Province says 141 communities absent from rural physician program an error

Community list to be revised Monday, says Alberta Health

Image | Tyler Shandro

Caption: Alberta Health Minister Tyler Shandro announced the government will spend $3 million to hire 30 nurse practitioners to work in primary care clinics. (Dave Bajer/CBC)

The Alberta government says the absence of 141 communities from a list of areas eligible for a rural physician compensation program was an error.
Health Minister Tyler Shandro faced backlash Sunday from physicians and the Opposition NDP following the apparent removal of communities on a list of eligible areas for the Rural and Remote Northern Program (RRNP), which compensates physicians in under-served areas.
On Friday, Shandro announced the province was walking back some of the physician compensation changes imposed on March 31 with measures especially aimed at keeping rural physicians in isolated areas.
A medical bulletin(external link) issued that day tied the definition of rural physician to an adjoining list of RRNP-eligible communities. Canmore, Camrose and Mundare were among the 141 communities absent from the list.
Alberta Health apologized for what it called an "oversight" in a series of tweets Sunday, saying the bulletin and community list would be revised on Monday.
"Med Bulletin 227 was published with incorrect information and did not list 141 communities," one tweet read.

Flat fee still available for 141 communities

Steve Buick, press secretary for Shandro, said in an email the 141 communities were the least isolated of the RRNP communities, according to the formula used by the program.
The automatically-applied variable fee premium for those communities was already set at zero per cent under the previous compensation table. However, doctors who lived and worked there could apply to receive a flat fee.
Under the new bulletin, the flat fee incentive would be discontinued for all rural areas. But on Sunday, Buick clarified that physicians who live in those 141 communities will continue to be eligible for the flat fee under the revised bulletin.
Only 29 of the 141 communities in question had physicians that claimed the incentive last year, he said.

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At news conference Sunday, held before the clarification was issued, NDP health critic David Shepherd criticized the minister's communication.
"Unfortunately, this is just more of the sort of chaos and uncertainty we've continually seen from Tyler Shandro in his working with doctors," he said.
"We see bulletins released at the last minute with information that is unclear which he then claims he needs to walk back."

Maintaining rural coverage

The list was released on Friday, the same day Shandro announced measures aimed at preventing rural physicians from leaving their communities or ceasing to work in rural hospitals.
A $60,000 cap on the RRNP was abolished and rural on-call rates for physicians were raised.
A previous change that prevented rural physicians from billing overhead costs when they work in a hospital was permanently removed and put on hold for urban counterparts.
"Many rural physicians organize their business model around practising in hospital and clinics. And rural hospitals, especially their emergency departments, work differently than in cities," the minister said Friday.
"They depend on rural physicians for coverage and we need to maintain that coverage in Alberta."