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Tag: Alberta Health

According to Health Canada, Paxlovid stops the Covid-19 virus from multiplying.

Health Canada ends Paxlovid coverage, Albertans to pay over $1.4K per treatment

During the Covid-19 pandemic, Paxlovid, a drug for immunocompromised individuals diagnosed with Covid, was covered by Health Canada on an emergency basis.  While private insurance may cover some of the cost, Albertans could now have to pay around $1,450 for the five-day supply of the drug, according to Alberta Health and confirmed by Pincher Creek Pharmasave.   As of the end of May, the Public Health Agency of Canada has discontinued coverage, now making the drug a provincial responsibility. 

Health and pharmaceutical care in Canada is a joint venture between federal and provincial levels, with federal agenda setting and provincial implementation. 

The Government of Alberta will cover the cost of Paxlovid for Albertans who have a government-sponsored drug plan, are immunocompromised and Covid-positive, according to a media response from Andrea Smith, Alberta Health’s press secretary.

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The coverage is listed by Alberta Blue Cross as restricted benefit with special authorization, meaning provincial plans for seniors would cap the patient’s cost at $25, with plans like income support and child and adult health benefits still seeing full coverage.

Some employer-sponsored plans may provide partial coverage, but depending on co-pay could still see patients paying large amounts for the treatment.

According to Andrea Smith, pharmacists were only notified of this change on May 24, and physicians on May 30. 

According to the Centers for Disease Control and Prevention, a person’s immune response to having Covid can protect them from reinfection for several months, but protection decreases over time. 

Those with weak immune systems may have a limited immune response or none at all. This can result in hospitalization due to severe illness, and even death.

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New variants can bypass existing immunity and increase infection risk.

Although rare, reinfection can occur as early as several weeks after a bout with the virus.

Pincher Creek resident Shannon Peace is recovering from her third run-in with Covid. The first was in 2022, while the latter were contracted in March and May of this year.

With her immunity weakened by a daily dose of a chemotherapy drug that treats a rare blood disorder, Peace has done what she can to avoid contracting the virus since the onset of the pandemic. Asthma is a further complicating factor for her.

In 2022, she was treated with Paxlovid at the onset of symptoms.

According to Health Canada, Paxlovid — brand name for a combination of  nirmatrelvir and ritonavir — stops the virus from multiplying. Once treatment begins, a patient’s symptoms should not get worse as the drugs help the body fight the viral infection.

Paxlovid treatment was relatively new at the time and Peace was advised not to take any pain relievers or decongestants. She felt miserable for about two weeks but believes it would have been worse without the drug.

Fast-forward to the spring of 2024 when fever and chills knocked Peace out of commission and a home test was positive for Covid.

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“My daughter reminded me that it was a rough go the first time so I consulted with 811 a number of times before choosing to forego a trip to the ER requesting treatment,” Peace says.

“I monitored my oxygen level and temperature, and promised the RNs I spoke with to go in if I went past certain thresholds.”

She wound up spending three full weeks in bed, sleeping up to 20 hours a day. Symptoms gradually subsided but fatigue and some breathing changes persisted.

“It was a complete shock to test positive again only two months later,” she says. “I hadn’t fully recovered yet when I got sick again in May.”

After conferring with 811 and her local physician, Peace was referred to the Covid Treatment Centre.

“At each step of the consultation, it was stressed that I would be responsible to pay for the Paxlovid prescription and to confirm with the pharmacist what that amount would be,” Peace says. “This was the first I heard that the drug was no longer being covered by Alberta Health.”

Fortunately, the prescription was filled the day before the change came into effect so there was no charge for the medication.

“While it was awful and I was still slow to recover, it was night and day compared to what I went through in March,” she says. “The medication absolutely makes a difference for me.”

Peace contacted pharmacist Amber Shepherd at Pincher Creek Pharmasave to find out what the medication would have cost and was astonished to learn that the five-day treatment would be more than $1,400 the next time it is needed.

“Amber was great with getting things looked after for me when it came to filling the prescription and helpful in providing a look at what will happen the next time I catch Covid,” Peace says.

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“She ran a test with my group insurance, which is through the Alberta Chambers of Commerce, and was able to tell me that half of the amount will be covered.

