The billing rollbacks announced by the provincial government to rural doctors’ fees show the lack of stability and trust in the administration, says a Rimbey physician.
Dr. Cian Hackett, who works at the Rimbey Medical Clinic and Rimbey hospital, said if anything, Friday’s announcement reaffirms his decision to leave the community once the COVID-19 pandemic is over.
Hackett says he wants to practice where he feels respected and valued. The doctor announced the decision when the Alberta government went ahead with changes to a funding framework on March 31.
Alberta reversed some changes to fees and added millions of dollars in extra cash to stop rural doctors from pulling back from hospital duties on Friday.
Health Minister Tyler Shandro said the changes total $81 million, including top ups for doctors who work in rural and remote communities.
“There’s absolutely no stability. It all goes back to what everybody needs in their job: some sort of agreement that’s going to be lasting that outlines the terms of employment,” said Hackett.
“The government’s track record is they continually change the rules on us month by month.
“There’s even less trust after the announcement on Friday.”
On Friday, Shandro addressed two concerns that have prompted some rural doctors to announce they must cancel hospital duties because they can’t make a living under fee changes imposed by the minister in March.
Physicians at Sundre’s Moose and Squirrel Medical Clinic said earlier in April they would no longer be able to provide patient care at the local hospital.
Shandro said Friday one of those rule changes — to no longer allow rural doctors to bill for overhead when working in a hospital — had unintended consequences.
A plan to change fees for longer patient visits — called complex modifiers — has been scrapped and other rollbacks on physician salary top ups, called clinical stipends, have been deferred. Hackett agrees this piece of information is welcoming.
But the rest of the changes and the instability from the government remain concerning for the central Alberta physician.
On Friday, Alberta Health published a bulletin to all doctors describing changes to the Rural Remote Northern Program, which allows doctors to access additional pay for working in listed communities.
The bulletin included a revised list of these communities, with 141 centres missing, including Lacombe, Blackfalds, Sylvan Lake and Penhold.
The government received social media backlash over it on the weekend.
On Sunday afternoon, Shandro said on Twitter there is no change to the list of communities where physicians are eligible for program payments.
“Alberta Health posted a revised list in error. The list and bulletin will be corrected,” said the minister.
Alberta Health said the bulletin “was published with incorrect information and did not list 141 communities.”
“We apologize for this oversight and will be revising the bulletin and community list on Monday,” Alberta Health’s Twitter account said Sunday afternoon.
Hackett said based on the various Twitter posts by the minister and his staff, “it appears they have no idea what they’re doing to the health portfolio.”
“Error, incompetence? They got caught and they’re back pedalling yet again?” Hackett said Monday.
David Shepherd, the NDP’s health critic, said the “oversight” doesn’t stand up to scrutiny.
“The suggestion that this list of eligible communities was cut by almost a quarter using specific criteria, by mistake, and that this mistake went undetected by the policy staff, the assistant deputy minister, the deputy minister, and the minister himself, and was then published to all of Alberta’s doctors, is preposterous.”
Hackett said physicians’ expectations of the government haven’t changed, arguing that the government needs to work with doctors.
“What we need is a signed, negotiated agreement with Alberta Medical Association, and that ask hasn’t changed, and the announcement on Friday hasn’t changed that. No physician trusts anything the government changes right now.”
The Alberta Medical Association said the announcement made Friday is a positive first step, which will help physicians in the short term, but said the lack of certainty, clarity and collaboration in the government’s approach to physicians needs to be addressed.
“We need long-term solutions to real challenges, not one-time ad hoc decisions. We need a partnership between physicians and government.”
With files from The Canadian Press