Alberta unveils new doctor pay model rewarding physicians for bringing on patients

The Alberta government unveiled a new pay model Thursday that it says will reward family doctors for bringing on patients and pay them for work done behind the scenes.

It says the model will provide incentives to doctors for maintaining a full-time practice of at least 500 patients and providing after-hours care to relieve emergency rooms.

The government says enrolment begins in January and the model would start in the spring — as long as at least 500 doctors sign on.

Alberta Premier Danielle Smith said the deal will dramatically improve the province's ability to recruit and retain primary care physicians.

She said high administrative costs, burnout and "a health system that wasn't working" are some of the challenges that make it difficult for Alberta to recruit and retain doctors.

"We think a big part of the solution is fair compensation and incentives that make sense," Smith said at a news conference.

"With this announcement, I think the risk of losing family physicians to more attractive jurisdictions is done. This new model will make Alberta an enticing and competitive place for doctors to come and settle and set up shop and stay for good."

The announcement came after repeated calls from the Alberta Medical Association to implement a new compensation model.

Association president Dr. Shelley Duggan said the new model will help to stabilize and sustain family practices and clinics.

"Our fee-for-service system has served us well since medicare first began, but it is less and less and less able to support the kind of care that Albertans need," she told the news conference.

"It is our hope that the model will help to restore Alberta as a destination of choice for physicians, residents and medical students who want to practise comprehensive care."

The province will commit $150 million for the new deal in 2025 and approximately $250 million in the following years.

It would make Alberta doctors among the highest paid in Canada, the province said.

The plan includes incentives not only for doctors handling a high number of patients but also for providing after-hours care to take pressure off emergency rooms.

There are also incentives to improve technology to streamline work and for using team-based care, where patients are looked after by not only physicians, but also by nurses, dietitians, nurse practitioners and pharmacists.

Opposition NDP health critic Sarah Hoffman said the new compensation model is a good first step and "way overdue."

"Although it is better late than never, this agreement should have been done back in May when the premier promised it would be signed within a couple of weeks," she said.

"Hopefully, this will stop the further hemorrhaging of health-care workers who have had to close practices, move away from our province and even leave the profession."

'This can be game-changing'

The new pay model is an "absolutely positive" step in the right direction, said AMA past president Paul Parks.

Parks argues the model should lead to more continuous, long-term care and treatment for doctors, and create a stronger foundation of primary care in Alberta, which Parks said should improve the entire health-care system from emergency rooms to cancer care.

"This can be game-changing," said Parks, who works as an emergency room doctor. 

"This is a huge positive step in the right direction to invest in primary care as a foundation of health care, to invest in family medicine specialists so they can do longitudinal care."

But a requirement that doctors who sign on to the model must have at least 500 patients may cause difficulties. Parks said the AMA has continued to raise this as an issue to the province, because doctors starting out won't qualify, nor would older doctors with less patients as they approach retirement.

Parks argues it would be better to offer targeted deadlines for doctors to accumulate larger panels, but he noted the government held the final decision.

Nevertheless, Parks is optimistic about how the pay model can evolve over time to continue to work toward providing primary care to more Albertans.

"The work's not done. We'll now have to build teams around it. We're going to have to think differently and be transformative of how we're going to deliver so that every Albertan can have access to primary care," Parks said.