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Alberta government closing in on new pay model to attract family doctors

The Alberta government says it's closing in on a new deal for family doctor pay, but a physicians' group says it must include those with small patient rosters.

Physicians' group says new deal must include those with small patient rosters

Medical tools are pictured in an exam room at a health clinic.
The Alberta Medical Association has been warned for months that family clinics were being pushed to the financial brink. (Jeff McIntosh/The Canadian Press)

The Alberta government says it's closing in on a new deal for family doctor pay, but a physicians' group says it must include those with small patient rosters.

The details of the framework announced Wednesday have yet to be hammered out, including specific pay rates.

"This compensation model will provide the necessary supports so family medicine and rural generalist physicians can provide Albertans with the lifelong care they need and that they deserve," Health Minister Adriana LaGrange said at a news conference Wednesday.

LaGrange said once the new model takes effect in the fall, Alberta will be a national leader in family doctor compensation. She did not directly answer questions about whether Alberta family doctors would be the highest-paid in the country.

The announcement comes after Premier Danielle Smith promised late last year to ensure every Albertan has a primary health provider by the next election, expected in 2027.

Alberta Medical Association president Dr. Paul Parks said the agreement is a positive step forward after several years in which some family doctors found their practices untenable. He said some physicians have been "under crushing financial pressures" and others have left the field entirely.

Although the minister has touted increases in the number of family doctors registered to practise in Alberta, those statistics do not indicate how often those doctors work.

Earlier this week, the Business Council of Alberta published data from the Canadian Institute for Health Information and Statistics Canada showing the number of Alberta doctors per capita has declined since 2019, in contrast with the national trend.

To qualify for the incoming family medicine pay model, doctors must provide a certain number of hours of service, see most patients in person, and commit to joining a provincial registry tracking doctor-patient relationships.

Two committees made up of doctors and government representatives will finalize details, including how many patients a doctor must have on their roster to qualify for the new payment approach.

That number could be a stumbling block, as 700 Alberta family doctors have a panel of fewer than 500 patients, according to government data. Those doctors recently were left out of a provincial government cash injection to keep family physicians afloat.

New model to address unpaid work

The new model would allow doctors to get paid for time they spend completing paperwork or reviewing patient lab results — free labour under the current fee-for-service model. It would also have incentives for taking on more complex patients with many health challenges, and for taking on larger patient loads.

"My colleagues tell me how they look at labs at 10 o'clock at night if there's a critical lab for their family practice patients," Parks said.

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President of the Alberta Medical Association, Dr. Paul Parks outlines the conditions in Alberta hospitals with not enough staff or space for patients

Although the government doesn't yet have a cost estimate of the new pay model, Parks told the Canadian Press he thinks it will cost hundreds of millions of dollars per year.

"This is going to be a historic investment into family medicine care in the province," Parks said.    

Although estimates vary, politicians agree there are hundreds of thousands of Albertans without a family doctor.

Alexandre Grant, a second-year medical student at the University of Alberta and advocacy chair for the university's medical student association, says family medicine is an unattractive path for many of his classmates.

Not only are family doctors the lowest-paid specialists in Alberta, family doctors in this province earn less than their colleagues across western Canada, he said. The burden of running a small business on top of caring for patients is another deterrent, he said.

Changing a fee-for-service model that requires doctors to see more patients to be able to cover their costs would go a long way to drawing prospective family doctors back to the specialty, he said.

"If [patients] need more time, then I want to be able to give them that time, because that's what they deserve," he said. " We're trained to provide the best care. And I think that it's not something that's prioritized."

medical student, medical students, University of Alberta
Alexandre Grant is the chair of the government affairs and advocacy committee of the University of Alberta's Medical Students' Association. (Submitted by Alexandre Grant)

The Opposition NDP said the government should have acted faster to prevent family doctors from leaving the profession and the province.

"We need to have competitive compensation if we want to retain the doctors we have, if we want to attract new doctors and we want to keep the graduates that we have here in the province," Calgary-Varsity MLA and health critic Dr. Luanne Metz said at a news conference.

ABOUT THE AUTHOR

Janet French

Provincial affairs reporter

Janet French covers the Alberta Legislature for CBC Edmonton. She previously spent 15 years working at newspapers, including the Edmonton Journal and Saskatoon StarPhoenix. You can reach her at janet.french@cbc.ca.

With files from Canadian Press and Michelle Bellefontaine