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Shandro calls mediation with the Alberta Medical Association ‘unsuccessful,’ says ‘all options’ now being considered

Doctor, NDP and health minister on proposed changes to Alberta physician compensation
WATCH ABOVE: (From Dec. 3, 2019) A St. Albert doctor, NDP MLA David Shepherd and Health Minister Tyler Shandro respond to changes the UCP is proposing.

Health Minister Tyler Shandro said Friday that his government is considering “all options at our disposal” after he described voluntary mediation with the Alberta Medical Association as being “unsuccessful” with regard to physician negotiations.

In a news release issued Friday afternoon, Shandro said that his UCP government is “spending more than ever before on our public health-care system” and that it will maintain current spending but that his government “must act to maintain physician spending at current levels” to keep the health-care system sustainable.

“Efforts to achieve this goal were unsuccessful during voluntary mediation with the Alberta Medical Association,” he said.

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“Cost overruns are forecast to amount to $2 billion over the next three years — this is unacceptable. Any savings that will be achieved through our efforts to curtail costs of physician compensation will be reinvested into front-line services such as reducing surgical wait times, addressing mental health and addictions issues, and investing in continuing care.”

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The Alberta government announced late last month that a mediator was being brought in to help talks with physicians progress in order to reach a new master agreement. The current contract expires at the end of March.

READ MORE: Mediator brought in to break logjam in contract talks between doctors and Alberta government

The master agreement lays out the relationship between doctors and the government, including aspects like working conditions and compensation.

Among the issues at play are Alberta Health advising doctors late last year that it planned to introduce new policies that would affect how long a doctor is required to see a patient before tacking on an extra fee, something known as a complex modifier. Shandro has said his government has the authority to bring in the changes while the AMA has argued such changes require negotiation.

The UCP government also wants to scrap double-billing for overhead, eliminate duplicate billing for diagnostic imaging and put a limit on how many patients a doctor can see and bill for in a day.

On Friday, the AMA’s president — Dr. Christine Molnar — posted on the association’s website and criticized some of the government’s assertions regarding challenges facing the health-care system.

“In our profession, we are obligated to obtain accurate data and assessments to provide high-quality care for our patients,” she wrote. “It is clear that government does not adhere to the same standards.

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READ MORE: Alberta government nixes AHS review recommendation to close 5 rural hospitals, Edmonton trauma centre

“The data used to justify several of Alberta Health’s consultation proposals is inherently flawed. The consultation proposals, which AH has now made public and the AMA has responded to, have resulted in an outpouring of profound concern by our rural and urban family medicine colleagues. What is most concerning is the fact that there seems to be zero recognition of the negative consequences to patient care that will ensue if these proposals are enacted in their current form.

“In what is still a public system, not paying physicians properly to spend time with their patients is directly denying care to Albertans.”

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Molnar wrote she is concerned the government continues to quote statistics from a report that says the average clinical payments to physicians in Alberta are 35.2 percent higher than comparator provinces of B.C., Ontario and Quebec.

“This claim is based solely on Canadian Institute for Health Information fee-for-service comparisons for 2016-17, and does not account for differences in ARP earnings, nor important concessions made by Alberta physicians in recent master agreements,” she wrote, adding that the statistics “do not reflect current labour market dynamics, such as interprovincial physician migrations.”

Molnar added that “once proper adjustments are made, Alberta’s average physician compensation is projected to be 5.7 per cent higher than our comparator provinces by 2021-22.” However, she noted that physicians’ wages in Alberta are impacted by other economic factors.

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“The AMA’s Economic Realities of Physician Compensation paper demonstrates that wage differences elsewhere in the economy (i.e., among other workers and their interprovincial counterparts) are much higher,” she wrote. “In 2017-18, Alberta’s industrial aggregate wage level was 15.4 per cent higher than the averages in B.C., Ontario and Saskatchewan.

“As employers themselves, physicians are directly impacted by these higher wages through increased staff/overhead costs.”

In his statement Friday, Shandro said he believes his government can achieve its health-care reform objectives “while also keeping our hardworking and dedicated physicians amongst the highest paid in Canada.”

Molnar said Friday that the AMA has “recommended that both sides work together to develop appropriate comparisons of physician compensation based on objective sources of information.”

You can read Molnar’s post in its entirety here.

–With files from The Canadian Press