The RF: Negotiations, a webinar and income equity

March 18, 2022

Dr. Vesta Michelle Warren, AMA President

Dear Members:

The Virtual Spring Representative Forum Part One was held March 11. The Spring RF Part Two will be held May 13-14 in person, COVID-state permitting. In this letter I want to share the March 11 highlights:

  • Negotiations
  • A member webinar on the evening of April 5
  • Physician Compensation Strategy and Income Equity

Negotiations

The RF session provided a sense of where our interest-based discussions are sitting and shared the AMA’s perspective on what a high-level framework for an agreement might contain. We also discussed some issues we think may prove the most challenging to resolve. The RF was supportive of the approach that the Board has directed.

The Section of Family Medicine, Section of Rural Medicine and Specialty Care Alliance will co-host a webinar to update members on negotiations. Please save the date: evening of Tuesday, April 5. The event will be recorded for the member-only website.

The RF meeting reinforced for me that members value solid processes to allow physicians, government and Alberta Health Services to address challenges without relationships breaking down. This includes:

  • A comprehensive physician compensation framework replacing the existing ad hoc, siloed approach that has created so many issues including AHS stipends, Z-codes and AHS overhead policy. We appreciate that some delays have been granted to planned changes while negotiations occur, but we are still uncertain whether AHS will continue to proceed with its implementation plan on July 1. We have asked for a clear commitment to put all physician compensation changes on hold until negotiations are complete.
  • A role for physicians bringing expertise to decision-making in the system. An agreement would establish a strong working relationship and safeguard it through dispute resolution mechanisms. The parties need to keep moving forward when disagreements arise over complex problems.
  • Enabling stable physician practices and the ability to attract and retain physicians and learners. The COVID care deficit backlogs need to be addressed. Strengthening primary care and mental health will promote integration that will improve quality and reduce future expenses.

Alberta’s physicians understand that our health care system must be sustainable. As inflation climbs, our population grows and practices remain fragile, sustainability involves balancing the financial challenges of the profession with government’s interest in managing costs. There is no single solution. Members at the RF were clear that physician fees and payments can’t be used to pay for increased utilization or budget over-runs.

Physician Compensation Strategy and Income Equity

The 2021 Fall RF passed a motion to “move forward with the Income Equity Initiative, including future allocations that are based on principles of income equity using the best available information.” The Board interpreted this direction as having two purposes:

  • Get the IEI work completed as quickly as possible
  • Develop an interim approach to matters of allocation using best-available evidence to ensure that principles of income equity are considered and given effect.

After hearing about a proposed interim measure and an update on the Hours of Work study, delegates expressed general comfort with the approach to moving forward. This feedback and the comments made will guide the AMA Compensation Committee to complete work on the interim proposal. The results of this phase will be reported back at the May RF meeting for direction. It’s important to note that nothing can be implemented until an agreement with government is in place. We have appreciated government’s willingness to include principles of income equity in our negotiations.

Your comments on these matters, or anything else that’s on your mind, are welcome at president@albertadoctors.org. I will be writing to you soon about the next phase of AMA advocacy on the care deficit. Stay tuned.

Sincerely,

Vesta Michelle Warren, MD, CCFP, FCFP
President, Alberta Medical Association

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