According to the Government of Alberta, the $60,000 cap on the Rural and Remote Northern Program (RRNP) will be abolished, effective immediately. Overhead changes announced earlier this year will be paused for urban physicians, while an extensive review by Alberta Health Services (AHS) with physician involvement is completed, it was stated in a recent media release. The media release also stated rural physicians will be exempted from any changes permanently.
“Medical liability rates for all rural physicians, including obstetrics, will be frozen at $1,000. Rates for all family physicans in Alberta will also be frozen at $1,000. Rates for all other urban physicians will range from a low of $1,200 to a maximum of $4,000,” it was stated.
“On-call rates for all rural physicians will range from $20 per hour to $23 per hour, increasing payments to more than 1,500 physicians who are on-call in rural Alberta,” it was stated adding, $6 million will be used to pay for the schooling of 20 medical students over the next three years to incentivize young Albertans from rural communities to return to practice in their home communities after completing medical school.
“Over the last several weeks, discussions with rural caucus and rural physicians have made it clear there are unique challenges to recruiting and retaining physicians in communities outside of Alberta’s major cities. These changes recognize that difference and will significantly improve access to health-care for patients in rural communities,” stated Tyler Shandro, Alberta minister of health, in the media release.
Dr. Samantha Myhr from The Associate Clinic in Pincher Creek and the Rural Sustainability Group said it was a step in the right direction. “But, we still didn't get what we were looking for, which was certainty.”
There just is no trust with this government, Myhr added, and without an agreement physicians really can't move forward because the Alberta government seems to keep changing the playing field week after week. “It's exhausting and it really hurts recruitment and retention, particularly in rural places, but I would say Alberta in general.”
“We're the only province without an agreement for their physicians. It's a lot to ask anybody to come here in this time of uncertainty,” the doctor noted.
Furthermore, Myhr explained, people were disappointed with the lack of accountability the minister of health has shown. “It seemed he was blaming the Alberta Medical Association (AMA) for entirely preventable mistakes. We said all these things were going to happen six months ago and he wasn't listening until it was in the public spotlight. That's not how health-care decisions should be made.”
It doesn't bode well for future decisions, said Myhr. “For us, it didn't change anything. But, actually it did – in the opposite direction. We had a couple of physicians that were uncertain before (the announcement) and now we're unified that we're still going through with our withdrawal of services.”
According to Myhr, there are nine physicians from The Associate Clinic withdrawing from hospital emergency room and obstetrics-based services, as of July 31.
“That timing is to try to get our patients through the COVID-19 pandemic. Regardless of how many replacement physicians the government says it has, we've been trying to recruit for years and we know they aren't coming. We want to make sure we're there to get our patients through that part. And we gave AHS 90 days notice, so they have a chance to try to cover the hospital services,” Myhr said.
Myhr noted the Rural Sustainability Group, which is made up of other rural community physicians considering putting in notices for the end of July, were contacted since the recent announcement was made by the Alberta government. “We continue to get responses from them. It's a mixed bag. There's been a few that say, 'You know what, this is going to allow me to continue with my hospital services. But again, no trust in this government. I'm just waiting for the other shoe to drop.'”
Those people are updating resumes and they're being clear about the fact they're looking at other provinces, said Myhr.
“There are some that have already decided to leave and they said, 'If there's no agreement by fall, I'm out of here. I can't handle this uncertainty and the constant change.' Then there's actually a good proportion of people who are saying the same as Pincher Creek. 'We don't buy it. We can't play by these ever-changing rules and you don't understand how much this hurts recruitment to areas like ours. So, we're not changing what we're doing.' I think there's still going to be a huge loss to rural communities, despite what happened (with the announcement),” said Myhr.
Myhr said the biggest thing is it doesn't have to be this hard. “It hasn't been this hard with other governments. We've always been able to work together. This government just seems intent on doing things their way, despite the continued mistakes.”
“It would be a lot easier to work with us. Because of that lack of trust, is why we need an agreement to be able to do that,” Myhr added.