CANMORE – Hosting a virtual town hall meeting, Bow Valley doctors have rallied together to address the potential ramifications to Alberta’s health care system under the current government's budget cuts.
“You can’t do medicine without being thorough and being thorough takes time,” said Dr. Zuzana Triska of the Alpine Medical Clinic.
Triska opened the town hall on Sunday (March 15), using the experience of one of her patients to highlight the importance of having time with patients.
Triska said she had a man in his 60s walk-in to her clinic complaining about a sinus infection. It was the end of the day and she said she squeezed him in for what was meant to be a 10-minute checkup. However, as she talked and examined her patient his symptoms made less and less sense, Triska said. Taking her time examining him she came to realized he was experiencing something more than a nasal infection.
She sent her patient to a radiologist for testing. The examination revealed that he had a heart attack he was unaware of – the bottom of his heart was no longer working and a large blood clot had formed. Her patient was able to get treatment right away and his life was saved because of the time Triska was able to spend with him.
“Our government wants to stop paying us for taking this extra time,” Triska said.
A major point of contention with the provincial government has been its failure to negotiate the contract with the Alberta Medical Association, she said.
The association was in the midst of negotiation when the government left the table and ripped the contract up in February, said Medical Director of Banff Mineral Springs Hospital Dr. Matt McIssac.
The cuts unilaterally proposed by the government will be incredibly detrimental to health care in the province, he said. McIssac added one of the major points of contention is how family doctors are compensated for the time spent with patients.
In the contract, these are listed as complex modifiers and are used as a way to compensate doctors for spending more time with their patients. Under the new model, this compensation will be capped at 10 minutes.
“Statistics and evidence time-and-time again have shown that time spent with patients reduces complications, improves the quality of care and reduces costs to the system,” McIssac said.
The current master agreement with physicians comes to an end on March 31. It is unclear what compensation for physicians will be as of April 1. The government announced on Tuesday (March 31) that changes to complex modifier compensation have been cancelled in light of the COVID-19 pandemic. It is unclear how and if complex modifiers will be applied when the pandemic has come to and end.
McIssac said by reducing the financial compensation for time spent with patients, the government is “directly attacking this model.”
These cuts are dangerous for patients because family doctors play a critical role in the continuity of care through the many different settings they can work in, said Dr. Mette Hoegh-Petersen of Family Medicine.
Hoegh-Peterson said that this type of service delivery is unique to family medicine. She added that they are also able to provide counselling and education along with diagnoses.
Hoegh-Petersen said the ability of family doctors to serve the public has been compromised by the current government cuts to health care. She explained this could also potentially result in higher costs for health care because patients will lack access and continuity of health care.
“There are many research studies into health system costs they all agree that strong primary care and good access to family physicians improve patients' quality of life and save the system money," she said.
Over the last five years the Alberta Medical Association has worked to reduce costs in the health care system, Hoegh-Petersen said, these saving equate to more than $500 million for the province.
Physicians were hoping to work with the province to continue to find a cost-saving measure that would not affect patient care, but this is no longer possible under the current government after it used Bill-21 to remove binding arbitration and began to implement its proposals.
“Our goal is to get the provincial government back to the negotiation table and be partners with us in achieving cuts,” Hoegh-Petersen said.
“We want them to engage in good faith negotiations and we expect them to listen to the front line workers – we cannot afford to make mistakes.”
Offering insights into the difficulties health care front line workers are facing due to cuts, United Nurses of Alberta second vice president Cam Westhead spoke at the event.
The union represents 30,000 registered nurses and psychiatric nurses across the province who are currently in the midst of negotiations with Alberta Health Services.
Westhead raised concerns about the government treatment of nurses during the negotiations as problematic because “we’re putting our lives on the line every day.”
In November 2019, the United Nurses were given notice by Alberta Health Services that they are planning to eliminate 500 full-time nursing positions, the equivalent of about 750 individual nursing positions, across the province. This equates to the loss of about one million hours of care, Westhead said.
“We know the health care system is already stretched quite thin,” Westhead said.
Westhead raised concerns with the Ernst & Young report cited in the Alberta Budget 2020 that called for cuts to the health care system – especially in regards to the number of hours of care nurses provide per patient.
“At the end of the day, nursing care decisions should be made by clinicians with an evidence base,” Westhead said.
“We shouldn’t be turning to accountants and lawyers to make our care decisions for us.”
Family doctor Liana Hwang of Mountain Maternity and Family Medicine said she felt personally compelled to speak out about the health cuts that have taken place under Minister of Health Tyler Shando.
The more time spent with patients has been proven to increase patient satisfaction, Hwang said, adding it improves health outcomes, shortens waitlists and saves money by preventing ER and hospital visits.
“If you were a patient on the table, would you want me to cut where I know it is safe to cut based on my experience and my training,” Hwang said. “Or, would you want me to cut where the government says I have to.”
