Province rolls out new physician compensation model
By Al Beeber - Lethbridge Herald on December 20, 2024.
LETHBRIDGE HERALDabeeber@lethbridgeherald.com
A new compensation model for Alberta’s family doctors was announced Thursday by Premier Danielle Smith and Health Minister Adriana LaGrange.
The province as well as the Alberta Medical Association believe the new primary care physician compensation model (PCPCM) will improve access to family physicians across Alberta.
And they say it will help Alberta attract and retain physicians.
Lagrange called the new model unique to Alberta.
The model is set up to encourage physicians to grow the number of patients in their care while encouraging full-time practices.
Incentives will be provided for maintaining a minimum panel of 500 patients and providing after-hours care to relieve pressure on emergency departments and urgent care centres.
The province expects the model will be “a game changer in attracting family physicians from other provinces and countries,” said LaGrange.
Enrolment will start in January with full implementation in spring, provided the minimum number of 500 doctors signing onto the model is reached.
Family physicians who are not paid through the traditional fee-for-service model will receive higher compensation rates under their payment model, which is known as the alternative relationship plan. These include physicians who provide inpatient care in hospitals as well as rural generalists.
The government says the model will make family doctors in Alberta “the strongest-paid and most patient-focused in the country.”
During a media announcement, Smith said the model is more than a year in the making. The UCP government was elected 18 months ago on a promise to improve health care for all Albertans, no matter where they live, the premier said.
A Memorandum of Understanding was entered into last year with the AMA to develop a new primary care physician compensation model and since then, the province has heard from doctors about their priorities. Those include a pay model that recognizes the work they do to provide comprehensive care indirectly, especially complex patients with chronic illness because the current fee-for-service model doesn’t reflect that, said Smith.
They also wanted “a market and evidence based payment model that will ensure family doctors in Alberta are compensated extremely competitively,” said Smith.
The government also identified priorities including maintaining high panel numbers of at least 500 patients to incentivize panel growth and improve access to primary care for patients, providing after-hour care to relieve that pressure on ERs and urgent care centres as well as enhancing team-based care to encourage the development of integrated teams, Smith said.
The new model delivers on priorities, Smith said, adding “we are confident that this new model will help build healthier communities and dramatically improve our ability to recruit and retain primary care physicians.”
She added that the province recognized physicians were struggling with administrative costs, burnout and a health system that wasn’t working for them, which made it difficult to recruit new graduates and to retain primary care physicians who practise in Alberta.
“Recruitment and retention of family physicians is a nation-wide challenge and here in Alberta we think a big part of the solution is fair compensation and incentives that make sense,” said Smith. “Our new model will reward physicians who build up stable practices and see more patients.” She noted the risk of losing family doctors to other jurisdictions is “done.”
“This new model will make Alberta an enticing and competitive place for doctors to come and to settle and to set up shop and to stay for good, and that’s exactly what we’re aiming for.
“When primary care is strong, the rest of our health system is strong, too,” the premier added.
LaGrange said the PCPCM “is part of our ongoing commitment to do everything possible to stabilize and improve primary care throughout Alberta and we are confident that these changes will continue to strengthen the system, give family physicians the support they need and ensure Albertans and their families are taken care of in their day-to-day health needs through every stage of life.”
The model is a blend of fee-for-service and elements of what is paid through other non-fee-for-service models, making it the first family physician compensation model of its kind in Alberta.
“It sets the stage and conditions for Alberta to be a national leader in the retention and recruitment of family physicians,” LaGrange added.
She said the model is critical to a fully functioning health system, will relieve pressures on other areas of the system and encourage comprehensive care in all stages of patients’ lives, she added. And it will give more Albertans timely access to care.
Shelley Duggan, president of the Alberta Medical Association, told media the model will “significantly, meaningfully and positively” impact health care in Alberta for years to come.
She said challenges exist everywhere in the system, some that Alberta shares with other provinces, some that are unique, and none that are easy to solve.
Lack of access to family and rural generalist physician care is a common denominator for many problems being seen by the AMA including bottlenecks, increased waits for care and deficits in care that develop when people can’t receive preventative screening, timely care and treatment, Duggan added.
“Family medicine specialists fill a truly unique role,” said Duggan. “Their training and knowledge allows them to consider many different factors and treat their patients in a comprehensive way. The care that they deliver not only deals with physical issues but also mental health and social factors. Thanks to what they know about this system, they can guide a patient through all of these areas.”
Duggan also pointed out that Alberta’s population is aging and growing rapidly.
“As we age, we tend to develop more health care needs and often experience multiple health issues that interact in complicated ways,” and those patients need more support, time and attention.
She added the fee-for-service system has served well since Medicare began more than 50 years ago, but it’s less able to support the kind of care needed by Albertans today.
The new plan drew cautious optimism from Sarah Hoffman, the opposition NDP’s shadow minister for health and a former health minister herself. In response to the government’s announcement, Hoffman pointed out that there are a million Albertans currently without a family physician.
“This agreement is way overdue and although it is better late than never, (it) should have been done back in May when the premier promised it would be signed within a couple of weeks.”
Hoffman added that the UCP government must now be focused on and committed to recruiting, retraining and showing respect to all health-care workers.
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Yah, blah blah from Hoffman. There are 7 million in the country without a doctor, but the UCP AND the AMA are doing something about it here in Alberta. What does the NDP suggest, criticism?….