When Dr. Cian Hackett came to Rimbey in July of 2018 he was excited and looking forward to serving as a physician in a rural community.
Now, with the latest changes about to be imposed by the Alberta government to physician rules and fees, he is concerned, not only for the physicians, but for the patients who depend on them.
As of March 31, the UCP government will be implementing a new funding framework which they say is necessary to prevent cost overruns and align benefit programs and administrative fees with other provinces.
One of the primary changes includes extra billing by doctors to compensate for visits which exceed 15 minutes.
Presently doctors bill $41 as a base fee for each patient visit of 15 minutes. If the visit exceeds that time limit, an additional $18 is charged to the province. As of March 31, that fee will be cut to $9.
Health Minister Tyler Shandro said physicians were billing the extra fee for half of the eligible visits, even if the extra time wasn’t required.
Dr. Hackett said the government is encouraging physicians to shorten visits in order to save money and not taking the patient’s health concerns into consideration.
He said many patients require more than the 15 minute time slot allotted for a regular visit, and physicians will continue to do their best to give their patients quality care. However, the financial implications of the funding cutbacks does adversely affect physicians who are small business owners operating a medical clinic which includes associated costs.
As well as the changes that are coming this month, Hackett is worried about the possibility of the province reducing the hours of operation in emergency departments.
In an excerpt from Ernst & Young Alberta Health Services Review it states 77 emergency departments within small/medium community facilities in Alberta meet the criteria to be considered for reclassification or consolidation.
Reduced hours of operation (typically around 16 hours per day) could be more suitable, the review states.
Dr. Hackett said if such a change was implemented at the Rimbey Hospital it would drastically affect patient care. He added it is absolutely crucial that the emergency department remain open at night.
“The sickest patients come in at night,” he said, adding medical care needs to be immediate, and can, in fact, be a matter of life or death.
He said labour and delivery services may also be at risk in small hospitals such as Rimbey.
During negotiations the Alberta Medical Association’s offer of short term savings worth over three per cent was turned down and the province cancelled the master agreement with doctors.
Dr. Hackett said the government’s “attitude towards health care” and “the broken trust” that has come about due to the recent changes is causing physicians from Alberta to look elsewhere.
“The atmosphere is so volatile right now,” he said. “It has caused some (former) medical students to not continue with their studies in the field of medicine.”
Dr. Hackett encourages the public to be proactive and speak to their MLA and write to the Minister of Health stating their opposition to these changes.
“We need community support. We need a voice speaking out. A very loud voice.”
AMA’s president, Dr. Christine Molnar, said the organization is preparing for a court fight.
She said that denying doctors binding arbitration is violating their rights under the Canada Health Act and the charter.
Molnar made the comments a day after Health Minister Tyler Shandro announced Alberta was terminating the master agreement, even though the current contract doesn’t end until March 31.
Last fall, the government passed Bill 21, which gives the government the right to unilaterally end its current agreement with the AMA.
Earlier this month, Ernst & Young recommended the government adjust physician compensation to align with other provinces following its review of Alberta Health Services.