Preparing for Representative Forum
March 1, 2017
- The upcoming spring Representative Forum (RF) will address many important activities under the Amending Agreement.
- Members may review information provided with this letter and contact their delegates to provide input for the forum, particularly with respect to a major session regarding relativity and equity.
The spring meeting of the Alberta Medical Association (AMA) RF will be held March 10-11 in Edmonton. This particular meeting will be pivotal to shaping the AMA's philosophy and approach to various issues. I wanted to make you aware of the subjects to be discussed so that you have time to provide input to your delegates to the meeting should you wish to do so. In particular, you may have comments on a session regarding equity and relativity in physician payments and the AMA's approach to addressing these things.
The RF agenda
The Report of the Board of Directors to the RF will address the topics that follow, among others:
Implementation of peer review: The RF will consider the AMA's role and the profession’s responsibility with respect to peer review. In fact, the RF has already directed the Association to undertake this task. It’s important to be very clear about the scope and AMA role in the process to encourage appropriate billing and reduce inappropriate claims.
Bridging the future with today's decisions: Several efforts are underway to transform the health care system and enhance sustainability. The Amending Agreement has placed the AMA in a position to lead health care change and serve as managers of the system. The RF will give guidance to the board in defining our roles, and in determining where and how we should focus our influence. The critical role of physicians has been recognized. The RF will help shape that role.
Physician resource planning: The Amending Agreement creates a multi-stakeholder Physician Resource Planning Committee to develop a needs-based physician resource plan. The AMA was able to negotiate broad representation at this committee. As I have written to you before, the parties will use the best-available information to identify the optimal supply, mix and distribution of physicians for Alberta. The RF will receive an update on the important work of this committee. The board has developed a set of principles to guide the AMA in these discussions. These will be presented to the RF for input and advice. We have also established an internal ad hoc working group to support our AMA representative and provide advice to the board on related issues. A comprehensive member engagement strategy will also be required and the RF will hear more about what is being considered.
Relativity and equity: Member feedback regarding relativity and equity as they relate to the Amending Agreement – as well as prior RF direction – have highlighted the need to address these topics on a greater scale. Many issues must be considered in the overall equity discussions, including: Schedule of Medical Benefits Rules Savings contributions; utilization increases; overhead costs; years of training; complexity and intensity of work; and pre-existing system inequities.
The spring RF agenda has been extended by an additional three hours specifically to seek guidance from the forum on these matters. This will be an extremely important session and the board will be seeking answers to some fundamental policy questions:
- Is it time to address income equity among sections?
- Should equity be achieved using regular, negotiated increases/allocation, or should some reallocation between sections occur?
- Do the RF and sections want to further explore and potentially target outlier billers?
To support the discussion on equity, the AMA Compensation Committee has developed a package of information for delegates. Given the importance of these policy questions, the Board of Directors agreed that members should also have a chance to review this material before the RF, in order to better provide input and questions for their delegates to raise at the meeting.
Here are the necessary links, including the list of RF delegates if you are unsure whom to contact:
The RF has shown itself to be a strong and wise assembly, and its advice has guided the Board of Directors in our policy setting and advocacy direction. I look forward to similar insightful discussion and thoughtful direction at next week's meeting.
You can reach me as always by email: email@example.com
Padraic E. Carr, BMedSc, MD, FRCPC, DABPN