“This will leave me with a big decision if I get sick again — do I forego treatment or fork out more than $700? That’s a tough question,” she says.

“What happens when we don’t have the option to afford treatment?”

This is a concern for her and for others, especially as there has been no public notification of the change.

Shepherd has not yet seen new prescriptions after the change in coverage, but worries about what this will mean for local patients.

“If they’re not covered it’s a big impact because you have to decide between eating and whether or not you get the medication,” she says.

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“It’s certainly going to make people think twice about accessing the medication and potentially going without to make sure they can still live, basically.”

Shepherd encourages anyone with questions or concerns about coverage to reach out to any pharmacy to confirm accessibility of the drug to them.

“It’s just going to be a case-by-case basis,” Shepherd says. 

Peace acknowledges that the Covid-19 pandemic has had a hefty price tag for everyone but is concerned that the cost of treatment skyrocketing for those who are immunocompromised will have a different expense in terms of severe outcomes.

For more information about Covid-19 outpatient treatment with updated eligibility criteria for Paxlovid, visit bit.ly/PaxlovidPC.

Cartoon woman with red hair, sneering with text bubble containing symbols as expletives.

Oops, did I say that, again?

I’m not sure which expletive slipped from my mouth last Wednesday as I watched a red line appear. I was doing a home test for Covid and the test line was glaring red and positive before the fluid even reached the point for the control line.

I hadn’t fully recovered from a bout with the virus in March that took me off my feet for three weeks and it seemed impossible to have been hit with it again.

My first experience with Covid was in June 2022, when the bug infiltrated our household.

Having asthma and a rare disorder treated by a chemo drug, I was eligible for treatment with Paxlovid, which was relatively new at the time.

The goal of the treatment is to reduce the chance of severe outcomes in people who are immunocompromised.

When discussing possible implications of Covid with my hematologist back in the early days of the pandemic, he told me to do whatever I could to avoid catching the virus.

“You would likely end up hospitalized but I don’t think you would die,” he said.

 

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Based on this advice, I was very cautious, not only because of my own health concerns but also because of my husband’s and daughter’s conditions. We chose to be immunized as a means of further risk reduction, and it was two years before the nasty bug caught us.

At that time, taking Paxlovid treatment meant forgoing Tylenol, decongestants and even herbal tea. Of the three of us, I had the worst symptoms. A cup of tea with honey to soothe my raw throat would have been lovely and it was a rough 10 days or so, but I believe it was worth the trade-off.

Fast-forward to early March of this year.

The takedown was swift — chills that led to nearly every blanket in the house being piled on my bed mixed with four nights of fever. Covid tests were negative until the third day.

It was the weekend and nearly midnight (of course), so I chose to call 811 rather than go to the hospital emergency room.

As with any time I’ve called, the registered nurse I spoke with was pleasant, helpful and informative. We discussed the pros and cons of being treated.

At the time I was experiencing terrible body aches and recurring fevers and couldn’t imagine not being able to use Tylenol for symptomatic relief. In the end, I chose to tough it out without treatment.

 

 

There’s no way to determine whether or not I made the right choice. What I do know is that my symptoms were worse and lasted longer than in the initial case.

I was home for three weeks and still not fully feeling up to snuff by last week when Covid came calling again.

I didn’t test until the end of the first full day of symptoms.

“Not yet. Twice in three months would be a bit much,” I replied to a friend who asked if I had tested.

Thus the expletive on seeing the positive red line.

I chose 811 as the starting point again and went through the diagnosis confirmation process before discussing options. By the time I called, I knew I shouldn’t forgo treatment.

Much of Friday morning was spent on the phone confirming eligibility (you must be immunocompromised to receive treatment) and local availability, as well as reviewing medical history.

I want to give a huge thanks to Amber Shepherd at Pincher Creek Pharmasave, who spent a lot of time ensuring the correct dosage and confirming drug interactions.

 

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At all three stages of discussion with 811 and the Covid Treatment Centre nurse and physician, I was told that patients are now responsible for the cost of Paxlovid and urged to ask for the price before committing to filling the prescription.

Amber assured me there was no cost, which was a relief.

