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Has the province reversed course in any of the areas that your colleagues were expressing con- cern over in May? What needs to be rectified in your opinion? “Since our letter was published on May 6, 2020, the Alberta


provincial government continues to receive an unprecedented amount of feedback from physicians and concerned citizens of Alberta.One of the most pressing concerns is that physicians no longer appear to have a voice in shaping our healthcare system. Bill 21,which was passed in December 2019, paved the way for the Health Minister,Tyler Shandro, to unilaterally terminate the govern- ment’s agreement with the Alberta Medical Association (AMA), which he did on February 21, 2020.The Ministry of Health thereby granted itself complete power and control to make all decisions inde- pendently, without regarding the opinions of the experts who actually work in the healthcare system. Instead of responding to the feedback with concern and attention,the Ministry of Health forged ahead with their agenda.The damaging legislation and policies that they imple- mented have not been reversed.No meaningful progress has been made in negotiations and, under the distraction of COVID, this govern- ment has forced through further legislation that threatens public healthcare as we know it. Bill 30 was passed without adequate review or debate, and in the middle of the night.” “Minister Shandro needs to get back to the table with the Alberta


Medical Association.Bill 21 and 30 need to be repealed.Alberta is the only province in Canada without a formal agreement between its physi- cians and health ministry.”


At the time,why did you and your colleagues want to express your message publicly,and do you feel the province is listening to the con- cerns of rural doctors? “Our unified message, signed by the ten physicians of the Taber Clinic, was a way to show solidarity with our rural physician colleagues and shed light on these concerning issues. For the record,we still do not think the province is listening to the concerns of rural doctors or patients. In the middle of a chaotic environment for doctors due to the COVID pandemic,our government is dismantling the existing frame- work of physician funding in Alberta.The Taber Clinic has been recog- nized nationally for years as an effective model for delivering primary care,and we are funded primarily by a unique Alternative Relationship Plan (ARP) rather than fee-for-service billings. Despite the fact that our funding was more stable than that of rural physicians in other commu- nities,we felt that we could not be silent as all physicians in Alberta and the Alberta Medical Association were disparaged and mistreated by this government.”


From what you’ve been seeing and hearing,do you think there will be an exodus of doctors out of rural Alberta under current conditions? “There may not be a mass ‘exodus’, but our province is already losing rural doctors due to the current conditions.The announcements about


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physicians leaving or closing practices because of government policies have been in the news and social media for the past several months.Under these conditions,doctors in the latter stages of their


careers are more likely to retire early,and new graduates or those without strong Alberta roots may look for stability and a healthier work environment elsewhere.We are very concerned about the damaging effects on recruitment of future physicians to serve Taber and all of Alberta.”


What has been your overall impression of how Minister Shandro has handled his portfolio since taking it on? “Our overall impression of Minister Shandro’s handling of his


portfolio is that he has done much more harm than good.Our reac- tions to his decisions have been a combination of disappointment, bewilderment, and outright frustration.There is an unprecedented level of animosity coming from the Health Ministry directed at Alberta physicians.Minister Shandro’s Press Secretary, Steve Buick, and his Issues Manager,Tara Jago, seem intent on repeatedly proclaiming that the Alberta Medical Association leadership is dishonest, that Alberta’s doctors are overpaid, and that the government has been infallible through this crisis. In a recent vote conducted by the Alberta Medical Association, in which 8,934 Alberta physicians, residents, and medical students participated,an overwhelming 98 percent voted non-confidence in the Health Minister,Tyler Shandro.The lack of wis- dom whereby the Minister of Health set out to achieve healthcare savings by cutting Primary Care is baffling. It is well proven that strong Primary Care providing Patient Medical Homes, for which Alberta was ranked #1 in Canada for 2019, is what creates savings and a healthier population.”


What kind of model do you believe would most effectively meet the needs of rural doctors and patients alike? “There is no one-size-fits-all model for rural doctors and patients, nor should the government try to mandate one.The Taber Clinic’s ARP has been successful for the past 20 years, and the model has served our patients and community well.We are able to offer comprehensive mul- tidisciplinary care and significantly reduce downstream costs associat- ed with ER visits or hospitalizations.However,many factors, including the size of a community,the number of doctors practicing, the proxim- ity to larger hospitals, etc. all influence the way that healthcare can be delivered.We hope that the government would offer the flexibility to permit rural healthcare to be delivered in the way that makes the most sense for each individual community.” “We want members of our community and surrounding areas to be


aware of these important issues that affect all Albertans,and voice their concerns with our elected representatives.We hold hope for con- flict resolution between the Government of Alberta and the AMA and physicians of Alberta such that we can innovate together to continue the healthcare successes we've achieved and strive for even better.”


insight magazine september 2020 - 9


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