Dr. Jared Van Bussel, who specializes in obstetrics, will stay on as a general physician and trauma surgeon at the Pincher Creek Health Centre and will continue his practice at the attached Associate Clinic, he told Shootin’ the Breeze on Thursday.

“If I were a younger man, I might be looking for greener pastures. I may yet look for other rural programs I can support for a little longer, but I intend to remain planted in Pincher Creek for now,” he wrote in an open letter.

“If my colleagues call me, I’ll always show up,” he said.

But it’s unlikely that the health centre can handle scheduled births, especially routine C-sections, without a dedicated obstetric surgeon.

The man has been on call for 70 per cent of his waking life for years, apart from his scheduled time off. The burnout is real, but Van Bussel repeatedly stressed that he’s scaling back his practice because of what he considers an acute and profoundly systemic lack of provincial support. 

“Alberta hates rural maternity care,” he wrote, telling the Breeze that in his 16 years in rural family medicine, he’d seen too many gaps in patient care and professional training for new doctors, and too many shortsighted cost-saving measures he said were untenable.

Things came to a head on his birthday, Jan. 16, when he received a letter from Alberta Health Services reminding him of the funding limits for on-call services paid for by an Alberta Health grant program.

“Please be advised AHS is unable to compensate you for (physician on-call) services in GP Surgery after you have reached 255.5 days of service,” the letter states.

AHS South Zone declined an interview for this story, but explained in a written statement that Van Bussel would continue to be paid, including for his on-call services.

“The South Zone recently sent a courtesy letter to physicians who were approaching the limited days paid for on-call time under the provincial Physician On Call Program,” the statement reads.

“We do not believe that any physicians (in Alberta) will go over their 255.5 days of on-call coverage,” AHS said in a followup statement.

The South Zone added that these courtesy letters “go out each year,” while other doctors at the health centre also received letters in the new year.

Van Bussel said  he’d never received any such letter before Jan.16, especially not in his six years as the town surgeon.

“They’ll always pay me for coming in, but they won’t pay to support physicians or the community in general,” he said.

As heartbreaking as it was for him to write his letter, he said he’d been crafting it for a long time. He’d told his Pincher Creek colleagues it was coming about a month ago.

“I’m willing to reconsider, but I just don’t see it,” he said.

The Government of Alberta is plainly not about to prioritize rural health care, he explained, and “when it feels like everything is pushing against it, it feels to me that we’re approaching a breaking point.”

Setting aside AHS’s “tone-deaf” letter,  Van Bussel reiterated that he wasn’t concerned about his take-home pay.

“I want to pull attention away from any one event and draw that attention to rural maternity care.”

With AHS insisting that “Physicians are a cornerstone of our health-care system,” Van Bussel said he’d made it known for years that it wasn’t sustainable for him to live on call while resources dwindled at the health centre.

The health centre serves around 10,000 patients over a broad swath of southwestern Alberta.

Its team of doctors is down from 11 to six and, instead of asking how the province could do more to help, AHS sent Van Bussel a letter that seemed to say no help was coming.

“I hope this will become a discussion point in the community. I hope that people will start asking their decision-makers why this is the case,” he said.

Read Dr. Van Bussel’s open letter

Read AHS letter to Dr. Van Bussel