Your representation matters

April 30, 2020

Dear Members:

The Alberta Medical Association plans to protect your rights and to ensure your voice is heard. The following is information pertinent to that goal.
 
The role of the AMA as the representative of Alberta physicians is a crucial piece of a well-functioning health care system that puts Patients First®. For a long time, representation rights came through our agreements with government. In 2018, legislation was enacted to enshrine the basic right to representation for physicians, though how this was effectively realized – such as access to dispute resolution and processes for negotiation – was specified within the AMA Agreement.
 
By terminating the AMA Agreement and imposing the Physician Funding Framework, the Minister of Health is imposing his own views about what should happen without appropriate consultation from physicians. This is why his rural initiatives announced last Friday - although welcomed and clearly necessary - did not receive the resounding applause he may have wished for. 
 
To be candid, he sought credit for solving a problem, but did not acknowledge that he was solely responsible for creating it in the first place. Instead, he sought to blame the AMA, which had responsibly warned him about these and other issues for months. The Minister has taken the position that he does not require contracts or agreements to govern the system; he will simply change things as he sees fit.
 
From April 15-21 we held our first ever virtual Representative Forum (RF), which included an initial meeting among all available delegates, followed by small group break-out sessions. Topics discussed included: the Minister’s Physician Funding Framework; involving the public; the profession’s role in managing the Physician Services Budget; support for physicians during COVID-19; and physician payment reform.
 
Last week, the Board discussed the direction provided by RF and will be working with sections, Zone Medical Staff Associations, the Family Medicine Task Force, the Specialty Care Task Force and others to implement. As a result, over the next several weeks you will see the following:

• More information and webinars related to COVID-19. We are waiting to hear from the minister, for example, on the income stabilization proposal that AMA has put forward. Many other provinces are much further along in this crucial aspect of ensuring that essential services remain available. Our Share the Care/#StayHealthyAB campaign continues to encourage Albertans to stay in touch with their physicians during the pandemic and discussions are now also occurring on the return to a “new normal.”
• We continue to call on government to repeal the remainder of the Physician Funding Framework and get back to the table to negotiate a full agreement. An important aspect of this is our legal challenge against government on your behalf. A joint statement from a broad segment of physician leadership in Alberta is forthcoming, and all physicians will very shortly be provided the opportunity to voice their concerns to MLAs.
• We have been keeping the public informed through the media, though rural physicians have also used other tools such as town halls. A more proactive engagement of the public will occur over the next few weeks.
• Government is attempting to make fee-for-service unaffordable in order to push more physicians to Alternative Relationship Plans. The AMA has no objections to ARPs, but no physician should be forced into making the move. In addition, every physician has the right to be represented by the AMA when considering and/or entering into an ARP. This needs to be made clear. Information will be provided to physicians outlining how to get the support they need when considering an ARP; the challenges of entering an ARP in today’s uncertain environment; and AMA proposals for improving the overall ARP environment.
• We need clarity on decisions, roles, responsibilities and accountabilities for programs and services involving Alberta Health Services. This includes AHS’s policies and processes related to: overhead support and recovery and the impact of these on the recently introduced Z codes; stipend payments; on-call payments; and contracts under the Strategic Agreement with independent physician contractors. A comprehensive and coordinated review of these issues that fully involves physicians and the AMA is required.

I anticipate sending information to you about these items over the next few weeks. Thank you in advance for your attention, feedback and support. 
 
In your service,
Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association