“We know those numbers are going to go up, up, up for the next few months. We’re in for very trying times”
Newly sworn in as the president of the Alberta Medical Association, Dr. Shelley Duggan embodies the very dilemma her organization is desperate to shed light on.
She recently got a “Dear John” letter from her own primary care physician who is closing her clinic. Now Duggan’s joining the swelling ranks of hundreds of thousands of Albertans — ironically, a doctor without a family doctor.
“I’m one of those 850,000 Albertans. Yep, I no longer have a family physician,” she said Monday.
Wariness ahead of flu season
Without the long-expected stabilization, and with inflation and an influx of patients new to the province, doctors running clinics and emergency rooms alike are overwhelmed, Duggan said.
“One of our members stood up at the representative forum and told the minister that her clinic has a date set for making the decision for closing. That would be another 5,000 patients that would then become unattached,” she said.
Family physicians are a critical first line of defence during the approaching respiratory virus season — and there wasn’t the usual pre-season lull in the emergency rooms, Duggan said.
“Sometimes emergency physicians would start their shifts with 50 or 60 people in the waiting room, and still have to manage patients handed over to them by the last person on shift because there hasn’t been a consultant to see those patients yet,” she said.
“We know those numbers are going to go up, up, up for the next few months. We’re in for very trying times.”
Between Premier Danielle Smith’s Alberta Calling campaign and displaced persons fleeing wartorn homelands, by the end of 2024, AMA members expect another 200,000 new prospective patients.
“We heard the premier talk about needing schools. We’ve not had an influx of doctors to meet that demand, and we’ve certainly not had investment in health care to meet that demand,” Duggan said.
“They’ve had surpluses, but they are willing to invest for a rainy day. The problem is that it’s pouring rain right now in health care.”
Agreement held back
There have been government announcements from October 2023 onward — a memorandum of understanding to talk about it, a Feb. 2 promise to discuss it with health professionals while on a tour around the province, an April 17 announcement of a new physician compensation model framework that the government expected to make Alberta a “national leader in recruiting and retaining primary care physicians.”
But the AMA says the plan is complete.
“I want to put any sort of claims to bed that we’re still working on it,” Duggan told Postmedia.
“It’s done. It’s been on the desk for signing to go to Treasury for months now, since April, and the AMA has been working in the background on implementation because we were certainly given many, many signals that it was going to happen soon.”
While Duggan said there’s a desperate need for investment into the health care system, Smith’s decision to use money and energy splitting it into four organizations — each with its own CEO — doesn’t make fiscal sense, she said.
“We certainly are very concerned that having four pillars instead of one integrated system is not going to be good for patients. We’re going to have a lack of co-ordination across the system. And we know the government is spending a substantial amount of money, although we don’t know the actual dollar figure, but there’s a lot of time and money being spent into reorganizing the system that is burning down,” Duggan said.
Asked Monday about the continuing subdivision of Alberta Health into four separate divisions, Health Minister Adriana LaGrange’s office issued a statement.
“Alberta’s government continues to take significant action to refocus the health care system so Albertans can get the right care when and where they need it most,” she said, promising more information in coming weeks.
Asked about the lingering primary care model agreement, LaGrange’s office said the government is committed to finalizing a new physician primary care compensation model that is financially sustainable and supports both physicians and Albertans into the future.
LaGrange pointed to a previously announced $257 million “to stabilize the delivery of primary care” and a “record investment in physician compensation in Budget 2024 of $6.7 billion.”
LaGrange said the expenditures “are growing far above population plus inflation.”
She said as part of the “ongoing collaboration” with the AMA, “we’ve asked them to work with us to identify opportunities to stabilize these growing expenditures.”
Asked about a finished agreement referred to by the AMA announed as pending in April and again in August of this year, LaGrange promised Monday to continue to work with the AMA “to finalize the key details of this model as soon as possible.”
Sarah Hoffman, Alberta NDP shadow minister for health, said Monday she’s met with doctors on the verge of closing their practices.
“When Albertans don’t have family doctors, they end up in emergency rooms with medical conditions that could have been prevented or treated early. This is bad for patients and more expensive care,” she said, urging the government to complete the agreement.
“Instead of causing more chaos, the government should prioritize patients and health-care workers,” Hoffman said.
New quality control
While the government is hiving off Alberta Health into four distinct organizations, at least until March 2025 it is pulling them all under the umbrella of one quality control mechanism to make sure the four work together.
LaGrange announced Monday Dr. Lyle Oberg will be heading up the seamless patient experience review, to hold accountable the agencies responsible for primary care, urgent care, continuing care, and the newly-created Recovery Alberta (for mental health and addiction).
This is expected to “make sure that when new provincial health agencies become operational, service providers deliver care in a manner that puts patients and their health first.”
“It’s a review to ensure Albertans using the health care system have an integrated, consistent and seamless patient experience,” said a release from LaGrange’s office.
Oberg will provide “recommendations to the integration council on the implementation of seamless patient experiences in the context of the refocused health care system.”
“When we began refocusing the health care system, we said that improving the patient journey would be at the centre of this work. I am confident Dr. Oberg will provide insightful recommendations that will support the overall efforts to improve health care for all Albertans,” LaGrange said.
Oberg will report directly to the minister of health and will provide an interim report in December to support the launch of the new provincial health agencies. A final report with recommendations will be provided to the integration council in March 2025.
A new chair is being appointed to fill shoes Oberg held since October 2023 at Alberta Health Services.
Effective Sept. 19, Angela Fong will take on the leadership role, and Oberg will remain an AHS board member.