Alberta has gained doctors so far this year — but that doesn't tell the full story

The number of doctors practising in Alberta has increased so far this year despite fears of an exodus due to a dispute with the UCP government — but both the College of Physicians and Surgeons of Alberta and the Alberta Medical Association warn the figures don't tell the full story. 

There was a net increase of 246 doctors for a total of 11,152 in the third quarter of 2020 compared to the same period last year, according to the quarterly report released by the College of Physicians and Surgeons of Alberta on Wednesday morning.

The gains so far this year are smaller than each of the past five years, but there is still an additional quarter left to report. 

From 2018 to 2019, the college registered a net gain of 274 doctors. Broken down further, the province had a net gain of 331 specialists year to year but a net loss of 85 non-specialists.

Family doctors are considered specialists, but general practitioners, who can be family doctors, are not. 

According to the quarterly report, most regions show a net increase in doctors in 2020, with notable exceptions in Grande Prairie and Fort Saskatchewan.

The figures so far paint a different picture than ongoing reports of doctors fleeing the province in the wake of the United Conservative Party government unilaterally tearing up its master agreement with the Alberta Medical Association. 

That move by the province has sent relations with Alberta's doctors into a tailspin as the two sides try to negotiate compensation and contracts in the midst of the COVID-19 pandemic. 

Health Minister Tyler Shandro was quick to pounce on the positive take. 

"This report shows that doctors continue to choose to live and practise in Alberta in impressive numbers — and for good reason," Shandro in a news release on Wednesday. 

"Alberta pays more than any other province, has lower taxes, and now has the most attractive compensation package available for rural and remote doctors in Canada."

But the Alberta Medical Association disputed that interpretation.

"Government refuses to acknowledge that so many physicians are in situations bad enough that they are contemplating leaving," Dr. Paul E. Boucher, president of the Alberta Medical Association, said in a statement, pointing out that an AMA survey in the summer suggested 42 per cent of its members were thinking of leaving the province.

"There is a real level of distress, burn out and financial stress on physician practices across the province. If the health system was a big corporation and almost half of the primary workers were so unhappy they were thinking about quitting, the shareholders of the company would want to know that. We think Albertans care."

Year-end numbers could change picture

The College of Physicians and Surgeons of Alberta pointed out that registrations are for the full year and can't be changed mid-way through. In other words, if there is an exodus spurred by the province's dispute with doctors, which flared up in early spring and amid the COVID crisis that erupted around the same time, it wouldn't necessarily show up in the third-quarter figures. 

Jessica McPhee, the communications director with the college, says while the numbers are promising, it's too early to tell whether the trend will hold for the year.

"Sometimes what can happen throughout the year is a physician may change the scope of their practice, perhaps they reduce their practice, maybe they're working part-time in our province but then in another province," said McPhee, regarding the nuance that isn't captured by the stats. 

"In those sorts of scenarios, we really don't have the full understanding of those types of situations."

She said the third-quarter always sees a bump as residents transition from one register to another on July 1.

'Massive drop off'

Dr. Sam Myrh, a family physician in Pincher Creek who is part of a group that has raised the alarm over the impact of government actions on health care in the province, agrees these numbers aren't a strong indication of a trend. 

She says doctors not renewing their registrations won't be seen until the first quarter report of 2021. 

"I think that's when we'll see the massive drop-off," said Myrh. 

She said even these numbers show a slowdown in growth, and the loss of 85 non-specialists is telling.

"Losing 85 non-specialists is quite indicative of where these cuts and where these policy changes are having the most effect," she said.

"That's your, you know, everyday family doctor who is sitting in the office and in rural areas seeing you in emerge and taking care of you in the hospital. Those are the people that are leaving."

Reports of doctor exodus

Recently revealed government documents show some rural areas of the province were considered at risk of a doctor's exodus earlier this year and, as noted by the CPSA, the figures could still change by the end of December. 

At the height of both the COVID-19 pandemic and the provincial government's dispute with doctors, more than 200 physicians were weighing the future of their practices, with 163 deemed to be at "high risk" of altering the services they provide or leaving Alberta altogether, according to internal documents.

The documents, obtained by Alberta's Opposition NDP through Freedom of Information laws and provided to CBC News, laid out the decisions under consideration by some physicians in the spring and early summer.

Rural communities

As of Oct. 1, those rural communities have not seen a mass exodus of doctors — however, many of them were on a confidential, internal watch list maintained by Alberta Health Services (AHS).

According to the list, 205 doctors in 17 rural towns had told the health authority they were unsure what the future would hold for them.

Only three communities have seen actual departures as of Oct. 1 but, according to the documents, some physicians have agreed to withhold any action until the immediate response to the COVID-19 pandemic has passed.

Dr. Myrh said she wants the government to take a hard look at what's happening with doctors in the province. 

"I would really appreciate a bit of honesty looking at these numbers, parsing them out for what they really mean instead of just putting out, you know, raw numbers that they can then spin to look good to support their cause," she said. 

"It's pretty clear, I think, to Albertans, that there's a problem and that physicians are leaving."