Overhead Survey – We need your input!

April 18, 2018

Dr. Neil D.J. Cooper, AMA President

Hello Members:

We are nearing the end of the time for you to contribute to an extremely important study of physician overhead costs in Alberta. If you haven’t taken the opportunity to do so, please do so now!

Many physicians have told us that they wish to participate but need sufficient time to do so. We know that physicians are extremely busy. Accordingly, the deadline for participating has been extended from the original date of April 20. The survey will now close May 18.

You can submit as an individual or as a group practice. Every member received a personal email and survey link. If you can’t locate yours, please immediately email overheadreview@deloitte.ca.

Why does it matter?

Business costs have a huge impact on our practices and the care we deliver. We need to manage them as individuals and groups. We also must understand them as a profession to promote fair compensation. The survey is being conducted by Deloitte for the Alberta Medical Association and Alberta Health. The results will matter to you in the near and long term. They will be used for:

  • Future allocations: Our allocation process takes into account overhead costs associated with each section. It is important that we understand overhead in order to do any allocations.
  • Any re-allocations arising from the Income Equity Initiative: Overhead is one of the fundamental measurements in the Income Equity Initiative Adjusted Net Daily Income model.
  • Negotiations for fee-for-service and alternative relationship plan physicians.
  • Fee valuation projects such as the new Standardized Intra-Sectional Relative Value project.
  • Fee modernization projects that may include splitting of certain health service codes into an overhead (technical) and professional fee.
  • Any future fee reviews conducted by the Physician Compensation Committee.

The last provincial survey of physician overhead was conducted to develop the physician business costs model in 2009. Obviously, many things have changed since then.

Your input matters. We hope to exceed the 16% response rate we achieved in 2009. As of last Monday, about 8% were complete or in progress. We want to receive more data as the higher the response rate the more valid and reliable the data becomes! Please add your voice to the process by completing the survey.

Some frequently asked questions and answers appear below.

I have received many emails from physicians with questions and comments on the survey. As we hear about the great variation in practices, it is important that we collect as many results as possible to ensure we have an accurate representative sample from your section. I know physicians are interested in having their own situations reflected in this study. Some of the survey wording has been clarified and improved as a result of recent physician feedback and I hope you will take the opportunity to complete yours (if you have not already) by May 18.

At your service,

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


Questions and answers

The overhead study was released to physicians April 2. The survey deadline has been extended and will close May 18. If you do not have the access link that was emailed directly to you on April 2, please let us know immediately via overheadreview@deloitte.ca.

Why is the survey so complex and lengthy?

It’s partly a result of physician overhead costs themselves being both varied and sometimes quite complex. The survey is designed to gather overhead information from a wide range of practices to help ensure fair reimbursement of overhead and ultimately fair compensation among physicians.

The business costs model that was used in the past was built around the concept of a model medical office and this survey carries that notion forward, updating cost data and addressing some deficiencies that were identified in the prior model. The model office concept requires detailed cost data and the current survey will be the primary source of this data (validated by several other sources).

In the new model, complexity also arises from the need to account for things such as different practice types, fixed vs. variable costs, and direct and indirect funding sources.

While the survey is quite detailed and lengthy for physicians with complex business practices (e.g., those with multiple practice locations, business and overhead arrangements, skill codes), the survey logic simplifies responses for those with more straightforward arrangements, such as hospital-based specialties, or those working in relatively straightforward community-based practices.

Will physicians be compensated for completing the survey?

Unfortunately no, this issue has been discussed but the costs are considered prohibitive. AMA and AH are hoping that physicians will take the time to complete the survey, given the importance of the information for so many different aspects of physician compensation.

Will any information that I provide remain confidential?

Deloitte is the contractor administering the survey on behalf of the Physician Compensation Committee and the project is co-funded by the AMA and AH. By using Deloitte as a secure third party, individual physician responses are kept confidential from both the sponsors.

There are data security and confidentiality restrictions in place with Deloitte, both in our contract as well as our data-sharing agreement to provide member email addresses for this study. Legal counsel has reviewed these restrictions to ensure they are consistent with the AMA’s privacy policies and all applicable legislation. Please note that Deloitte email communication regarding the survey should come directly from overheadreview@deloitte.ca and jasolum@deloitte.ca.

I am in an ARP. Is the survey applicable to me?

In addition to fee-for-service, the survey applies to you if:

  • You practice in a clinical ARP.
  • You practice in an academic setting under an ARP and you either directly incur overhead expenses and/or pay an overhead levy.

The survey does not apply to you if:

  • You practice entirely under contract with AHS.
  • You are not reimbursed through FFS, ARP or AARP (e.g., you are in a salary arrangement).

I made an error. How can I go back to fix it?

There is unfortunately no back key, so physicians are encouraged to contact overheadreview@deloitte.ca to request a reset. Please note that you will be required to complete the survey from the beginning and your previous responses will be voided. This restriction was “by design” to protect the integrity of the data given all of the skip points/programming logic in the survey.

Can we submit one survey on behalf of a group?

For the demographic and practice-related questions on the survey (about 15 minutes to complete), we ask that individual physicians complete their own survey, as this information varies significantly among individuals.

For the financial data, the financial template provided in the initial survey email can be used to assist in preparation for Section 4 of the survey if you are in solo practice, or in a group or locum practice and have access to financial data.

Share the template with your business manager/accountant to compile the group’s responses. Responses compiled in this template will need to be manually entered into Section 4 of the survey.

If you are part of a group practice and do not have access to financial data, the survey will enable you to download a group practice financial template that can be shared with your business manager, who can then provide group financial data directly to Deloitte. Please ensure you share your URL link with your business manager, as URL links will be used to match template and survey responses.

Has Deloitte been responsive in dealing with queries and concerns?

Deloitte has been extremely responsive. At time of writing, 96% of queries had been answered.

The AMA advances patient-centered, quality care by advocating for and supporting physician leadership and wellness.