta’s threat to rip up contract with doctors is destined to end badly.



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Alberta Medical Association Mission: Advocate for and support Alberta physicians. Strengthen their leadership in the provision of sustainable quality care.