Alberta doctors ready to roll with new care model

By Al Beeber - Lethbridge Herald on August 13, 2024.

LETHBRIDGE HERALDabeeber@lethbridgeherald.com

The president of the Alberta Medical Association says it’s urgent that the province approve the physician comprehensive care model before fall.
Paul Parks, an emergency room doctor in Medicine Hat, said in an email late last week to media that no firm date has been set for the model’s approval.
Since then, the province has told The Herald the approval is scheduled for September. Premier Danielle Smith addressed the matter Saturday on an Alberta radio show, saying she hopes to get the matter settled within weeks before Parks’ term as president of the AMA ends.
In her radio show that airs on 630 CHED Saturday’s at 10 a.m., Smith told a caller that Parks is “really quite a champion” on the subject, saying “I’m so impressed at how much he has prioritized this…when he came in as the president, he knew that this was a piece that was going to be essential because once you get everybody with a family practitioner, it’ll put less pressure on the hospitals.”
Smith said she has told Parks she wants to announce approval of the model before his term expires because “he knows the most about it, he’s done all the hard work on it. So we’re talking about weeks,” adding there is some tweaking being done.
In a statement to the Herald Monday, Parks said the Physician Comprehensive Care Model has been essentially finalized since April with “an incredible amount of work done by government and the AMA” on it.
“We are ready to roll. We must get this model out there. The urgency is real. We had docs almost a year ago who said they couldn’t carry on with their businesses if we didn’t act quickly. Just look at many rural towns like Hinton where emergency rooms and community clinics go unstaffed by physicians,” said Parks.
Every week I’m hearing from someone who is leaving comprehensive care because they can’t afford to keep going. Without the new model available, they aren’t renewing their leases or able to keep their staff. They are feeling hopeless and leaving practice.
“We can’t delay any more and every day is a day too long. I’m hoping very early September for the PCCM. They have said it would be locked and done so let’s do it. Implementation is key to start supporting these family and rural practices so doctors can resume seeing patients and more patients. That’s the end result we need – not just making the announcement.”
Parks said implementing the model will be extremely positive for Alberta but it won’t be the solution to every issue.
“We have lots of issues brewing around safe access and care in our hospitals where there a concurrent crisis is growing as we struggle to save family and rural medicine. In supporting primary care, we also have to bolster and restore acute care in the hospitals, he added.
Smith told her audience that doctors salaries in Alberta are $6.7 billion, which she called the largest line item of Alberta government funding for any employee groups.
“We know the demand is going to keep going up, we are very generous with our doctors and we want to continue to be generous with our doctors,” said Smith, noting the new funding arrangement will hopefully incentivize more doctors to be in primary practice.
Smith said the province has learned that doctors have increasingly over the years reduced the number of patients they were willing to take.
“We’ve got 500 doctors who have less than 500 patients, some as low as 200, said Smith, “and we know that to be able to give continuous care from cradle to grave, manage chronic diseases, we need doctors to have a minimum patient load of 500.
“We have to have doctors working in rural hospitals, yes, but if you’re going to make sure that when you call and get an appointment you have to have a doctor that has enough patients that they’re working more than one day a week,” added Smith.
“I know that’s frustrating for some doctors, doctors are going to have to make choices. We’re actually being a lot more generous in what we’re proposing to doctors in giving them more time to work in hospital. With nurse practitioners, we’re asking them to have a 900-patient panel so those are the kinds of things we’re putting out there. We know that doctors increasingly have decided not to have practices and we want to create a funding model of team practice, so that we’ll get more people in.”
Smith said there are between 600,000 and 700,000 patients without a family doctor.
“We want to every single person to be attached to a family practice,” said Smith.
Parks said last week the acute care system is overwhelmed by complex diseases and increased illnesses while cancer care wait times are increasing and surgeries, treatments and tests are disrupted.
Parks believes the province is facing potentially between 800,000 and 950,000 patients lacking primary care thanks to existing shortages and the demands of new residents coming to Alberta. The province has lost 2,471 practising physicians in the last five years, according to Parks.
The province announced in spring it had developed the new model in consultation with the AMA to try to retain family doctors in Alberta.

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