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AMA weighs in on doctor dust-up


BY NIKKI JAMIESON insight magazine


The dispute between doctors and the province has been a public one. In November 2019, the province and Alberta Medical Association started negotiations for a new agreement, and it quickly became apparent that things weren’t going to go smoothly. “We were kind of surprised when the negotiations began,and the gov- ernment immediately introduced 11 consultation proposals that affect the way doctors work and how they’re paid,and that we felt should actually be part of the negotiations, but they wanted them outside of the negotia- tions,”said Dr.Christine Molnar,president of the AMA, in an interview at the beginning of September.“We didn’t agree with that, but they did eventual- ly agree to have them discussed within the negotiation framework.” Negotiations had started after the public release of the MacKinnon


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report in September 2019, which claimed Alberta physicians made 35 per cent more than in other places in Canada.This,Molnar said “is just not the fact”. While they may have made eight to 10 per cent more at the time — something she said likely has changed now — it was similar to what other Albertans had enjoyed at that time, due to factors like cost of living. Molnar said typically,physician compensation contracts over the years


have been based on rates, roles and responsibilities of physicians in the health care system.The contract the provincial government introduced, however, was a budgetary contract. “What this government has wanted and demanded — and we have


agreed to now — is basically a hard-cap budget, which means they’ve set a budget,and they do not want to go over,”said Molnar, adding the province felt a $5.4 billion budget was good enough for the next few years.“The problem with that, from our point of view — although we agreed to work with them on that for the sake of Albertans — the problem is that year over year, all across Canada, because our populations are increasing, our populations are aging and requiring more services.When your population increases, it requires more services; more people have babies,more people get sick,more people get injured,more people need care, that all costs money.When your population ages,they need more services too.” Along with inflation, all of these things increases the cost of health.While Molnar acknowledged it was a lot of money, if you have a capped budget that is set for a few years, it would mean either they could offer less servic- es than needed, or they are paid less for performing the services needed. “I think that’s the fundamental issue that we’ve been grappling with, with


the government.Who is responsible for the services that Albertans need? Are you really asking Albertans to have less services? Do you really think it’s fair that physicians who repaid for there services are now paid less because we have more patients that need more care,and so we have to be paid less and less and less as that grows? Is that really fair?” In Ontario,Molnar noted that courts there had ruled that physicians should not be held responsible for increased utilization. Another problem was the province “denied them”a dispute resolution


process such as arbitration,which was something the Canadian Health Act recommends as physicians are not allowed to bill for their services.This, said Molnar, is the principle issue in their current lawsuit against the province. “It’s not about money, it’s about our rights,”said Molnar.“Above and


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beyond the desperate economic climate that we’re in right now,we need to proceed fairly in that climate to address disputes and to work together to find solutions.”


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