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Alberta Medical Association calls health-care changes irresponsible during pandemic

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EDMONTON — The Alberta Medical Association says it's irresponsible for the provincial government to go ahead with its health-care restructuring as doctors battle the COVID-19 pandemic.

Association president Dr. Christine Molnar sent a letter to doctors Monday to explain that the government is proceeding with changes to its funding framework for physicians.

"I believe the implementation of this framework undermines and destabilizes the health-care providers," Molnar said in an interview Tuesday. "It affects their focus.

"The last thing that health-care providers need to be worried about right now is a lack of support ... from their own government when they are doing everything they can to help Albertans in this pandemic."

Responding to Opposition questions in the legislature, Health Minister Tyler Shandro said the government will provide whatever resources are needed to protect Albertans during the COVID-19 crisis.

"Spending on physicians has not been cut," he said. "In fact, we fully expect it to be significantly increased this year."

Total physician compensation remains flat at $5.4 billion in the government's 2020-21 budget, but the new funding framework will change how doctors are paid for their work.

Molnar acknowledged that the province had suspended changes to how family doctors are paid for in-person visits and has delayed changes to stipends for some hospital physicians.

Shandro noted that, prompted by the pandemic, the province has also introduced a new billing code for phone and video visits with family doctors.

"Now with unlimited virtual visits paid at the same rates as office visits we expect to spend significantly more," he said. "That's what physicians asked for to support them and their patients."

Alberta Health suggested any changes that went ahead were minor in nature, but Molnar called them both disruptive and damaging.

"If this new framework was a bad idea on Feb. 21, it is a critically bad idea during a pandemic," she wrote in her letter.

More than 800 doctors signed their own open letter to the government on Monday asking it to delay the changes. The group said hundreds of clinics across the province, particularly in rural areas, have already been forced to reduce staff or close their doors.

Alberta Health said that's not unique to doctors' offices.

"Many other industries have seen the same phenomenon as Albertans are told to stay home," spokesman Steve Buick said in an email. "We also suggest doctors offices look at recent wage subsidy supports that the federal government announced for small- and medium-sized businesses."

Molnar said community clinics, which have been hit by both the pandemic and the funding framework, are important services for Albertans and doctors don't feel supported.

"It speaks to the relationship that this government has developed with physicians," she said. "It's very alienating. It's very adversarial. It's not one that physicians are comfortable with so ... they feel diminished, disempowered. Many of them are at their wit's end."

During question period Tuesday, Shandro sat expressionless, occasionally sipping water, as the Opposition demanded he quit or be fired for battling doctors, as well as for recently going to the home of a doctor-acquaintance and berating him in front of his family for reposting a meme critical of Shandro.

"We need a leader who is focused on the health and safety of Albertans," said NDP Leader Rachel Notley. "Instead (Shandro) is focused on his own personal vendettas."

Shandro didn't rise to answer for his actions, but government house leader Jason Nixon accused Notley of playing partisan politics in the middle of a pandemic.

Molnar said physicians will remain on the front lines, but she noted in her letter that the association will respond to the government's actions.

"Our legal challenge is prepared and ready to launch," she wrote. "The board will discuss the timing this week."

This report by The Canadian Press was first published March 31, 2020

— With files from Dean Bennett

Colette Derworiz, The Canadian Press

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