Dr. Gerry Prince, who helped establish the Family Medicine Maternity Clinic at Medicine Hat Regional Hospital, is seen at the clinic in a file photo from earlier this year. The future of the clinic is in jeopardy with two-thirds of the doctors considering no longer participating due to changes in compensation and funding.--FILE PHOTO
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The future of the local Family Medicine Maternity Clinic is in jeopardy as two-thirds of its physicians contemplate leaving.
Dr. Gerry Prince, who was instrumental in the establishment of the clinic 17 years ago, says one physician has already ceased obstetric services and of the remaining eight, at least five are considering a similar move.
“The uncertainty created by Health Minister Tyler Shandro’s threatened changes … affects our ability to provide the service and undermines the confidence of our doctors to be able to continue,” said Prince.
Not only has compensation for physicians at the FMMC changed, since the government cancelled the contract and implemented a new fee structure on April 1, funding for the clinic itself is now uncertain.
Prince says previously the Palliser Primary Care Network covered 80 per cent of the budget.
“The provincial mandate for the PCN has changed so that’s not a part of their requirements anymore,” said Prince. “The funding has shifted more onto AHS (Alberta Health Services) directly.”
This will require AHS to build this into its funding model, and in the current environment that is tough to do, said Prince.
AHS was on board in establishing the local maternity clinic originally because there was a shortage of doctors willing to do obstetrics. In Medicine Hat that number had dwindled to just three.
“It was built to stabilize the supply of general practise physicians doing obstetrics,” said Prince.
The Family Medicine Maternity Clinic handles about half the deliveries in Medicine Hat each year for a total of 500 to 600, and that means 6,000 to 9,000 prenatal visits each year.
FMMC provides a core group of doctors who developed “a streamlined, efficient method of care to ensure all of the important things through a pregnancy are monitored,” said Prince, who added that the clinic’s staff are very experienced.
This is much more difficult for an individual family doctor to provide in a general practice, Prince says, and the streamlined process at the clinic is more cost effective with improved quality.
If Alberta Health pushes ahead with funding changes, that directly affect doctors at the local clinic, the final crunch time will occur, he says.
Generally doctors do 24-hour on-call shifts at the maternity clinic four or five times a month, and Prince says funding change makes that not viable. The stipend paid per hour while on call was $18, and that has dropped to $11. The stipend was put there so that they were not out of pocket when not seeing patients at their own clinic but continue to have those overhead expenses. This change was supposed to happen at the end of August but implementation has been delayed until spring next year, said Prince.
“The minister threatened to reduce the fee by 20 per cent for all visits done in hospital,” said Prince, noting the Family Medicine Maternity Clinic is located in the hospital.
Patients already in the clinic will be taken care of but at some point new patients would not be taken on, Pricine says.
“It would be a tremendous loss. I think the minister does not recognize the profound effect that these proposed cuts have on … Medicine Hat.”
Most doctors do not deliver babies and some can provide the care up to a point. Liability means many can provide prenatal care to about 20 weeks, said Prince.
“Beyond that they have to have a very clear plan of who is going to deliver that baby.”
Obstetricians could take on some but there are not enough, and midwives are already operating at near capacity, he said.
