Family physician Peter Bouch is concerned about the provincial government’s proposals to reduce costs associated with primary medical care. (Photo by SUSAN ZIELINSKI/Advocate staff)

Red Deer doctor fears ‘end of family medicine’

Alberta can say goodbye to better access to family physicians if the provincial government goes forward with proposed funding cuts, says a Red Deer doctor.

Dr. Peter Bouch, with the Red Deer Primary Care Network, said improvements made to primary care will be lost because 85 per cent of the proposals impact family physicians.

“If they go with these cutbacks as they are proposed, it will probably mean the end of family medicine as we know it right now,” Bouch said Wednesday.

As part of negotiations with the Alberta Medical Association, the province has proposed changes to doctors’ fee structure that the AMA says will largely impact the elderly, those with chronic and complex conditions, and those living in rural or remote areas.

But a government spokesman said nothing in the proposals will harm the ability of family doctors to give high-quality primary care.

“We spend $5.4 billion a year on physicians. Spending is out of line with other provinces and there needs to be some modest reductions to get costs in line,” said Steve Buick, press secretary to Health Minister Tyler Shandro.

Bouch said currently, family doctors receive additional pay when they spend 15 minutes with patients. The province proposes that the fee increase will kick in when the visit reaches 25 minutes.

If that happens, doctors who don’t think they will need the full 25 minutes, will only spend a maximum of 10 minutes with patients, he said.

“It will be a loss to the patients, and it will be a loss to us as well, because we need to spend more time with people,” said the family doctor.

Spending less time with patients defeats the point of primary care, he said.

“It’s going to be the downfall of family medicine. You will probably see a lot of family doctors leave the province, or their work time is going to be cut back, and that’s going to be detrimental to the patients in general.”


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He said another controversial proposal is capping the number of patients a family doctor can deal with daily. Physicians would only receive full payment for their first 50 patients. Pay would decrease to 50 per cent for their 51th to 65th patient, and doctors would not be paid once they reach their 66th patient of the day.

Bouch said doctors are paid less if they contact patients by phone, or speak with staff at a hospital or nursing home regarding a patient. If those calls are included in the daily patient cap, doctors will change their focus, he said.

“That means a lot of doctors are going to give up their long-term care commitments. They do see (residents) on a regular basis, but they also get a lot of phone calls and faxes from nursing homes.”

Bouch said instead of dealing with patients efficiently by telephone when appropriate, doctors will make them come into the clinic and wait.

Buick said the province’s proposals are common-sense revisions, such as paying doctors for overhead costs only if they have to pay them, not if they work in a publicly funded facility.

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