Doctor says number of factors point to shortage

By Al Beeber - Lethbridge Herald on December 14, 2021.

LETHBRIDGE HERALDabeeber@lethbridgeherald.com

Al Beeber

Lethbridge Herald

An Edmonton doctor says several factors are responsible for the doctor shortage and the inability for them to take on new patients in Alberta.

Ed Papp, a veteran of 48 years in the medical profession who owns and operates a community clinic in Alberta’s capital, says doctors had high hopes when the UCP came into power in 2019.

But the government tore up its agreement with the Alberta Medical Association, taking away previously negotiated benefits that cost his clinic alone $49,000 per physician last year for doing the same work.

Papp, who is in his mid 70s, is still working 80 to 90 hours a week and wants to retire so he and his wife can spend time with their family. But he’s just lost two doctors to retirement and a third has moved to Calgary. While he’s managed to recruit one new doctor, Happ said in a phone interview he’s actively searching for more for his clinic which has a capacity for five but says “they are few and far between for all locales – larger cities, smaller centres and rural areas where all of us are constantly searching.” With his lease expiring soon, he doesn’t know what the future holds for his patients or his remaining doctors on staff.

Papp is a specialist in family medicine and an associate clinical professor in the Department of Family Medicine at the University of Alberta.

Papp says the UCP is limiting to 50 the number of services a physician can bill in a day which means if they want to work extra hours to take care of patients they can’t unless they work for free and that means dipping into earnings to pay for staff and supplies.

“It is impossible unless we work for free as we must dip into our previous earnings to pay for the staff and supplies needed for doing this. This scenario is now constant due to viral pandemics and the need to see sick patients more frequently because our access to all referrals for lab testing, imaging studies, and all manners of other tests and specialist consultations are met with exponentially increasing wait times.

He says wait times for tests and specialist consultations are now being delayed with services such as ultrasounds now taking 30 days, joint replacement four to five years and consultants months to years, depending on the work involved.

Papp has told patients if medication he has prescribed isn’t working to go to Emergency in several days and wait even if it takes hours because physicians there have immediate access to such things as ultrasound.

Papp says rural physicians are in worse shape than their urban counterparts with emergency wait times between 8-12 hours or longer. He says patients are being discharged prematurely and premature death rates, increased morbidity and decreased quality of life are all becoming implications for patients and their families.

But Papp says the medical system here wasn’t in good shape under the NDP government, either.

“Fortunately for me, my wife joined me and she manages the clinic so we have a little bit there like I can pay her because any dollars I make its 50 per cent tax bracket and all the socialist governments, anybody that makes a large amount of money, it doesn’t matter how you did it, through hard work or what, they’re just going to take more and more away from you,” he said.

“That’s why we were hoping Kenney would have helped but he sent his fellow in (Tyler Shandro). He’s the one that did it – he tore up the contract we had negotiated,” Papp said.

“Myself and my billing staff we’re counting every service because the minute you hit 50, you don’t get anything,” Papp said.

Healthcare issues in Canada, Papp said, started with the Canada Health Act.

“In Canada, all healthcare is outlawed except that paid for by the government. Every other civilized country in the world has a healthcare system for their citizens that gives them a really nice spectrum of care but for some things they’re going to have to wait. But now, in Canada because the budgets are horrible, the government doesn’t know how to manage it and they want to build the golf courses and take care of all the drug addicts and all of this kind of stuff, with millions and millions of dollars going into that,” so the budgets have to be cut, Papp said.

“I’ve been doing this for 48 years, I’ve been active in the AMA (Alberta Medical Association), the College and everything. This is getting to be crap because our own association isn’t even standing up for us anymore. The new way of negotiating is ‘lets play nice in the sandbox, find out what we can agree on.’ They gave away a ton of money from all the community docs and family docs and that cost me just about $50,000 a doc for doing exactly the same thing and then the real icing on the cake, because whenever that’s happened in the past, I just work harder. I’ll put in 80-90 hours a week because you’ve got to take care of the patients and especially now that I’ve lost three physicians,” Papp says.

“There’s just nobody there because none of the new grads want to do the full meal medicine like we’ve been doing,” Papp added.

“The government has never acknowledged that we are an absolute key integral part of the health care system and they keep attacking any entrepreneur in the community that has their own clinic. So they take away money, they put in all kinds of restrictions, everything,” he added.

Papp says one problem with trying to recruit doctors is they can make more money in a day spending two or three minutes with clients at big medical centres than a physician like Papp does spending 10 to 15 minutes with patients – which he does because many of his are in their 80s, he says.

He said specialists are also getting picky about taking on patients. Papp says he can send four or five letters out hoping to get one response for a patient.

Papp says “medical tourism” right now is at an all-time high with people going elsewhere such as the U.S. to spend thousands of dollars on surgeries they can’t get in Alberta, surgeries which can mean the difference between being off work and being able to support a family.

He also tells families with patients in hospitals to make sure they have someone at bedside 24 hours a day to make sure family members are getting needed care because there isn’t enough staff on hand.

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