Alberta Medical Association consulting with city stakeholders on health system

By Al Beeber - Lethbridge Herald on November 8, 2023.

LETHBRIDGE HERALDabeeber@lethbridgeherald.com

The president of the Alberta Medical Association was in Lethbridge Tuesday meeting stakeholders including physicians, Alberta Health Services and others as part of a provincial tour to talk about the state of the health care system.

That stop included a private town hall meeting with city doctors last night.

Paul Parks, an Emergency room physician in Medicine Hat, is well familiar with the issues impacting Lethbridge and area residents including the shortage of physicians which has left between 30,000 and 40,000 residents without a family doctor.

In a phone interview, Parks said there is reason for optimism, however, with new Health Minister Adriana LaGrange making a commitment to work with the AMA in stabilizing health care in Alberta.

Lethbridge was the fifth stop on his tour after Edmonton, Calgary, Red Deer and Grande Prairie.

The visits aren’t just to talk to doctors but other stakeholders such as universities and government, he said.

“The big thing that we’re trying to do is get a sense of what are the big common themes and issues around the province. The second is what are the local issues, what are the things that are specific for example, here in Lethbridge, the local challenges” that people are dealing with and how the AMA might be able to help on those issues, he said.

“No question the big issue here that we’re seeing province-wide two-fold is access to family physicians and the viability of family physician practises. And then the second is acute care” in hospitals as well as capacity and workforce issues, said Parks.

“The really big common theme that we’re seeing between those two is workforce by a mile, not only health care workers and nurses but physicians, as well.”

On the family medicine side, with recruitment of physicians and access to physicians, one of the biggest issues is the funding model.

“The old-fee-for-service model of just only being able to pay the physician when they see the patient directly in front of them and see the whites of the eyes of patient that doesn’t work anymore. We need a funding model that will allow us to do virtual care, do team-based care, do complex care and try to evolve in a way that meets the needs of a larger group of people in the area,” said Parks.

Another piece that’s important is the need to compensate physicians for the administrative burden they carry.

“We’re hearing from more and more physicians that the amount of paperwork they have to do and the amount of unpaid administrative work is just inordinate. That we’re hearing quite frequently, as well,” said Park.

Family physician clinics are essentially private businesses and when doctors leave fewer physicians have to pay the costs of staff and overhead. If a four-doctor clinic drops to two, then the remaining physicians are paying double the staffing and overhead costs they previously did, for instance.

“That’s one of the things we’ve been talking to the public and government, saying ‘listen, a family physician and their office is a small business.’ What we’re hearing repeatedly now is that the way the old funding model works is that they are no longer able to actually make enough money to be able to keep the lights on, pay the overhead and pay their staff,” said Parks.

“There’s no question that four years ago when the government tore up the government and fought with doctors, that made an environment where physicians were leaving and ultimately an environment” where nobody wanted to come to Alberta because of the uncertainty here, he said.

And COVID made it more difficult for doctors, too.

“Thankfully, the new government understands that and the new Minister of Health gets that and is starting to make some commitments with us to work on that and to fix that and to change that narrative,” said Parks.

Support from LaGrange, he said, “is absolutely welcome. It’s absolutely night and day from the previous government. Minister LaGrange did give us a memorandum of understanding directly with the AMA saying ‘we get it now, we want to work directly with the AMA on trying to stabilize and invest in a new funding model for family doctors’ so we can change the narrative, so we can gain back the Alberta Advantage and have a place now where the current family doctors that are here that we can retain them and they can afford to keep their practises running and of course, have a new funding model” that considers comprehensive complex care so new grads and doctors and international doctors will want to come to Alberta so the situation can be changed, he said.

Parks said the agreement with the minister will result in a co-design of the funding model to transform it and have it in the budget by February of 2024.

“If we don’t get a real stabilization, and a transition of how funding’s done by early next year, we’ll lose more and more clinics and I really worry we’ll have nothing left to build on,” added Parks.

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