Physician Compensation

Posted Under: Peter Guthrie

Physician Compensation

Alberta is fortunate in that we enjoy an excellent quality of life. We live in the lowest taxed jurisdiction in Canada and we are home to a young, vibrant, highly-skilled and educated workforce.

Alberta is also home to nearly 14,000 dedicated physicians who treat their patients with unparalleled care and compassion. The COVID-19 pandemic has brought into focus the critical role doctors play in the everyday lives of Albertans. From the outset of the pandemic, Alberta’s Government has spared no expense in ensuring that physicians can meet the needs of their patients. That being said, it would not be prudent of government to ignore our current fiscal reality and the pressures it puts on the delivery of all programs and services Albertans need and deserve.

Physicians in Alberta remain among the highest paid in Canada and Alberta will spend a record $5.4 billion on compensation this year. This accounts for 25% of our overall health budget and 10% of the province’s total budget. Our province also enjoys the highest per capital ratio of doctors compared to provinces with similar demographics and spends the most per capita on health care in the country. For example, a doctor in Ontario makes $90,000 less than one in Alberta.

Back in September of last year, Alberta’s government notified the AMA of their intention to open negotiations giving the AMA ample time to prepare workable proposals that would maintain physician compensation at $5.4 billion and avoid a projected spending overrun of nearly $2 billion. Unfortunately, the AMA came to the table with no workable solutions and government’s attempts at compromise were met with silence. This was disappointing. At that time, both sides agreed that they were at an impasse and that arbitration would not be effective. Alberta’s government was left with no choice but to end the then-current agreement.

Interestingly enough, a 2017 letter to the AMA from the NDP government stated clearly that Alberta has the highest paid physicians in Canada, Alberta requires cost-certainty in terms of physician compensation, and that the master agreement could be terminated through legislation. This letter was tabled in the legislature by Minister Shandro. Also, past agreements between the AMA and NDP government claimed to reduce costs but in reality, Albertans saw physician compensation rise by more than $1 billion. This is simply not sustainable.

There are many factors at play in terms of how physicians are compensated. The focus of Alberta government proposals was to address redundant, inefficient, and out-of-scope billing codes. Streamlining billing codes makes the process more efficient to allow physicians to focus on patient care rather than administration.

Recruitment and retention of rural physicians has been an on-going issue in Alberta, and nationwide, for decades. Alberta spends $75 million per year in incentives for rural physicians but only 7% of all physicians in Alberta practice in a rural setting. Alberta’s government, AHS, the AMA, health care professionals, and Alberta’s Medical Schools continue to explore new ways to promote practicing medicine in a rural setting.

Many Albertans have contacted me with concerns about physicians withdrawing services from hospitals or leaving the province altogether. Rest assured that claims of physicians leaving or withdrawing services in mass are untrue.

Doctors moving in or out of our province is nothing new and the reasons for this vary. In fact, 599 more physicians registered to practice in Alberta between January and June of this year. This also coincided with an increase of 879 more physicians billing for services over the same period.

Alberta Health Services employs a successful locum system to ensure that there is adequate coverage in Alberta’s hospitals so that every Albertan has access to timely and quality health care. If a physician chooses to withdraw their hospital privileges, they must give AHS 90 days notice. To date, the number of notices for withdrawal of services received by AHS is within normal variations.

Albertans have a lot to consider during these uncertain times. From adjusting and adapting how we go about our every day business, to home-schooling and school re-entry, to loss of income and job security, to wondering about the future. The AMA recently published newspaper ads full of misinformation and falsehoods in an attempt to garner public support and further their position at the bargaining table.

This sort of tactic does nothing but prey on the fears and emotions of a population already under incredible stress. This negotiation strategy is divisive and is not conducive to cooperativity or collaborative engagement. It really comes as no surprise that the president of the Eye Physicians and Surgeons Association and President of the AMA’s Section of Ophthalmology, has approached Minister Shandro to negotiate separate from the AMA.

As Alberta continues to navigate its way through this pandemic and its economic ramifications, I am continually impressed by how we all come together to help each other through each challenge we face. Resiliency and determination are but two of the defining characteristics of all Albertans.

Our province is faced with a fiscal reckoning associated with the triple threat of COVID-19, a global economic recession, and a crash in energy prices. On August 27th, Alberta’s UCP government provided Albertans with a fiscal update outlining the severity of our fiscal position. Albertans hired this government to be responsible stewards of tax dollars and we are committed to doing just that.

It is incumbent upon government to look at funding models across all departments and make deliberate, thoughtful, purposeful adjustments that protect public services now and into the future.

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