Programs have differences; we value all of them

January 19, 2018

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: president@albertadoctors.org
• 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.
President