Today is the first time I’ve been out of bed for more than a few minutes at a time. I’m almost through the Paxlovid regimen and am confident it kept my symptoms from getting as bad as they were in March.

But, I swore out loud again on Monday — and that’s the real reason I’m sharing my experience.

Curious about how the loss of government coverage for the drug will affect people, I checked back with Amber.

It turns out Friday was the last day it was free, so my prescription snuck in just before the change. That was lucky for me now but not for anyone needing treatment in the future.

Learning the cost prompted the second expletive, and it may elicit something similar from you as well. The five-day Paxlovid treatment will now cost more than $1,400 for those without insurance coverage. For seniors, there is a maximum co-pay amount of $25.

Shootin’ the Breeze carries the Chambers of Commerce group insurance and Amber ran a test claim to see its impact. The next time I have Covid, I will have to choose between paying more than $700 for a course of Paxlovid or not being treated.

 

 

 

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With a commitment, we move forward

The health system remains under immense pressure. I am pleased that the Alberta health minister has made two commitments with the 2024 budget in response.

First, she has agreed to implement a new funding model for the comprehensive, lifelong care provided by family and rural physicians.

Second, she will ensure that Alberta can compete with our neighbouring provinces when it comes to retaining and recruiting physicians and medical learners.

Budget 2024 also provides more funding for the additional services that physicians are providing to more Albertans as our population continues to grow. We will work with the government to implement our AMA agreement.

I had a chance to speak with Minister Adriana LaGrange after the budget announcement. As you know, the AMA has been advocating loudly and ceaselessly for a commitment to a new comprehensive-care payment model and stabilization for family and rural medicine.

I am grateful to many members who lent their voices to our SOS campaign to save family and rural medicine. You were heard.

The minister has given me her word that we will implement the physician comprehensive care model as quickly as possible. She went further with a commitment to ensuring that Alberta will once again be competitive with other provinces for retention and recruitment — and make family and rural medicine viable across the province.

 

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The minister can move forward, now that there is money in the budget that can be used, to lock stabilization and the new payment model down and get the job done. We need to move expeditiously. The urgency is still very real.

This will allow us to work collaboratively on some of the other big pieces. I made a promise to physicians in acute specialty care that we would advocate strongly for their needs when family and rural medicine matters were starting to turn in the right direction.

We will need to keep pushing on primary care, but you will be seeing acute-care advocacy really coming to the fore. I hope we can count on members to continue to participate and show support for your colleagues in all specialties.

By the numbers, Budget 2024 has funding for primary care. There’s been an increase to the physician services budget that will offset some of the volume we have seen from population growth and add a partial funding top-up for inflation. It does not catch up, but because we negotiated a rate agreement, this is less of an issue.

Among line items in general, the specifics need to be worked out about where the money is going. We’ll be digging into that as we head into the busiest two-year period of our four-year agreement.

Dr. Paul Parks, President
Alberta Medical Association

 

Shootin’ the Breeze welcomes submissions about local issues and activities. Personal views expressed in Mailbox articles are those of the writers and do not necessarily reflect views of Shootin’ the Breeze management and staff. 

 

 

Pig roast at wedding venue — the Cowley Lions Campground Stockade near Pincher Creek in southwestern Alberta.

 

 

 

Torsos of three medical staff with crossed arms. One in a white coat and two in blue scrubs.

Alberta’s health-care future front and centre at engagement sessions

The Alberta government is looking at changing the province’s health care, a system many describe as broken.

A series of in-person engagements began last week, hearing from health-care providers and community members on what the government called some of the challenges Albertans are facing.

Two of those gatherings were held Jan. 24 in Crowsnest Pass and Pincher Creek. Unlike a packed town hall meeting in August 2023 at Pincher Creek Community Hall, last week’s sessions can be best described as roundtable discussions.

“I think any time that there’s change there’s an opportunity, and with opportunity a chance for folks to participate, to contribute,” said Sarah Murrant, speaking on behalf of the province.

“What I understand, and why we’re running this entire process, is not every answer is there.”

Discussion during the two-hour event centred around topics including experiences and outcomes, but also on a proposed unified health-care system the current government says will enhance local decision-making and lead to early detection and intervention. Just what that might look like is yet to be determined.

