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Tag: Tyler Shandro

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Retired doctor decries ‘Shandro’s shambles’

The results of what is known as the “resident match” were announced recently. They clearly show serious damage continues to flow from the thoughtless changes that Tyler Shandro inflicted on Alberta’s health system while he was health minister.

Try as they might, the current minister and the AHS administrator have clearly not reversed the damage that was done to Alberta’s ability to attract new physicians.

For those not familiar with how new doctors finish their training, let me provide a bit of background to the opening paragraphs.

Medical students take their initial training in whichever medical school took them in. In their last year, the students must decide what career path they wish to follow, and where they wish to pursue further training. Those decisions are critical, because it is very difficult to change specialties or training sites after that.

During the fall of their final year, students file their choices with a national body, the Canadian Resident Matching Service, better known as CaRMS. This body compares student and program choices, and assigns students to specific programs and sites. Results are announced in late March. A second round is then conducted to fill vacant slots with Canadian students who did not match in the first round, or other candidates.

The total number of training slots, known as residency positions, in Canada is slightly more than the number of students expected to graduate from Canadian medical schools each year. Most years, there are a small number of vacancies in certain programs.

 

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In the past, family medicine residencies have had only a few vacancies. In southern Alberta, where most of the doctors that ultimately settle in this area train, there have typically been only a few vacant slots. Generally there are less than 10 vacancies for the whole province.

The results this year are devastating for Alberta. There are 42 vacant family medicine positions in the province. For comparison, there are two openings in British Columbia and none in Saskatchewan.

In the south, more than 20 per cent of the slots in Lethbridge are vacant, while Medicine Hat filled less than 30 per cent of its spaces. Those two cities have supplied most of the doctors that have begun practice in this area over the last few years.

In a setting where there is a desperate need for doctors in every area of Canada, the medical students have spoken clearly. They have decided that Alberta is definitely not a place that they want to work and live.

In essence, they have said that they have many choices, almost all of which are promising a stable and predictable work environment. Alberta offers the exact opposite, judging by recent history. Viewed from that perspective, choosing somewhere other than Alberta is a rational decision.

 

 

Alberta, and especially rural Alberta, will be trying to attract its future doctors from a group where many of the potential recruits either did not want to come to Alberta or trained in another country initially. Those doctors are unlikely to see any place in Alberta as their desired location when choosing where they will set up practice.

The Shandro shambles will haunt the patients of Alberta, and especially rural Alberta, for years to come.

The two main parties have both promised to spend a lot of money trying to get doctors for rural Alberta. One of them has released a detailed plan on how they will do it. The other party has only promised to spend. Even the president of the Alberta Medical Association has written a note stating that they do not know how the second party will use the promised dollars.

When you vote in May, it would be a good idea to see which party has a viable plan to recruit more doctors to rural Alberta. If the voters make the wrong choice, the staffing woes in Pincher Creek are unlikely to improve.

RCMP Sgt. Ryan Hodge speaks into a microphone at Pincher Creek town council

RCMP patrols in Pincher Creek to be scaled back

A policy change by Alberta RCMP (K Division) will shave an hour off Pincher Creek Mounties’ regular patrols, likely at a cost to the town, according to Sgt. Ryan Hodge.

“It will specifically impact our detachment,” Hodge told town council on Feb. 13. 

K Division announced the policy a week earlier, citing the need to protect Mounties’ safety, he explained. Pincher Creek RCMP will either scale back regular patrols by an hour in the early morning or start patrols an hour later, he added. 

Coun. Mark Barber asked if this would increase the town’s annual policing costs, now budgeted at over $200,000. 

“I believe there will be a cost increase,” Hodge answered.

 

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The new scheduling policy will not take away from the detachment’s ability to police the community, and may increase the number of officer shifts, Hodge explained.

Hodge said he hoped to explain the policy change and hear from town residents more generally at an open house before the town’s police advisory committee meets on March 15.

The detachment is currently at full strength, Hodge said.

The United Conservative Party under former premier Jason Kenney voted to phase in policing costs to Albertan municipalities under 5,000 residents starting in 2020. 

