Alberta doctors ponder next step in fight with province

By Sheila Pratt, Edmonton Journal November 23, 2012 7:07 AM

EDMONTON – Doctors will look at “novel” ideas, such as donating a day’s pay to Alberta’s opposition parties or local charities, as they figure out their next step in the dispute with the province, says Dr. Michael Guiffre, head of the Alberta Medical Association.

But “it would be a sad thing” if doctors had to resort to such tactics, he said Thursday. The AMA would prefer to restart talks “with a clean slate” with Health Minister Fred Horne on a fee schedule and on the Redford government’s new family care clinics that doctors have not been consulted about.

Guiffre is meeting doctors this week and next to devise a strategy to deal with what they have called the government’s “offensive” decision to impose a fee schedule and leave doctors out of plans for health care reform initiatives.

Physicians were angered last week when Horne imposed a $463-million fee package that includes a 2.5-per-cent increase and cost-of-living increases for three years, but also reduced funding for some specialties. Doctors said they would lose $210 million over the next five years.

Guiffre said money is not the issue, it’s the lack of consultation with doctors and the province’s decision to impose a contract.

When it comes to family care clinics, “we’re not even at the table, and what a terrible message that is for doctors,” Guiffre said.

Guiffre said the AMA has no problem in principle reviewing the fees paid to specialists, “but the ministers can’t just cherry pick a few specialists” and unilaterally lower fees. It requires an open process and an independent third party, he said.

At a Wednesday meeting with doctors, Dr. Lloyd Maybaum, president of the Calgary and area Medical Staff Association, suggested that doctors could donate a day’s pay, minus overhead — up to $4 million if all 8,000 doctors contribute — to charities or the opposition in the Alberta legislature to protest Horne’s decision to impose the fee dispute.

“This is not about money, it’s about having the AMA represent doctors,” said Maybaum, adding his idea was well received by doctors at the meeting.

If his proposal to donate to opposition parties is accepted, “this is going to be healthy for democracy in this province,” he said.

About 20 months ago, an eight -year agreement “that worked well” expired between doctors, the Ministry of Health and Alberta Health Services, Guiffre said. It required consultation between all parties and decision by consensus.

A lot of progress was made with innovations to recruit doctors, get them into rural areas and devise alternative payment plans, Guiffre said. But “that’s all gone now and its insulting to doctors.”

Maybaum noted that in a recent survey, more than 80 per cent of doctors agreed that some fee codes are “outliers” and need to be rolled in, he said, but the issue cannot be resolved internally in the AMA.

“We need a transparent process with an independent, neutral body to set fee codes,” he said. “The health minister wants the AMA to get torn apart.”

The AMA had such high hopes when Horne was appointed health minister because he had “a brilliant career of 30 years” in health care policy, he said.

“Our expectations were through the roof in terms of co-operation and new scenarios, and then, bang, ‘it’s my way or the highway.’”

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