Delays in family doctor pay deal put lives at risk, says Alberta Medical Association

Alberta doctors are accusing the provincial government of breaking its promises to lock in a new payment model for primary care physicians as the family doctor shortage drags on.

The Alberta Medical Association has been working for a year to get in place a new payment model for family doctors and rural generalists.

Alberta Health Minister Adriana LaGrange has publicly committed to a new deal on a number of occasions.

A memorandum of understanding was signed last October, and LaGrange has also publicly stated a new model would be in place this fall.

"They are not putting their money where their mouth is and they are not putting actions to their words," said Dr. Paul Parks, AMA past president, during a Monday news conference.

"I don't think we can wait any longer."

Parks said the association formally submitted its primary care stabilization proposal to the government in late 2023. It also put forward a plan for acute care.

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Parks said he's received many private assurances a deal is coming. In July, according to Parks, doctors were told the premier had signed off on the deal.

After more delays, Parks said he received a commitment from the premier in August that the deal would be announced in September.

"Unfortunately, the impact of indecision and inaction is that Albertans' health care access will deteriorate and many will suffer. And some will sadly and needlessly die," said Parks.

The primary care pay model would add an additional $200-250 million a year to the current physician services budget, according to Parks.

A significant proportion of that money would be operational in nature, he said, going to support business costs associated with running a clinic and to help doctors keep their clinics open.

"There is nothing left to be done other than a signature, Treasury Board and an announcement," said Dr. Shelley Duggan, the Alberta Medical Association's new president.

"Our team has been working on implementation for the past couple of months. So if we were to have an announcement this week, we could get rolling.… So we are not the barrier here."

For its part, the provincial government said it's still working on the deal.

"Alberta's government is committed to finalizing a new physician primary care compensation model that is financially sustainable and supports both physicians and Albertans into the future," the health minister's office said in a statement emailed to CBC News.

It cited a previous announcement of $257 million to stabilize primary care.

"This is an addition to our record investment in physician compensation in Budget 2024 of $6.7 billion," the statement said.

"These expenditures are growing far above population plus inflation, and as part of the ongoing collaboration with the AMA, we've asked them to work with us to identify opportunities to stabilize these growing expenditures. Our government will continue to work with the AMA to finalize the key details of this model as soon as possible."

In a statement issued last week, LaGrange said significant progress had been made.

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"We knew from the start that developing a new physician compensation model would be a complex and time-consuming process. This work was never about quick fixes, and there is still a little more work to be done," the statement said in part.

NDP health critic Sarah Hoffman is also calling on the provincial government to take action, given that hundreds of thousands of Albertans are without a family physician.

"When Albertans don't have family doctors, they end up in emergency rooms with medical conditions that could have been prevented or treated early. This is bad for patients and more expensive care," she said in a statement.

"Instead of causing more chaos, the government should prioritize patients and health-care workers. They should sit down at the table and sign an agreement to create a stable and reliable health-care system that we can all be proud of."

Meanwhile, doctors are frustrated.

"We are deeply, sincerely afraid that the health-care system in Alberta is ready to collapse, past the point of repair any time soon," said Duggan.

Parks said the second proposal — the acute care stabilization plan — is on hold.

And he described negotiations with the provincial government over the past year as a "seamless progression of one step forward, one step back."

"You can't sign a lease, you can't hire staff and you can't run a clinic based on hope."