Airdrie physicians are speaking out against the Alberta government’s cuts to the health-care sector, voicing concerns that potential funding changes will negatively impact how medical services are provided at community and family clinics.
Members of the Airdrie Community Physicians Association (ACPA), which represents roughly 50 doctors in the city, are lending support to other physicians in Alberta who have criticized the government’s proposed adjustments to the province’s health care insurance plan.
“The government is making unilateral decisions by doing these proposals,” said Dr. Fozia Alvi, ACPA chair and a physician at Doctors Plus Medical Centre. “In this vein, the [United Conservative Party]…did not honour previous agreements with the Alberta Medical Association (AMA), so it’s really disheartening to see.”
In mid-November, the government contacted AMA with a list of proposed amendments to the Alberta Health Care Insurance Plan. The changes include reducing the time modifier for appointment times, no longer paying for senior drivers' mandatory medical exams and reducing the stipend for on-call doctors in rural communities, among others.
The Ministry of Health has defended the cuts, stating the adjustments would bring Alberta’s health-care spending in line with other provinces. In 2017, Alberta was the province that spent the second-most, per capita, on healthcare in Canada, according to 2017 data from the Canadian Institute for Health Information, with only Newfoundland and Labrador spending more.
Regarding the time modifiers, Alvi said the shift would de-incentivize doctors from offering longer appointment times, as physicians would be billed the same for a 25-minute visit as a 15-minute visit. For patients with complex medical issues, she said, that would mean booking more trips to the doctor, instead of discussing multiple issues during each visit.
“When I see a patient coming in… not everyone [do] I have to spend more than 10 minutes with,” she said. “But my sicker patients, I’m worried about it, because if someone comes in – an elderly patient who has diabetes or newly-diagnosed cancer, and they’re very stressed out about it… I cannot get them out of the door in 10 minutes. I need to spend more time with that.”
AMA’s past president, Dr. Alison Clarke, said the association is concerned how shorter appointment times would impact patient care – particularly for seniors and patients with multiple chronic health conditions.
“By…funding extended times we can spend with patients, we’re able to delve deeper into the issues, find out how things are impacted, and really put together plans going forward for these patients,” she said. “The nice thing about being able to devote that time is we can see them as needed, instead of more regularly.”
She added, since community medical clinics are essentially small businesses, with facility leases, staff and other expenses to pay, spending more time with patients – while not being able to bill for that time – is not always feasible.
Another of the UCP’s proposed changes would see seniors over the age of 75 pay out-of-pocket for mandatory physical exams when they renew their driver’s licenses. Currently, the province handles the fee.
Reducing or removing the on-call stipend, Alvi and Clarke said, would dissuade doctors from practicing in small towns or rural areas.
“The main issue is for those physicians who may not be overly busy on an on-call basis, but the community still requires their services,” Clarke said. “Think of the physician who may be in a small town and has to cover the emergency room. They’re on call for 24 hours and may not be called in often enough to make it financially feasible, but they’re still required to be there within 10 or 15 minutes, depending on what service they provide.”
Clarke added for many rural doctors, the stipend made being on-call worthwhile.
“It wasn’t a tremendous amount of money, but it was a recognition of their commitment to their job, and it did make it a little more acceptable to put your life on hold,” she said. “That’s had a huge impact on certain communities.”
AMA is currently in negotiations for a new agreement with the provincial government, according to Clarke, with a deadline of late March. But she said many of the government’s proposed changes are not included in the negotiation process.
“What we’d like to see is for them to actually be brought back into negotiations,” she said.
“Our concern is they are only looking at the dollar sign on a budget, and they feel if they stop that, we’ll cut the health-care budget by this amount. We’re concerned they’re not really looking at the impact of some of these decisions.”