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.
“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.”
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.