Thoughts on health care from UCP leadership candidates
Rebecca Schulz
The Alberta Medical Association is seeking to understand each UCP leadership candidate’s vision and plan for addressing the challenges in our health care system. We asked our 14,000 members what health care related questions they have for the candidates. We also asked our online patient community – made up of over 40,000 Albertans – at PatientsFirst.ca.
The following 10 questions will be posed to each UCP leadership candidate on behalf of member physicians and Alberta patients. Here are Rebecca Schulz's answers.
Every Albertan needs a family doctor (supported by a team of health professionals to look after their comprehensive, life-long needs), but many Albertans either cannot find a family doctor, or cannot get in to see theirs. Albertans are worried and want to know what your vision is to improve access to primary care in Alberta?
Albertans need access to a doctor, no matter where they live. A Schulz government would ensure every Albertan has access to a doctor with new targets and metrics to recruit, retain and train family doctors. This may mean incentivizing family practice and evening and weekend hours, addressing concerns with overhead costs, and further tuition rebates or student loan forgiveness for those who work in rural and remote communities. We also need to reduce the time for credential recognition of foreign trained doctors and ensure we have the training and practicum seats needed to address our challenges.
While some Primary Care Networks have been successful we need to ensure more complete centres with doctors, nurses, a lab, x-ray, ultrasounds and other services all in one place, like the Taber Clinic. We also need to open more urgent care and/or walk-in clinics in or near hospitals where nurses can triage patients rather than have them wait for hours in emergency departments for non-emergency health concerns.
Alberta is facing a shortage of all kinds of health care professionals. What would you do as premier to increase our ability to attract and retain the physicians that Albertans need? What do you think will be required:
- For rural Alberta?
- For our small and large cities?
- To attract and retain medical students and resident physicians?
We need more training and more recruiting of health care professionals in Alberta to address the short and long term challenges. This includes increasing medicine and nursing spaces as well as practicum seats (and how to increase these seats in rural Alberta); addressing concerns raised by nurses that stem from AHS staffing protocols that create barriers in cities and rural alike, such as lack of full-time positions and 12-hour shifts; working with medical colleges to set targets for recognition of international training; and recruiting more international health care workers and expanding bridging programs.
I’ve spoken with many municipalities who also want to be a partner in recruiting and retaining physicians, so I’d be willing to work with them on this as well, in communities where there are major shortages.
Patients are experiencing extremely long wait times in emergency departments and hallways are lined with emergency responders who are unable to hand-off their patients. How will you address this crisis to reduce the waiting time for patients and improve the care they receive?
I’ve heard of Albertans waiting in emergency rooms, but also have heard of Albertans being directed by their physicians to emergency rooms to access diagnostics. I understand these health care system challenges are not unique to Alberta, but we can develop made-in-Alberta solutions. I also recognize there’s no silver bullet, and it will take a number of changes to address this. This could include eliminating unnecessary inter-facility transfers or not moving a patient until their bed is ready, which is something that’s been raised by paramedics and physicians alike. We would consider an inter-facility transfer system that is separate from the 911 system. Virtual and mobile care, as proposed in the Schulz healthcare plan, could also help reduce inter-facility transfers for basic appointments. Adding urgent care centres near emergency rooms is another approach that could reduce emergency room pressure.
Physicians support the medical home model, where many health professions work together (to their full scope of practice) to care for patients. How would you increase this team-based approach so that patients can avoid delays, avoid duplicate testing and receive the care they need, at the right time, from the right provider?
We need to put patients first, this includes a team-based approach to health care. Our campaign has committed to shift more practices to the medical home or Primary Care Network model to be complete centres with doctors, nurses, a lab, x-ray, ultrasounds and other services all in one place. Again, we’d open more urgent care and/or walk-in clinics in or near hospitals where nurses can triage patients rather than have them wait for hours in emergency departments for non-emergency health concerns; and even promote a network of not-for-profit community health care centres (similar to the Alex in Calgary) that provide doctors, nurses, pharmacists, mental health supports, and more to low-income and at-risk Albertans in a way that’s unique and flexible.
With respect to private contractors providing public health care services, how will you ensure all patients receive the same quality of care regardless of where they receive it or from whom? How will corporations like Telus or Shoppers Drug Mart fit into the delivery of health care for Albertans?
Much like with primary care doctor’s clinics that are private operators, the health care professionals involved in private practices will be governed by their respective colleges and the patient complaint process. Any private care directly contracted by AHS or Alberta Health would also have standards to be met in the contracts. Virtual healthcare providers could also have an evolving role to play to help address the shortage of doctors and nurses to serve Albertans, particularly in rural areas. My commitment is to be open-minded and committed to putting patients first, while maintaining a publicly funded healthcare system.
Academic medicine plays a unique role in delivering clinical care but also in research, teaching and leadership/administration. Academic doctors in Alberta want to know what you would do to sustain academic medicine and ensure that we attract the best and brightest to Alberta?
Our province is full of innovators and entrepreneurs. We need to continue to bring world-class talent to Alberta, including academic medicine. Before entering politics, I worked in post-secondary, where I saw the impact of innovation, research and philanthropy in driving both innovative medical research and practice - whether that be cancer treatment or biomedical engineering. First, and most importantly, we need to keep Alberta affordable - this includes low taxes and affordable housing. A Schulz government would encourage this innovation, but also consider creating an international student recruitment office to make our province more competitive in attracting students, including in medicine, to our province.
Albertans were having difficulties accessing mental health services before the pandemic and now it is much worse. What would you do to provide increased access for Albertans and particularly for children and youth?
I see the barriers to true wraparound services for youth. Alberta invests a significant amount across a number of ministries into mental health, but we need to take a look at whether these dollars are making it to front line services. There are innovative models, which include non-profits, AHS and post-secondaries that we could expand. We would make sure that schools who need to and want to be hubs for their students, families and communities are supported with resources to make school based mental health care happen, including physical spaces and funding for part- and full-time mental health resources, starting with pilots in rural, urban, southern, central, and remote northern Alberta, as well as partnerships with Indigenous communities.
We would also prioritize mental health supports for front-line workers and educators – this will take partnership with organizations like the ATA and also post-secondary institutions to ensure pre-teacher training in mental health and educator wellness.
The medical laboratory system in Alberta exists to help Albertans diagnose, treat and monitor disease. That system has been in constant flux over the past decade with changing directives of various governments. Significant infrastructure and equipment issues plague urban and rural communities alike. Given the history of conflicting directions with lab services in Alberta over the past decade, what is your plan to provide certainty and stability when it comes to this crucial medical service?
A Schulz government will continue the transfer of lab services already underway.
Patients expect government and system leaders to think about long-term quality, sustainability and better integration in health care. Sometimes the four-year election cycle of governments can complicate long-term decision making. How will you ensure that solutions and improvements in health care are truly in the best interest of patients over the long term?
One of the best ways to ensure improvements are in the best interest of Albertans is by engaging front line healthcare staff in creating and implementing the solutions. Engaging in long-term planning and budgeting and being transparent with Albertans about what we are doing will help build trust as well.
As many Albertans are aware, physicians have not had a contract with government for over two years. Do you see this as a problem and what is your plan to reach an agreement? If an agreement is reached, what priority would you place on building a solid working relationship with physicians?
A deal with physicians is a priority. We would continue the work that has already been done to rebuild the relationship with doctors and encourage the Minister of Health to complete a deal. Working with all healthcare professionals, including our doctors, will be critical in navigating the future of healthcare in this province as we recover from the pandemic and rebuild a system that is more nimble and responsive to the needs of Albertans.