Chelsae Petrovic, MLA for Livingstone-Macleod, feels any conversation must include patient care outside of the larger centres.

“It’s extremely important that we look at rural health. That we start to see the unique challenges and some of the unique solutions that, maybe, can be brought forward,” she said.

 

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A former nurse with 13 years in the field, Petrovic knows all too well about the challenges.

“I think it’s great to meet with front-liners, coming from that experience and understanding where they’re coming from. Being able to, I guess, sympathize,” she said. “And it was only seven months ago that I was in those same positions, so I really do understand.”

Some health-care providers at the Pincher Creek event, who didn’t wish to go on record, felt the agenda items lacked details and “weren’t sure what they were signing up for” in any future plan.

Dr. Gavin Parker, a local physician, agreed engagement is important, however.

“I think we have a system that has long failed Albertans, in particular the lack of investment in primary care and rural services. But if these conversations lead towards improving that, then it was time well spent,” he said.

One of the talking points zeroed in on Alberta’s burgeoning population and the added stress it’s putting on the health-care system.

Parker acknowledged there’s more at play.

“I think what you’ve seen in the last few years is not only an exodus of family physicians in the province or people going into early retirement, but also changing the scope of their practice.”

 

 

He said the end result is less focus on primary comprehensive care and more doctors working toward a niche practice.

“Until we train, pay and support rural family physicians better, the situation won’t change,” he said. “The problem is we’re running into a dearth of physicians who are trained as rural comprehensive physicians, and when they are trained they aren’t compensated adequately.”

Parker also noted a drop in specialty practices, like maternity, declining to less than 50 per cent in the south zone compared to when he started his training.

“So, these young doctors that want to provide comprehensive rural care, including maternity, feel utterly unsupported to do that right now because of the current situation,” he said.

The sessions in Crowsnest Pass and Pincher Creek were the second and third of more than 40 visits scheduled to communities across Alberta.

Although there aren’t further meetings scheduled for the southwest region, a complete list of the remaining sessions can be found online and you can have your say here.

 

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Province engages with public on health system

Community members and health-care professionals gathered on Jan. 23 at the Coast Hotel in Lethbridge for the first of 45 in-person engagement sessions to be hosted throughout the province by the Government of Alberta.

The sessions looked to get input from the community on the health-care system and the overhaul that was announced in November of last year. 

During her introduction, Minister of Health Adriana LaGrange emphasized the importance of public feedback saying, “The goal of these in-person engagement sessions really is to dig deeper into our current health-care system to look at what’s working, what’s not working and what kind of solutions may exist to improve or eliminate the challenges.” 

Calling the discussions “critical” she told attendees, “The future of healthcare is in your hands,” adding, “We know the current system is broken, or at the very least not doing well, but for too long we’ve seen our nurses, doctors and health-care teams buckle under the strains and stresses of an inefficient health-care system.” 

Stresses to the health-care system have been an ongoing concern for Albertans, with rural emergency rooms regularly closed due to a lack of physician availability. Just hours prior to the event, the Milk River emergency room had announced its temporary closure scheduled to last until Wednesday morning. 

When asked what was currently being done to address these closures, Assistant Deputy Minister of Health System Refocusing Matthew Hebert was unable to comment. 

 

Aerial view of the Cowley Lions Campground on the Castle River in southwestern Alberta

 

Of the 45 engagement sessions listed on the Government of Alberta website, more than half are scheduled during the day, which could impact participation. Of those during the day, all are rural locations. Only nine of the engagement sessions are scheduled after 5 p.m., including Edmonton and Calgary events. 

Following LaGrange’s address – which included an anecdote about 27 patients at the Royal Alexandra Hospital in Edmonton who occupied beds because they were unable to access other supports due to issues filing their taxes – Hebert presented an overview of the planned restructuring and what issues in the current health system needed to be rectified.

Among the reasons for the restructure was the concern that despite spending per capita aligning with similar provinces, health outcomes were not as expected, in addition to long wait times – especially in rural areas and Indigenous communities, a complicated health care system, and leadership needing improvement. 

Though barriers of access for Indigenous communities were a key concern, it was not specified whether any consultation with the Indigenous community has occurred or is planned for the future. 

