Programs have differences; we value all of them

January 19, 2018

Dr. Neil D.J. Cooper, AMA President

Hello Members:

Evolving toward a fully integrated, high performing health care system takes more than just intentions. Physician practices need to remain viable as an important part of system infrastructure. As clinicians and medical leaders, we also need support to learn different ways to work, to work with different levels of care more effectively, to take full advantage of the value of team-based care, informatics and more.

We have a strong foundation to build upon in all these areas under the terms of the 2011-18 AMA Agreement. These programs have performed extremely well to maintain or improve efficiency, quality, access and patient care.

Under the agreement, some of these programs are considered “evergreen” and thus can continue past the March 31, 2018 end-date of the agreement.

Evergreen programs have provisions for binding interest-based arbitration. Binding arbitration is also available for contracts under the Strategic Agreement where physicians are independent contractors with AHS. The evergreen programs are:

  • Continuing Medical Education
  • Medical Liability Reimbursement
  • Parental Leave
  • Physician and Family Support
  • Compassionate Expense
  • Physician Locums (Regular and Specialist)
  • Practice Management

Non-evergreen programs have non-binding dispute resolution provisions, but the ultimate decision rests with the Minister of Health. These programs are not guaranteed to exist past March 31, 2018:

  • Physician On-Call
  • Physician Learning
  • PCN and ARP Program Management Offices
  • Toward Optimized Practice
  • Business Costs
  • Retention Benefit
  • Rural Remote Northern

All of these programs are valued and remain an important part of the AMA’s negotiations stance.

As I have discussed recently, though, government has signaled that it may legislate to prevent the arbitration provisions for evergreen programs and rates from being exercised if “budget certainty” cannot be achieved.

I am writing today about the non-evergreen programs particularly, because they are not guaranteed to continue past March 31. We felt it only right to let members know that government could end the programs on that date, even if arbitration proceeds on the evergreen programs.

Because of evergreen provisions in the agreement, we are in a much stronger position than we have been in the past when there were no continuance provisions at all. Again, we believe all these valuable programs need to continue in some form and will be negotiating accordingly. Should any wind-down or transition be necessary, these provisions would also have to be discussed.

We remain at the table with Alberta Health and expect them to honor the commitments they have made.

I have appreciated the feedback I’ve received on recent President’s Letters about Negotiations 2018. There will be more information ahead. Please keep the comments coming and let me know who you are, where you practice and in what specialty. The usual three methods to exchange with me appear below.

  • Communicate with me privately and directly by email if you would like a reply:
  • Comment publicly below on this President’s Letter.
  • Share your perspectives with colleagues in our new Discussion Board for members only (member log in required).

At your service,

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


Commenting on this page is closed.

  • #1

    Thomas Kerlis


    1:50 PM on January 19, 2018

    Why is "Retention benefit" still mentioned under non-evergreen programmes?
    I believe 2018 will be the third year now that this program has not been available.
    Do we really think AHS will renegotiate/reintroduce a program it already had successfully scrapped?
    With POSP gone for years, there is a systematic process in motion by this government to disenfranchise and disempower doctors across Alberta.
    I am a GP in my fifties and have worked in my small community for 26 years now.
    With more and more expected for less, what incentive do I have in the last 1/3 of my career to stay in Alberta and work??
    Maybe the grass is actually greener.....

  • #2

    Allan Garbutt


    6:44 PM on January 19, 2018

    If the Govt. Kills RRNP and on call and business cost plus the already lost Retention benefit and out COLA a hard working rural doc would probably be out more than 100K. That is 10 for retention and 60 for rural/rrmote and 15 to 20 for on call and substantial amounts for business cost. Cannot think of quicker way to destroy rural med. AMA must stop this.

  • #3


    Member of the public

    1:27 AM on January 20, 2018

    In response to Thomas Kerlis [comment #1]

    @Thomas Kerlis

    AHS does not negotiate funding for these programs. AH - Alberta Health, aka the health ministry, does the negotiating and provides funding. AHS - Alberta Health Services - gets funding from Alberta Health as well, and does not deal directly with physicians.

    Besides, where else are you going to go? Albertan physicians are the highest paid in the country. You could head over to BC to escape AH.. but you'd be taking a 40% pay cut.

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