The Taber Clinic. (Alberta Health Services)

By David Opinko

Taber doctors: health changes like “a bank robber returning a portion of the money he has stolen”

May 7, 2020 | 1:58 PM

TABER, AB – A group of 10 physicians at the Taber Clinic have written a scathing letter to Alberta Health regarding the many changes they have made in recent months.

It covers, among other things, the termination of the province’s agreement with the Alberta Medical Association, the new Physician Funding Framework, a recent investment of funds into rural healthcare, and the impacts that these alterations have had or will have on rural healthcare delivery.

The full, unedited letter can be read below:

We, the undersigned physicians of the Taber Clinic, would like to inform our community of our urgent concerns for our health system.

In December 2019, Bill 21 was passed into legislation which gave our province’s Health Minister the authority to terminate the longstanding agreement between Alberta Health and the Alberta Medical Association (AMA). The AMA represents the interests of all physicians in Alberta and has done so for 114 years. Physicians rely on the AMA to represent us so that we can focus our expertise and energy into our medical practices. On February 21, Minister Shandro enacted Bill 21 and terminated our agreement with the AMA. Physicians in Alberta were, suddenly and completely, shut out of critical decision-making with respect to allocation of physician payment and their implications on health care policy. Shortly thereafter, government announced a new “Physician Funding Framework” (implemented on April 1, 2020), which is a collection of drastic changes to physician funding. This was widely recognized among physicians as unfairly targeting rural family physicians due to their unique work which spans multiple healthcare settings (Clinic and Hospital; Emergency, admitted patients, obstetrics and long-term care). The minister denies any reductions to overall physician funding, but make no mistake, these are definitely “cuts” to rural health care funding and family physicians.

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You may have seen headlines in the last several weeks indicating that many rural family physicians throughout the province, in response to the aforementioned cuts, have announced that they can no longer afford to work in rural hospitals, and will be resigning their hospital privileges. Others have announced plans to move to different provinces, and others have opted for early retirement rather than continue to work under this oppressive situation. Seven physician colleagues in Pincher Creek, a renowned primary care group with a busy clinic and hospital similar to ours in Taber, announced last week that they will no longer be providing any hospital services including Emergency Department coverage, starting in July of this year. They, like many others, are hurt by the changes to rural funding. However, they have expressed that the underlying problem is a Health Ministry that does not fully recognize the complexities of rural health care delivery, is unwilling to work with physicians, and continues to recklessly change healthcare policies, while excluding the AMA.

Considering these concerning announcements, rural health care in this province appeared to be on the verge of collapse. The Health Minister clearly felt the heat. In an announcement on April 24, 2020, he repealed some of his previous changes to rural physician funding. He referred to this as an “$81 million investment to rural health care” and “significant investments to protect rural physician recruitment & retention”. That is akin to a bank robber returning a portion of the money he has stolen and then calling it a charitable donation to the bank. A careful examination of Mr. Shandro’s announcements shows that rural allocation is not back to its previous level, and indeed, some rural physicians have been subjected to additional new cuts through fine-print changes to the Rural, Remote, Northern Program – a program implemented to increase recruitment and retention of physicians to our rural towns.

Mr. Shandro does not seem to understand why there is so much unrest among physicians. It is not entirely about money. If that were the case, why did his announcement to reverse some of the cuts on April 24 cause the number of physicians resigning from hospital services in Pincher Creek to increase from 7 to all 9 of them? Why did 18 rural physicians in Westlock release a letter after the minister’s backpedaling, indicating their intention to do the same? There are dozens, if not hundreds more rural physicians who feel the same way. Only 7% of Alberta’s 14,000 physicians are providing 24/7 care for around 1 million Albertans. Rural Health will suffer as we lose physicians to these haphazard policies. What is Mr. Shandro’s plan for all of those communities’ emergency departments? It is challenging enough to recruit one rural family physician (just ask a community like Milk River).

Alberta’s physicians want stability and a relationship of trust with Alberta Health; we need an agreement with the government and to be represented by our association, the AMA. We are now the only province in Canada without an agreement! We have been denied meaningful negotiation and refused third-party binding arbitration. Physicians have been cut out of meaningful contribution in stewardship of a financially viable health system and as partners with Alberta Health.

As physicians in Taber, we remain committed to providing comprehensive care in our clinic and hospital. But, like our physician colleagues across the province, we are affected negatively by the government’s recent changes, despite the fact that The Taber Clinic has a unique Alternate Remuneration Plan (ARP) created in partnership with Alberta Health over 20 years ago. Many of us moved here because of this arrangement. As you saw in the media in November 2019, you, our patients benefit from improved health outcomes via team-delivered care compared to provincial averages and it also saves our government millions of dollars each year. It has been the means of providing outstanding primary care to our community. We have been apprehensive to voice our opinions, as we feel at risk of drawing attention to our agreement which could be terminated by the stroke of a pen by the Ministry of Health. We stand in solidarity with our physician colleagues across the province. We want stability for our patients and the community’s healthcare system, with security and a real partnership for physicians with our government. If you share these concerns, we encourage you to make your voice heard by contacting your local MLA at taber.Warner@assembly.ab.ca.

Dr. Eric Leishman MD CCFP

Dr. Andrea Hargrove MD CCFP

Dr. Jeff Hughes MD CCFP (anesthesia)

Dr. David Yamabe MD FCFP

Dr. Wes Steed MD (GP-surgeon)

Dr. Davis Yawney MD CCFP

Dr. Kelly Tackaberry MD CCFP

Dr. Adam Williams MD CCFP

Dr. Ian Armstrong MD CCFP (anesthesia)

Dr. Derek Rasmussen MD

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