Central Alberta physicians resign from ER ahead of government cancellation of master agreement
Seven family physicians have handed in their resignation for emergency room practicing privileges at the Stettler Hospital and Care Centre. Their decision follows one by the Alberta government to end its master agreement with doctors and introduce new rules starting April 1.
Family physicians in Stettler have an on-call rotation where one in ten days they have a 24-hour call shift in the emergency room. Dr. J.B. Lombaard said when the news broke that Alberta was terminating its contract with the Alberta Medical Association, he had a frank discussion with his staff and family. “I had to see whether it was viable for me to continue working in the emergency room,” Lombaard told CTV News. “My decision was to rather give up my emergency room privileges and to continue to provide care in the clinic.”
The Stettler physicians are also concerned by an ability given in Bill 21 to terminate agreements regarding doctor’s compensation.“What we understand from the government is that on March 31, when we come to work in the emergency room, we won’t know what we will be earning,” said Dr. Kimberly Chapman. She handed in her resignation from emergency room practicing privileges two weeks ago.“It makes it difficult to plan if you don’t know what you’re going to earn in the hospital two weeks from now.” Dr. Phil Vogel has also handed in his resignation and he said the ability for the government to terminate future contracts will make it difficult to recruit new physicians.“I cannot go to somebody and say, you know what, you can expect to earn this or that... I cannot do that anymore.”
Another cause for concern for Stettler doctors is changes to a fee called a complex care modifier where doctors are compensated for longer visits with patients. Currently, doctors bill the province a base fee of $41 for every patient they see. However, when a visit from a patient takes longer than 15 minutes, for patients who require more time, doctors can extend the visit 10 minutes, and charge the province an additional fee of $18. With the new rule, which will be implemented April 1, that fee will be cut in half to $9. On April 1, 2021, the complex modifier fee will only be allowed if a visit takes longer than 25 minutes and doctors can bill the province $18 again. Dr. Willem Pretorius hasn’t rescinded his emergency room privileges, but he said these changes will make it difficult to spend the time needed with patients.“If someone walks in and they’re going through a crisis in their life, I can sit down with them, I can spend time with them, I can figure out what makes them tick as a person, what makes them sick as a person, and try to heal them on a global scale.”“With these new changes, this is going to cut me over the knees.” Pretorius argued that with the current complex care modifier there was an incentive for doctors to spend more time with patients, but with the new model, doctors will end up seeing as many patients as they can in a day to remain financially viable.“We will be forced to do this,” said Pretorius.
He also argued that in rural areas, many patients are not able to visit a doctor frequently because they have to drive far distances. Therefore, when they do visit a doctor, they come with multiple issues which requires a longer visit.The doctors who have resigned will continue to work in the emergency room services until they’re resignations are official.“We’ve resigned privileges, but due to the medical staff by-laws the process to officially resign can take up to 3 or 4 months,” said Chapman.“Obviously, we don’t want our patients to be caught in the middle or suffer because of this, so it’s important to us to follow the proper procedures.”
Efforts to contact the Alberta Health Services central zone communication director on Thursday were unsuccessful. Previously, the government has said the old complex modifier system was misused, and that the provincial health care system needs to be made more efficient.