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.
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.