Patients that attend the Battle River Medical Clinic (BRMC) in Ponoka will soon feel the affects of the provincial government’s abrupt and unilateral ending of its agreement with doctors.
That move, made Feb. 20, means the structure around payments and other changes will take effect on April 1.
Details of the new rules include a phasing out of added pay for longer appointments to discuss complex medical issues, a move to eliminate the current fee-for-service method, a cap on how much doctors can bill on daily basis, ending clinical payments and putting an end to ‘good faith’ billing for patients that can’t provide proper identification.
Ponoka Dr. Gregory Sawisky, speaking on behalf of the physicians at the BRMC, explained doctors are already preparing for some issues that are going to rear their ugly heads.
“There are a couple of immediate effects to patients in Ponoka. First is that all seniors will have to pay out of their own pocket for a driver’s medical. That used to be covered,” he said.
“Secondly, the government is taking away the complex care modifier. If a patient had multiple needs during an appointment, it was the physician’s discretion to spend a bit longer and preemptively address those other concerns.
“That may mean we might have to shorten those patient appointment times. We will still do our best to address all of the issues affecting a patient’s care in every appointment. But, because of the government cuts, we may have to ask patients to book second or third appointments which will inconvenience them.”
And with the current crunch in getting an appointment or even seeing a doctor on a walk-in basis, adding appointments for issues that could have been dealt with already will cause delays in treatment.
“As a family doctor, I provide the best medicine when I have the time to address all of my patients’ needs and the government is taking that away from me,” Sawisky added.
“People are concerned that they are not going to have the time with their doctor to address their need. We will always work hard to ensure comprehensive and complete care is provided. However, with these cuts, we might have to change the way this clinic operates which will inconvenience patients.”
Currently, the complex care modifier allows doctors to bill $18 to extend the appointment past 15 minutes. The government, as of April 1, is cutting that in half and will then eliminate it come April 2021. At that time, doctors will also be able to bill an additional fee after 25 minutes.
Sawisky added the move creates another challenge for the medical group locally as it attempts to bring more doctors in to serve Ponoka.
“We are actively trying to get more doctors into town. These cuts will make it harder to attract physicians to rural Alberta,” he said emphatically.
“With fewer doctors, we all have to work more at the hospital emergency and at the hospital, which means more time out of the office. These cuts by the UCP will make it harder to get new doctors.”
He added there are a pair of doctors that the clinic were courting, but that this move by the province could likely mean they won’t want to move now.
However, the government doesn’t believe these are cuts, as a press release from the Health minister Tyler Shandro pointed out Alberta will still be paying out the highest-ever spent on physicians, maintaining the 2019 level of $5.4 billion.
“Our province is facing cost overruns of $2 billion in the next three years due solely to physician compensation. Despite repeated efforts, the (doctors) failed to put forward alternatives that would hold the line on physician compensation,” he said in the release.
The release also stated Alberta doctors will remain among the highest paid in the country.
Sawisky doesn’t dispute that physicians in the province are highly compensated, but he argues that they also have high overhead costs and pay higher rents than elsewhere.
“Our clinic is a small business and these cuts, in the provision of health care, may affect everything,” he said.
“If these cuts go ahead, it may cause some physicians to relocate to other provinces, may cause some to close their practice. From the money the government pays us, we pay some of the highest rents and business cost in the country.”
“To be clear, physicians understand that times in this province are tough and that cuts and reductions need to happen. We are simply asking the minister that we be part of that process, not dictated to.”
Talks between the Alberta Medical Association, which represents doctors, and the province began back in November with a mediator coming to the bargaining table in January. However, the government cut off talks on Feb. 14 as it stated that mediation wasn’t working and it would be implementing its final offer — put on the table Jan. 31 — and then used an order in council to kill the current master agreement on Feb. 20.
“The AMA wants to be at the table to see that cuts can be made equitable across the board and that all physicians help address the financial challenges. The government’s cuts have primarily affected family doctors and will primarily affect patients,” Sawisky added.
The provincial budget that will come down on Feb. 27 may also provide some further details on the direction this government will be taking regarding health care, but Sawisky is hoping some public opinion might be able to sway them a different way.
“We are urging people to contact the local MLA Ron Orr, the health minister and the Premier and ask them to come back to the table. Let’s work together,” he said.