The overhaul will include four pillar organizations: Primary Care, Continuing Care, Acute Care, and Mental Health and Addictions. Under the umbrella of the Primary Care Organization, the government intends to ensure every Albertan is attached to a care provider, and “ensure accountability for all publicly funded providers and clinics.”

 Additionally, the primary care level is intended to “support Alberta Health in determining alternative payment models.”

 

 

The other organizations of care look to improve access to services and will contract third-party service providers with the provincial government maintaining oversight. Alberta Health Services will only provide primary and continuing care in rural areas where necessary.

Herbert highlighted in his presentation that the overhaul is intended to meet the needs of current Alberta residents while also managing the demands of a growing population. 

Since 2019, the population of Alberta has increased by nearly 42,000 people, with much of that growth attributed to the “Alberta is Calling” campaign that targeted those in urban centres like Vancouver and Toronto and encouraged them to move to Alberta.

Despite that growth – and taking into consideration the 13.73 per cent inflation rate – the 2023 health-care budget has only increased by 1.71 billion as compared to 2019, when the current government was elected. 

Herbert said “we’re looking forward to getting that direct feedback from the public just to inform how we will continue over the coming years to build and establish the new health care system.” 

Members of the media were not permitted to attend the community discussion and feedback portion of the event.

 

 

 

Heading for My Little Corner and editorial by Shannon Peace

‘It’s crumbling around us as we speak’

Should there be public consultation when changes affecting health care are proposed? Should there be an opportunity to ask questions? Should we be concerned when budget cuts could drastically affect our community?

I asked these questions in a March 2020 article after Pincher Creek physicians voiced concerns about budget changes at a community town hall.

A key point, one I hadn’t considered before, was that rural family medicine practices are small businesses with fixed costs. And when cost outweighs income, changes must be made for a practice to remain viable.

Financial costs aren’t the only consideration. At the time, Dr. Jared Van Bussel referred specifically to potential changes to maternity care and the cost of losing it. His concerns have not changed.

He also noted that disruptions to maternity care and individual health services impact the viability of the community.

A month later, Associate Clinic physicians announced a planned withdrawal of hospital-based services to come in 90 days. The move was prompted by a continuing lack of trust between doctors and Alberta Health, and ongoing uncertainty for the future. The uncertainty was not just for the physicians themselves but for their staff, patients and community.

 

 

The point hit home, and Pincher Creek rallied around its doctors. Letters were sent to government officials and a drive-by rally was held in June.

At the same time, Covid-19 was moving in, stretching local, provincial, national and global medical care to its limit.

Negotiating a master plan between the Alberta Medical Association and the provincial government piled even more pressure on Alberta’s medical professionals.

In October, local physicians chose to continue working in the emergency room and hospital rather than withdrawing those services. The community gave a collective sigh of relief, but problems remained unsolved.

By April 2021, a tentative master plan from Alberta Health had been brought forward and voted down by AMA members. Tyler Shandro, then minister of health, had also been to Pincher Creek to meet with Associate Clinic doctors, who were cautiously optimistic that agreement could be found.

It was September 2022 before a new funding contract was agreed to between AMA and the province.

The number of doctors at the clinic began to decline. Some retired while others chose to pursue careers elsewhere.

Finding replacements continues to be a challenge. Meanwhile, the cost of operating the clinic remains.

As we have all seen the cost of living rise dramatically, the cost of running any kind of business has increased as well.

To put this in perspective, as with any business, the financial burden on each partner increases substantially when the number of partners declines.

Speaking from personal experience, the stress and workload also increase significantly when staffing changes occur.

 

 

Let’s take stock of what we have in Pincher Creek.

We have a clinic and hospital providing continuity of care under one roof, personal relationships with physicians, an anesthetist and a surgeon, and even a CT scanner. Most importantly, we have a team of family doctors providing comprehensive care.

We also have our medical community working in difficult circumstances and likely losing hope for positive change. The emergency department was closed overnight twice in July due to a shortage of physician coverage.

About 800,000 Albertans do not have a family doctor, a situation especially dire in rural areas.

Our community has amazing medical resources, which are easy to take for granted, but a lack of stability under the very foundation of our health care system leaves it in danger of caving in.

“It’s crumbling around us as we speak.”