 

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Pincher Creek’s new policing budget has steadily risen from $74,000 in 2020 to just over $217,000 in 2023, according to finance director Wendy Catonio. 

Premier Danielle Smith, who succeeded Kenney last fall, instructed Justice Minister Tyler Shandro in a Nov. 8 letter to “finalize a decision on establishing an Alberta Police Service,” but Public Safety Minister Ellis said no decision had been made as of the new year.

K Division wasn’t immediately available for comment when Shootin’ the Breeze went to press Tuesday.

 

Read more from the Breeze:

At least eight vehicles collide at Cowley

Crowsnest Pass council approves business licence payment plan

Folklore shrouds early NWMP camps in mystery

 

 

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Alberta faces uncertain battle against Bill C-21

Speaking with southern Alberta reporters Friday, Tyler Shandro condemned C-21 as “a gigantic mistake” and “an attack on the way of life for folks … particularly in rural Alberta.”

Strong words aside, the minister struggled to come up with specific countermeasures.

Shandro hinted at using Alberta’s Sovereignty Act (Bill 1) against C-21. Premier Danielle Smith promised her supporters during the United Conservative Party’s leadership race last summer that the act would empower the legislature to ignore federal laws the province deemed harmful to Albertan interests.

“Now that Bill 1 has passed … we’ve asked for folks to take a look and provide us with suggestions,”  Shandro said Friday. “Maybe there are opportunities for resolution in the house in 2023.”

But the act can only direct provincial bodies not to enforce targeted federal laws. It cannot compel individual Albertans to do the same.

“I think that’s why we’re also looking at a number of initiatives that don’t involve the Sovereignty Act,” Shandro qualified.

 

 

“There are things that we can do now to move quickly, and stuff we can learn from what’s happening in Saskatchewan,” where, Shandro said, the legislature in Regina is working on a constitutional challenge to Ottawa’s proposed gun buyback program. 

Alberta is already pursuing six applications for judicial review of the federal cabinet’s decision in May 2020 to ban 1,500 types of guns. Bill C-21 seeks to toughen gun restrictions through a host of amendments to the Firearms Act.

Recent amendments by Paul Chiang, Liberal MP for the Ontario riding of Markham-Unionville, would significantly add to the ban by prohibiting any gun capable of taking a magazine containing more than five rounds. This would effectively ban all magazine-loading rifles, as well as many types of shotguns.

Guns that shoot with a force of more than 10,000 joules or that have a bore of two centimetres or more would also be banned.

Shandro said the Liberals were “playing politics,” misleading Canadians by purporting to show that legally obtained guns were driving violent crime.  

“I think we know that, anecdotally, we have a sense or an intuition that that’s not the case,” he said.

 

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

 

A May 2022 report by Statistics Canada shows that gun violence in 2020 accounted for less than three per cent of violent crime nationally. 

But the report shows that the per capita rate of gun crime in Alberta’s rural south jumped by 31 per cent between 2019 and 2020. Firearms were present in 264 violent crimes reported to regional police detachments for that year, accounting for roughly 4½ per cent of violent crime, or a rate of 54 incidents per 100,000 people outside metropolitan centres. 

For comparison, regional violent crime was overwhelmingly driven by physical force and threats in the same period, with police finding no weapons at all at just over 4,500 incidents. That number accounted for just over 75 per cent of all violent crime reported to regional police. 

Saskatchewan, Manitoba and Nunavut had the sharpest increases in police-reported gun crime dating back to 2009, the report showed. 

Guns were used in 37 per cent of investigated homicides in Canada in 2020, but the report notes that this figure was skewed by the April 2020 gun massacre in Portapique, N.S., that killed 22 people. The shooter’s guns were illegal because he did not have a possession and acquisition licence as per the Firearms Act.

 

 

Handguns were the most common weapon used in Canadian gun murders dating back to 2009. Gun crime was more associated with rifles and shotguns in rural parts of the country, according to the report. 

There are no available statistics to show the origins of guns used in violent crime.

