Stipends delay allows time for a comprehensive approach

December 10, 2021

Dr. Vesta Michelle Warren, AMA President

Dear Members,

Physicians working in Alberta Health Services facilities, particularly those involved with programs that are remunerated by AHS stipend arrangements, will probably have seen a December 8 email from Dr. Francois Belanger, AHS Vice President, Quality and Chief Medical Officer. His email confirmed that an extension has been granted to many AHS clinical stipend programs so that they will not be ending December 31. I wrote to members that evening, promising more information to follow regarding this announcement. I am providing that to you today. The AMA’s Stipend Action Committee has prepared a detailed SAC Update, and we are sharing that here for your convenience.

In general, we are pleased with the extension and this is consistent with our views about Alberta Health’s decision to delay implementation of the proposed Z-code changes and AHS overhead policy (about which I wrote to you on December 3). The breathing space that both these announcements bring will be welcome to the many physicians who have faced significant uncertainty in the approaching deadline. Just as the delay in Z-codes and overhead policy was appreciated, so too is this extension to stipend payments. The reality of the struggles facing community care physicians is another priority in our advocacy and communications with government. The role of the Physician Compensation Advisory Committee and its processes in determining fees, and our work on improving the virtual care codes have kept our teams busy.

That being said, the delays themselves are not a solution. We continue to believe the extra time granted must be dedicated to aligning all elements of physician compensation into a comprehensive and integrated framework. This includes fee-for-service (including virtual codes), clinical ARPs, AHS stipends, overhead policies or any other alternative funding arrangements, as well as Physician Compensation Advisory Committee processes.

Moving forward, the Board believes that these matters, and others that affect physician compensation, need to be brought together through negotiation of a provincial agreement. Ultimately, the comprehensive physician compensation framework that we are seeking should ensure fairness to physicians, value for patients and sustainability of community practices. We are discussing these issues with government and I will keep you informed on any developments as we consider if and how we can return to the negotiating table.

I want to thank the Stipend Action Committee for their tremendous work and leadership in coordinating the efforts of stipend program physicians and helping them to clearly articulate the nature of these programs and the range of implications related to their termination or transition to other arrangements. This advocacy has been invaluable and will continue to be as we move forward.

You will hear from me again soon. In the meantime, you may get in touch by:

  • Communicating with me privately and directly by email if you would like a reply:
  • Commenting publicly on this President’s Letter below (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member).


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

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