Dr. Paul Parks, president of the Alberta Medical Association, spoke those words Tuesday morning while sharing the results of a family and rural generalist physician survey conducted last week.

Asked to put the current state of affairs into medical terms, he likened it to a mass casualty that is bleeding out. The bleeding needs to be stopped and the patient stabilized.

Only then, once the chaos has passed, can treatment proceed.

 

 

About 30 per cent of Alberta doctors participated in the AMA survey. Most have been practising for 11 or more years and 43 per cent are dealing with 1,000 or more patients.

Of respondents, 21 per cent feel their finances can sustain their practices for up to a year, while 20 per cent say they are unlikely to be viable beyond six months and eight per cent say only three months.

While $100 million of federal assistance earmarked for stabilization was announced in December, Parks says “not one cent has flowed to family physicians yet.”

He also noted that financial assistance is available immediately when there are wildfires and other emergencies. The health-care crisis, which physicians and their association have been red-flagging for over a decade, has yet to trigger the same response.

The old model needs to evolve because physicians are leaving Alberta for greener pastures where governments are responding to the crisis. Actions must match promises so health-care workers and all of us can look forward with hope.

If we sit quietly and say nothing, the system will continue to crumble, with disastrous consequences.

At a town hall last May, Dr. Gavin Parker said, “If you want to find someone who can fix this, find a mirror.”

On its website, Alberta Health says, “The future of health care is in your hands.”

Alberta Health is holding public engagement sessions in Crowsnest Pass at 10 a.m. today and in Pincher Creek at 5 p.m. Registration is required.

TODAY!

This long backstory leads to a strong call to action.

If you are concerned about a crumbling health-care system, please register for a session.

Have your say — your life may depend on it.

 

 

 

 

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Health-care planning needs drastic changes

Concerned about the coming changes to health care? Worried about the current state of health care in southern Alberta?

The Alberta government is giving you a chance to express yourself this Wednesday evening at the Heritage Inn. Not that many of us likely knew about this. Indeed, most Pincher Creek readers of Shootin’ will have to rush to register for this event, since it is at 5 p.m. Wednesday (that is, today). Readers in the Pass have probably missed their chance, since that meeting is set for 10 a.m.

The discussion seems to be focused on the upcoming changes to the structure and function of what is currently known as AHS. We are to get that behemoth chopped up into four pieces. Which might be fine if our problem was just the way that management is structured.

But, it is not.

As a retired physician with 26 years of practice in Crowsnest Pass, I lived through multiple reorganizations (or, more accurately, redisorganization). Each created its own special kind of chaos for at least a couple of years. The system, if you can call it that, kept functioning due to the goodwill of the front-line troops.

After years of being overworked and being told that they are not worth whatever their wage might be, there is very little goodwill left. If chaos follows a management shuffle, there will not be goodwill to pull function out of the chaos.

 

 

Anyone who has contact with health-care workers knows that what is lacking is not managers. What we need are workers and “stuff.” In case our politicians have not noticed, health-care workers are in short supply across Canada and indeed throughout the world.  You do not get them by tearing up contracts, offering lower salaries than the competition, and promising to make huge but unspecified changes to how the system is run.

Similarly, the system needs “stuff,” starting with long-term and acute-care beds, plus the technical equipment to support them.

None of those people and things will come to be just because a politician is unhappy with the current state of affairs. Training a doctor takes at least nine years after high school. A nurse requires at least four years. Lab and X-ray techs need two years for the basics, and more for extra skills.

Building hospitals is a 10-year process, from idea through planning, construction, staffing, commissioning, and receiving patients. The new long-term care building in Crowsnest Pass took a couple of years to plan, and another couple to build. Not to mention the years of asking that preceded approval to build.

 

 

Alberta is growing rapidly, with nearly 200,000 new residents moving here last year. Not to mention the babies that were born here. Since every thousand folks require about two doctors of varying types, the province needs close to a net of 500 new doctors each year, just to stand still. And, that 500 does not account for retirements and other losses. We are not building any giant new hospitals in the near future, and not many smaller ones.

Unless we make drastic changes to how we plan for our health-care system — from training, recruiting and retaining staff to planning and building infrastructure — our health-care system cannot improve. Splitting up the management team will not do that, at least not for a few years.

