New pay deal needed before end of 2024, Alberta doctors warn

More than a year after the Alberta government signalled it was ready to bring in a new compensation model for family physicians, doctors are still waiting and they're calling for an announcement before the year's end.

The provincial government signed a memorandum of understanding last October, committing to develop a new pay model and to stabilize primary care. 

Despite promising it would roll out this fall, the government still hasn't announced a new deal.

"It really needed to happen yesterday," said Dr. Sarah Bates, a Calgary-based family physician.

"Every month that we delay … is another month we potentially lose more family physicians in the community."

According to the Alberta Medical Association (AMA), physician pay has not kept up with the pace of inflation, and many doctors, who face significant overhead costs, are struggling to keep their clinics open.

It's now calling on the provincial government to announce the new physician comprehensive care model — expected to move away from the traditional fee-for-service compensation — in December.

"It's important for a lot of physicians as their year-end would be December. And a lot of them are about to make decisions about whether they're going to continue their practice [or] perhaps change their practice," said Dr. Shelley Duggan, AMA president.

According to Duggan, the AMA also needs time to run information sessions so doctors who want to join the new payment model can prepare.

Health Minister Sonya LaGrange's latest plan would see the new model included in next year's budget and in place for April 1, 2025.

When asked about the deal on Tuesday, LaGrange said there are still a few steps to go through before it's signed.

"One of those items is Treasury Board.… We want to make sure that this is sustainable for the long-term," she said.

"We're working really hard to get it done."

LaGrange wouldn't go into detail about what is holding up the deal, and she didn't commit to making an announcement before the end of 2024.

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Alberta NDP Leader Naheed Nenshi called the delays "very troubling," noting many Albertans are without a family doctor.

"Just signing the deal you've already agreed to will certainly help stem that bleeding. But the government seems completely unwilling even though they already agreed to the basic elements of that deal," he said. 

Bates, who is the president of the AMA's section of family medicine, said the practice has become more complicated as patient needs become more complex, and change is necessary.

"This newer model takes into account time that a physician invests that is not purely face-to-face time with a patient but of all that other time that family doctors are required to put into comprehensive care. And of course what it does is encourages longitudinal care," she said.

"It's not there to compensate episodic walk-in care." 

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The AMA has said previously the new pay model would add an additional $200-250 million a year to the current physician services budget.

In a statement emailed to CBC News, the health minister's office said it will have more to say in the coming weeks.

"Alberta Health continues to work with Treasury Board and Finance and the Alberta Medical Association to finalize a fair, successful and financially sustainable compensation model for primary care physicians," the statement said.