Local physicians raise concerns over future of health care

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Pincher Creek’s doctors rallied together for a town hall at Verticle Church on Monday, March 2, to inform residents about how provincial changes to health care funding can adversely impact the quality of health care that is found in the community.


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Hundreds of residents sat in the audience to listen to physicians from The Associate Clinic about how provincial changes surrounding health care funding will adversely affect rural communities, and Pincher Creek in particular.

Ernst and Young’s Alberta Health Services Performance Review was prominently talked about during the town hall.

The summary report was released on February 3, and according to the province on, was accepted under the conditions that there will be no hospital closures and no urban trauma centre consolidations.

Despite the provinces stance that no hospitals be closed, Dr. Jared Van Bussel pointed out that the small and medium hospital findings within the report make a different suggestion.

In the second point on page 98 of the Ernst and Young Report, it reads, “of the 83 small/medium facilities outside the main population centres, 77 emergency departments within small/medium community facilities in Alberta meet the criteria to be considered for reclassification or consolidation.”

Van Bussel said that indicates that 77 small and medium hospitals around the province would effectively no longer be hospitals if the suggestion acted upon, and would serve a different function.

“What that means is perhaps going to an urgent care model, or going to a reduced hours model, which makes a difference in the staffing in the hospital… and in the physicians,” said Van Bussel.

The following point in the report reads, “36 acute sites do not meet the criteria for clinical viability in their current configuration.”


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Van Bussel said it could affect the amount of patients a location is capable of accommodating.

“This means they have to do something with the patient beds in order to make it viable. Some of that may be a reduction, or the types of beds that they are, whether it’s long-term care beds or otherwise,” he said.

Van Bussel said the report suggests changes that could impact the availability of maternity care, which would also adversely impact other avenues of care.

“Maternity care really is the leash pin of rural hospitals. The reason is, is that things that need to be in place for maternity care to work are all the things that support the other functions of the hospital,” he said.

The Ernst and Young report observes that 28 small and medium hospitals across the province have maternity care services, and on average support 201 births annually.

The report says that less than 250 births is sub-optimal.

Dr. Tobias Gelber, who also sits on the Alberta Medical Association (AMA) Board of Directors, said that the negotiation process with the province so far has built a level of mistrust.

April 1, 2018 saw the creation of a negotiation agreement between the AMA and Alberta Health come into place, which is set to expire on March 31 this year.

On Sept. 3, 2019, the AMA received a letter from the province inviting them to the table for negotiations, which Gelber observed is standard policy.

He said by October 28, before negotiations had begun, Bill 21 reached legislature for first reading.


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“There was two things in Bill 21 that affected us in health care. One—it gave the government the ability to tear up AMA contracts if it so chose, and the second thing it did was it gave the government the ability to limit billing numbers so it could restrict where people could go,” said Gelber.

“Ostensibly, that was there so it could help serve rural communities, or underserviced communities. There are many people who would look at our community and say that we’re adequately serviced—we’re blessed to have nine physicians here in a community of 3,600. What they don’t recognize is that we actually serve a population of 10,000, and are trying to recruit new physicians,” he said.

“If outside forces do not recognize that, then there’s a very real possibility that we could be on the list where we would have restricted billing numbers, and would not be able to recruit, or fill in for people who leave for retirement.”

In her opening statement, Dr. Samantha Myhr said that Pincher Creek’s physicians felt the need to host the public discussion out of passion for the job and the community.

“We’re here because we care about our patients, about (the community) as our neighbours, our friends, we care about providing excellent health care here in Pincher Creek, and we care about each of our health care in Alberta,” said Myhr.

“We’re concerned because the recent changes—and there have been many of them—all seem to amount to a threat to rural health care in particular. We’re concerned for what it means for our ability to continue providing… the excellent care that we’ve been able to.”


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Myhr said the consensus among rural physicians is that they’re willing to make cuts, but said there are other ways to do so without adversely impacting rural communities.

“We’re willing to take cuts. That’s been our position all along—we want to be able to help balance the budget, but in a way that doesn’t affect (the community),” she said.

During a question and answer period following physicians’ presentations, Gelber said that The Associate Clinic has no plans to reduce staff.

“At the present time we have absolutely no desire or plans to change our staffing levels at all. The physicians are going to try to get creative to find a way to make this work,” said Gelber.

The meeting fell on the same week that 568 physicians from around the province signed a 19-page letter penned by Dr. William White, a Calgary-based psychiatrist, urging Alberta Health to reconsider the impacts of the changes to doctors’ compensation.

Pincher Creek physicians didn’t sign the letter as they weren’t aware of it in time, but Gelber said that they would have if they were aware.

During a news conference on March 4 in Edmonton, Health Minister Tyler Shandro said he wasn’t aware of the letter, but marked growing concerns about government changes to a misunderstanding among doctors.

“I do know there has been a lot of misunderstanding among our health professionals in the province about what was changed. I look forward to being able to continue those conversations with rural and emergency physicians to be able to explain the misunderstanding,” said Shandro.


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Gelber agreed that there is a misunderstanding, but it’s on Alberta Health’s part.

“I believe it is the (Ministry of Health) that has the misunderstanding. They have no idea the impact that cutting comprehensive primary care is going to have on the system,” said Gelber.

“They’re not admitting the fact that through removing the complex modifier they’re cutting family doctors by up to 30 per cent.”

Shandro assured that only the minimum of 15-minute complex modifiers are the only ones that are being removed, but Gelber said anything above that is essentially useless.

“I would submit that well over 95 per cent of visits that use the complex modifier, use (only the 15-minute) complex modifier,” said Gelber.

“Given that most people only use (the 15-minute complex modifier) they have effectively eliminated it.”

The Government of Alberta held third reading for Bill 21 in December of last year, and changes to how doctors can bill their services are set to be put in effect for April 1.

The first impacts people may see in their visits to physicians may be shorter visit times with doctors, and those who do consultations with visiting specialists may be forced to drive elsewhere to meet their specialists.

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