Alberta doctor withdrawing services says any new aid won't fix core trust issue

One of numerous doctors giving up hospital work due to funding changes says even if Alberta delivers extra support for rural physicians, it doesn't solve the underlying problem.

Dr. Samantha Myhr, who works in Pincher Creek, says the fundamental issue is that the government cancelled a master agreement with doctors earlier this year and imposed billing changes that physicians say threaten the viability of their practices, especially those outside big cities.

The government has since rolled back some of the changes. But Myhr suggests any help it may decide to give doctors can just as quickly be taken away, since the province passed a bill late last year giving it the power to do so.

"This government, or any government in the future, can just make changes with the stroke of a pen now," Myhr said Thursday in an interview.

"We really need some stability in our health-care system, and the only way that we're going to get that is with an agreement.

Health Minister Tyler Shandro is scheduled to announce further help for rural doctors at a news conference Friday.

Myhr said such support may work for some doctors trying to keep their doors open, but added: "I don't know if it does change anything for us."

Giving notice,withdrawing services

The Alberta Medical Association, which represents physicians, has filed a lawsuit against the government in which it demands fair and reasonable negotiations toward an agreement and the right to arbitration.

Myhr is one of the doctors at The Associate Clinic, which is attached to the Pincher Creek Health Centre, to announce this week that they are withdrawing some or all hospital services, including delivering babies.

Myhr said seven of nine doctors are withdrawing services while the other two are still deciding what to do. They have given 90 days notice to help get their patients through the COVID-19 pandemic

They are among physicians from around the province, including Stettler, Lac La Biche and Sundre, who are giving notice they are pulling back on services due to, among other things, billing changes.

Myhr said the issue includes the end of overhead payments to doctors who work in hospitals, where such payments are made by Alberta Health Services.

The Alberta Medical Association has criticized that as an ineffective, cookie-cutter approach and has pointed out that doctors in AHS facilities have a range of counter-balancing financial agreements in place.

Myhr said in her case the clinic is attached to the hospital and she moves back and forth between the two. She is now paid less for work she does in one part of the building compared with the other.

She said another problem is reduced government funding for medical liability insurance, which makes delivering babies out of reach financially in a rural setting.

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The United Conservative government has responded to some concerns.

Shandro rolled back changes to extra payments, called complex modifiers, for longer patient visits.

He has also delayed a plan to end salary top-ups that were brought in when there were multiple health authorities. There are also new billing codes to compensate doctors for virtual and phone work during the pandemic.

David Shepherd, health critic for the Opposition NDP, said Shandro needs to repeal legislation allowing the government to dictate agreements with doctors, roll back all recent billing changes, and negotiate a new deal with doctors through binding arbitration.

Roger Reid, the UCP member for Livingstone-Macleod, which includes Pincher Creek, said in an email he is working with Shandro on the doctors' concerns.

"I have shared the unique challenges we face in rural health-care delivery with the minister, and he has committed to responding in the near future," said Reid.

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