Hopefully, many locals will come out Wednesday evening to tell the government to make changes that will actually improve our health care.

Allan Garbutt
Resident of Cowley, Alberta

 

 

Shootin’ the Breeze welcomes submissions about local issues and activities. Personal views expressed in Mailbox articles are those of the writers and do not necessarily reflect views of Shootin’ the Breeze management and staff. 

Signing papers of contract negotiation

Alberta government reaches tentative deal with AMA

It’s been a tough year for Alberta physicians.

Pandemic aside, doctors across the province have been practising in an insecure partnership with the Alberta government since the province unilaterally terminated the master agreement with the Alberta Medical Association in an order of council on Feb. 20, 2020.

Negotiations between the government and AMA had been mired for months before the government pulled the plug. The central issue was the province’s insistence that physician compensation remain at $5.4 billion a year, which doctors said didn’t fairly compensate clinics experiencing inflation and rising numbers of patients requiring care.

Health Minister Tyler Shandro and AMA president Paul Boucher announced a new, tentative agreement had been reached on Feb. 26. Minister Shandro said negotiations proceeded on the basis of fiscal sustainability, fair and equitable solutions for physicians, and maintaining focus on patient care.

“I’m confident that what we’re presenting doctors with is an agreement that provides certainty, provides stability, and it does so in the best interests of patients, the best interests of doctors, and the best interests of all Albertans,” he said.

Finally reaching a deal, added Dr. Boucher, was a critical step in helping the province get through the pandemic and bringing the health-care system back to full strength.

 

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“This year of Covid-19 has changed the health-care system and Albertans forever,” Dr. Boucher said. “I know we will find a way through the pandemic, but we also need to look beyond it.”

No specific details of the agreement have been publicly released, as the tentative deal must be ratified by the AMA. One hundred and forty members of the representative forum, which makes up the AMA medical leadership, will meet virtually this week to discuss the agreement.

If approved, the forum will recommend to the AMA’s board of directors that the matter be presented to a general AMA membership vote. The process is anticipated to take about three weeks.

The tentative agreement is a step in the right direction, says Dr. Sam Myhr of the Associate Clinic in Pincher Creek. “We obviously work better together, and that’s been the goal all along,” she says.

Dr. Myhr represents the province’s rural physicians in the representative forum as the sectional president of rural health.

 

Rural physicians have faced multiple challenges this past year, she says, and terminating the master agreement had an especially detrimental effect on rural practices as the lack of stability deterred recruits from committing to rural areas. Pincher Creek, for example, lost two such physicians who initially expressed interest in coming to the community.

The lack of formalized agreement establishing doctors’ working relationship with the government led local physicians to notify the government last summer they would discontinue hospital care at the Pincher Creek Health Centre unless a master agreement was signed.

Though at the request of town council the group never fully withdrew care, Dr. Myhr says the local advocacy of physicians and community members helped move the situation toward the tentative deal.

“It was tough; those were not easy times,” she says. “But it helped keep the issue in the limelight, and it would have been easy for it to sort of get swept under the rug if there weren’t places like Pincher Creek and other rural sites that have been continually standing up and saying no, this isn’t OK.”

Community members, she adds, are especially to be credited for their advocacy with elected officials and for their public support of doctors that “kept us going.”

 

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Moving forward in co-operation, Dr. Myhr continues, is now the best step, though she acknowledges the actions of the provincial government last year will still weigh on physicians’ minds as they consider voting on the new agreement.

“We all need to put down our swords to some degree and just work together, but I think everyone is quite wary,” she says.

Rebuilding trust with physicians will require concrete action from government officials, such as the health minister visiting the Pincher Creek hospital, which was initially scheduled back in January but was postponed due to rising Covid-19 cases.

The visit is still something that Dr. Myhr feels is important, as it would showcase what rural physicians are able to accomplish and why decisions made in Edmonton have such a dramatic impact on rural medicine.

“It would be an important step to show they are willing to hear us, that they are willing to collaborate, and they are willing to try and understand rural medicine better,” she says.

The health minister’s office has expressed interest in rescheduling the visit but says plans to do so will proceed once the number of Covid diagnoses is low enough to make such a visit safe to do.