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.

 

4 comments

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  • #1

    S. C.

    Other health care professional

    5:03 PM on November 05, 2019

    As a medical student, the changes made by Bill 21 not only discourages me to seek a residency in Alberta, but makes me more likely to go elsewhere in Canada for permanent employment. This Bill does not benefit Alberta.

  • #2

    Britt Simmons

    Physician

    11:08 AM on November 06, 2019

    CBC Calgary interview on Eye Opener regarding cuts to on-call fees:

    Very disappointed with the comments of AHS in response to concerns of rural physicians providing on-call support for surgery and anesthesia. Suggested that despite reduced fees, physicians will just continue to provide the service because of professionalism and duty to patients. This is the type of cut that will not make much difference in the health care budget, but will contribute to attrition of rural physicians providing on-call support and physician burnout for those who remain to provide the service.

  • #3

    Dr Mitch Parsons

    Physician

    4:54 PM on November 06, 2019

    As one of the physicians affected by the on call reduction I am certainly annoyed but it isn't going to impact my financial bottom line all that much. As a long time teacher of residents and member of an under serviced specialty I am far more concerned about Bill 21. I completely agree that it will backfire and result in much needed young physicians going elsewhere.

    The government and the population who voted for them need to realize that a revenue source is needed rather than draconian cuts to services which are already spread thin. A sales tax would share the burden most fairly among all Albertans with rebates offered to the low income group.....like those who are having their AISH payments de indexed. I am very concerned about the future of this province. I can already see the morale deteriorating with the teachers, nursing staff and other government employees I deal with every day.

  • #4

    Paul Kirvan

    Physician

    8:37 PM on November 06, 2019

    I think the point that should be made to the public as loudly as possible is that restricting the number of doctors in the cities won't turn Edmonton doctors into Peace River doctors. The people who want to work in a city will still work in a city. It will however turn Edmonton doctors into Saskatoon doctors.

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