For more information on gun violence in Canada, consult “Trends in firearm-related violent crime in Canada, 2009 to 2020” on Statistics Canada’s website, www12.statcan.gc.ca.

There were 241,794 guns registered in Alberta as of October, according to Ethan Lecavalier-Kidney, press secretary for Minister Shandro. 

Of that number, Lecavalier-Kidney said 237,638 were handguns, 2,918 were rifles, and 1,238 were guns registered as “other.”

Rifles and shotguns are probably vastly underrepresented in that total, because most long guns don’t need to be registered under current legislation.

Alberta Health Minister Jason Copping giving bill 4 announcement from a podium in front of a background of provincial and Canadian flags.

Bill 4 announcement met with skepticism at Pincher Creek hospital

 

Pincher Creek’s chief doctor remains skeptical about prospects for an enduring partnership between Alberta doctors and the provincial government after Bill 4 announcement.

Dr. Gavin Parker, community medical director at Pincher Creek Health Centre, spoke with Shootin’ the Breeze Dec. 5, shortly after Health Minister Jason Copping vowed to repeal the province’s authority to unilaterally scrap its funding commitments to the Alberta Medical Association, which represents roughly 1,600 practising physicians across the province.

Copping said the Alberta Health Care Insurance Amendment Act, 2022 (Bill 4) heralds “a collaborative environment founded on mutual respect and trust” more than two years after the United Conservatives, under then-premier Jason Kenney, ended the AMA’s contract and imposed a new one.

The amendment, which Copping endorsed alongside AMA president Dr. Fredrykka Rinaldi, underscores a deal that the two sides brokered over the summer and which was ratified in September by 70 per cent of doctors, Copping said.

The UCP government will undo section 40.2 of the original act, used by former health minister Tyler Shandro in February 2020 to terminate the AMA’s last contract. In return, the AMA will drop its pending lawsuit against the government.

The proposed legislation comes roughly a week after Edmonton removed a cap on the number of daily patient visits that doctors can charge to Alberta Health Services.

 

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The amendment pledges $750 million to “stabilize the health-care system” over the next four years, delivering a more than five per cent pay bump for family doctors. It also holds out “the potential” for binding arbitration should future contract negotiations break down, according to Copping.

Rinaldi thanked Copping for making a show of good faith, but stopped short of a glowing prognosis.

“It’s a step in the right direction, but it’s not a panacea,” she told reporters. 

Over at Pincher Creek Health Centre, Dr. Parker was less optimistic. Most of Bill 4’s substance had been hammered out months earlier, he said. Meanwhile, the medical community is perhaps less willing to trust the UCP than Copping let on.

“That’s great that they’ve said they’d take (section 40.2) off the books. But, I don’t think we can safely assume this kind of legislation will never come back,” Parker said. 

The health centre and attached medical clinic now have five full-time doctors, less than half of the 11 docs that were on-staff when Shandro tore up their contract.

 

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“It was pretty disastrous at the time,” Parker remembered.

Two doctors left the health centre to practise in urban centres in Alberta. One left the province altogether, highlighting the AMA’s aborted contract in their resignation letter. Others left to retrain in other medical specializations, while another doctor retired, according to Parker.

The health centre has recently brought on extra staff and “Alberta is still a great place to practise medicine,” Parker said, noting that doctors are paid well.

Surgeries are still performed at the health centre. “We’re one of a few places that still provide obstetric care,” while there’s none to be had in neighbouring Fort Macleod or Cardston, Parker said.

And the clinic has held on to its patients, despite the shortage of doctors.

“But, it’s been really tough,” Parker said, “because we haven’t been able to provide the same level of service and efficiency that people have come to expect.”

 

 

Emergency room patients with routine health concerns can wait up to eight hours to see a doctor if that doctor is busy performing a cesarean section, he said.

The health director also praised former health minister Shandro for his role in bringing a new CT scanner to the health centre.

“I’m glad to see the province’s finances are better now than when we were looking at contract negotiations a few years ago,” Parker said.

Watch news conference

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.

 

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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.

 

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