Alberta physicians’ group keeps finger on pulse of delayed pay plan

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A looming gap between fiscal calendars could be a headache as the province has yet to sign off on a plan for primary care physician practices beleaguered by inflationary cost spirals.

A year has gone by since the Physician Comprehensive Care Model (PCCM) was promised, then drafted in the spring, and left unbudgeted in the current fiscal year.

Meanwhile, other Western provinces have settled on more modern physician compensation strategies in a field where competition for primary care physicians is fierce.

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“We’re still working on it, would be the way I would phrase it,” said Dr. Shelley Duggan, president of the Alberta Medical Association (AMA).

There’s no formal “pens to paper” yet, Duggan acknowledges, adding she has met with both Health Minister Adriana LaGrange and Premier Danielle Smith.

“Again, they have indicated to us that this is a priority for them, that they foresee this happening,” she said, adding the AMA is “cautiously optimistic we will get somewhere.”

“We are at least keeping the lines of communication open to see where we can get. I think all indications would be that we should be up and running with the PCCM as of April 1,” she said.

“One of the things that we did communicate with the premier is that for a lot of family physician offices, year-end is December, unlike the government, who has a year-end of April. It’s going to be important that they know as they reach their year-end if this is really coming in April 2025 or not,” Duggan said.

“I think it’s important, though, that even if we are not going to start enrolling people into the PCCM until April 1, it’s important that that announcement comes sooner rather than later, right? Because it will make a difference for people who are barely hanging on, to know what’s coming. So our indications would be that if it’s coming, it will come in on April 1,” she said.

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Meanwhile, bringing $42 million to the table shored up primary care for Alberta’s urban vulnerable population and up to 30 rural communities this week.

The measures announced by LaGrange included $6 million in matching funds to help up to 30 rural communities form their own clinics, $6 million for rural team building, and $30 million to support four inner-city clinics to support vulnerable urban individuals.

AMA wants physicians to indicate change

While the AMA doesn’t have a specific count on how many doctors are poised to move to other jurisdictions or leave comprehensive care for less stressful or more stable specialties, Alberta’s organization for doctors is about to open a category on its website to give them a better idea.

Doctors will soon have a chance to telescope major practice changes, said Duggan.

“We don’t know how many we’re at risk of losing. And so to that end, the AMA is creating on our website (for logged-in members) a ‘practice change,’” Duggan said.

When an Alberta primary care physician closes shop to either retire, leave the province, or switch to a hospitalist or other specialty, thousands of patients can be left without a primary care home.

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“We will encourage physicians who are thinking of changing their practice to input what it is they’re planning to do. That is coming so that we can answer that question, right? Because it’s important that we all know how many physicians we’re going to lose, and particularly physicians who are providing comprehensive care and moving to something other than that,” she said.

Meeting with primary care czar

This week, Duggan met with Dr. Kim Simmonds, head of the newly established Primary Care Alberta, the organization hived off from Alberta Health Services to consolidate primary care around the province.

“As the AMA, we thought it was quite important to chat with her sooner rather than later, get a sense of what her ideas were, and to see how we can work together,” she said.

Duggan said she expects a “reasonable partnership” with Simmonds for her organization.

“We obviously share a similar goal, which is to make primary care the foundation of the system, to stabilize it and to really build upon it. So we thought it was pretty necessary to meet with her quickly,” she said.

“She’s got some great ideas. I think she certainly wants to involve and hear the voices of the family medicine specialists,” Duggan said, citing things like contracts for bulk buying to save on clinic supplies.

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Once primary care’s sorted, acute care will follow closely.

“The two of them are tied. One will help the other, obviously,” Duggan said.

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