The provincial government has announced plans to restructure the way physicians are paid in Alberta.

According to Health Minister Tyler Shandro, Alberta spends more on physician salaries than other provinces in Canada. He says the current compensation model is broken and the province is going to fix it.

"An Alberta physician earns about $90,000 more every year than a doctor in Ontario," says Shandro. "More importantly, at existing growth rates, we would spend another $2 billion in the next three years beyond the current $5.4 billion and that's just not an option."

Shandro says the UCP campaigned on holding the line on health spending and intends to do just that. He says adding another $2 billion over the next three years is not sustainable and would impede efforts to reduce surgical wait times, improve mental health and addiction services, and expand the number of continuing care beds.

"The new framework will maintain physician funding at the current $5.4 billion, the highest level it's ever been, and Alberta will continue to have among the highest paid physicians in all of Canada," Shandro says, adding physician pay is one of the biggest financial challenges in the province with it making up a quarter of the health budget and 10 per cent of the overall provincial budget.

Shandro says at no point during negotiations or mediation with the Alberta Medical Association in recent weeks did the AMA bring any meaningful proposals to the table to hold the line on health spending.

On March 31, 2020, the province will implement 11 consultation proposals including the phasing in of complex modifiers, reducing the rate physicians can charge for this billing code to $9 from $18, for a period of one year before the code is removed in 2021-22. This Summer, Shandro will introduce a new alternative relationship plan to encourage physicians to move from fee-for-service to a three-year contract.

David Shepherd, NDP Official Opposition Critic for Health, says the new framework will impact patient care.

"This chaos is going to be felt most especially in rural areas. Family physicians warned Jason Kenney in November that his plan would devastate rural care, with job losses and the closure of entire clinics," says Shepherd. “It’s widely acknowledged that Alberta needs to contain the growth of physician compensation. It’s a problem that Conservative governments created. But I really question why this government chose to cut the most and the deepest from family doctors. It’s almost like a plan designed to inflict pain on the largest number of people.”

Shandro says he believes the changes will be good for patients.

"This is about us trying to say, if we're going to spend $5.4 billion on physician compensation, how do we make sure we're using that in the best way for patients so that we're making sure we get more care in the system. That's where our focus is on the changes we're making, is how do we make sure the patients have more care," says Shandro.

Elements of the new funding framework include the following:

  • Changes to Alberta’s complex modifier billing system. The rate physicians are able to charge for complex modifiers will be reduced to $9 from $18 for a period of one year before this billing code is removed in 2021-22. Once the new framework is fully phased in, physicians will be able to bill an additional fee after spending 25 minutes with a complex patient case. Alberta remains the only province in Canada that allows for a top-up payment for complex visits.
  • Removal of the comprehensive annual care plan from the list of insured services. Currently, physicians can also bill for a similar consultation called a comprehensive annual visit. No other province in Canada compensates physicians twice for annual care consultation.
  • Implementation of a new daily cap, modelled after a cap in place in British Columbia, of 65 patients per day. Large patient loads can contribute to physician burnout and may compromise patient safety and quality of care.
  • Removing physician overhead subsidies from all hospital-based services. Physicians who work in AHS facilities should not be billing for overhead costs that their community physician colleagues face, such as leases, hiring staff and purchasing equipment.
  • Ending of clinical payments, or stipends, by AHS to physicians. This change ends duplication of payments to contracted physicians.

To read more on the new physician compensation framework click HERE.