Alberta health minister responds to doctors' survey with threat to reveal billings

The months-long battle between the provincial government and the Alberta Medical Association flared up on Friday with a threat from the health minister to start publicly disclosing the billings of individual physicians. 

The statement from Health Minister Tyler Shandro followed the release of a survey from the Alberta Medical Association suggesting 42 per cent of the 1,740 doctors who responded are planning to leave the province due to changes in how they are paid. 

Shandro called it "questionable" that doctors would leave Alberta when they would earn less in another province.

He also slammed the AMA for not presenting a "credible" plan to manage costs when the two sides were still negotiating. 

"Since Albertans should know the facts, the government is also exploring introducing physician compensation transparency, as exists for public servants in Alberta and physicians in a number of other provinces," he said in the news release. 

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Physicians — particularly specialists like radiologists and ophthalmologists — have opposed public disclosure of their billings because they say the figures don't present a true number of their take-home pay. 

Doctors pay for staff, clinics and equipment out of their fee-for-service billings.

But Shandro and his United Conservative government believe Alberta doctors are paid higher than their colleagues in other provinces and say the province needs to control costs. 

"The AMA needs to stop playing games, and start taking the economic crisis facing this province and this country seriously," Shandro said in the release. "We're still offering to hold our spending at the highest level in Canada, and frankly that commitment is looking more generous by the day, considering the fiscal situation in this province and this country."

Premier Jason Kenney was asked about the AMA survey at an unrelated event in Fort Saskatchewan on Friday. He suggested the AMA was using the survey as a tactic to scare the public. 

"According to the College of Physicians and Surgeons, there is no evidence of a increase in the number of physicians leaving service here in Alberta," he said. 

Dr. Christine Molnar, president of the AMA, said the survey shows how physicians feel they are at the breaking point. 

"It's not about the money," she said. "It's about the way they've been treated. They've been devalued, in fact, almost vilified and they really don't deserve that kind of treatment."

Months of discord

In February, Shandro unilaterally ended the Alberta government's master agreement with the AMA, and imposed a new funding framework.

The AMA filed a lawsuit against the government in April, alleging Shandro's actions breached their Charter rights. The province filed its statement of defence this week. 

The AMA survey suggests the months of discord are taking a toll.

Of the physicians who responded to the survey, 87 per cent said they will alter their medical practices in response to Shandro's changes.

That includes changing or withdrawing the services they provide to hospitals and other AHS facilities (48 per cent), reducing their working hours (43 per cent) and cutting staff (34 per cent). 

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Nearly half of the respondents said they are thinking of leaving for another province or are on their way out and 34 per cent said they may retire early or leave medicine for another career. 

Dr. Paras Satija, a recent graduate of the University of Alberta's faculty of medicine, is ending his family practice in Ponoka in August because the province's dealings with the AMA have left him feeling discouraged and frustrated. 

"This is my first year in practice. I am at a point in my career where I have to set down roots and I would like to be in one place for a long time," he said. 

"It didn't make sense for me to set down roots with all this uncertainty. So that's why I'm now looking at other places to do it." 

Satija plans to do locums in other provinces to test the waters about where he wants to relocate next. 

"I didn't think that I was going to be looking at relocation so early in my practice," he said. 

Satija said the results of the AMA survey don't surprise him. He said many of his colleagues from medical school and his residency are also looking at opportunities in other provinces, with some even applying for medical licenses elsewhere. 

"I can't think of a single friend of mine who's fully committed to setting up a full-time practice in Alberta right now," Satija said. 

Edmonton-City Centre MLA David Shepherd, the NDP Official Opposition critic for health, says the government was warned physicians would start leaving after Shandro tore up the master agreement with the AMA in February. 

Shepherd said the government has created a toxic and divisive atmosphere for Alberta physicians. 

"I can understand why doctors would want to find a more stable and pleasant place to practice," he said. 

As for Kenney's contention that doctors haven't actually left, Shepherd said rural doctors have already announced their intention to close their practices or withdraw hospital services in places like Canmore, Sundre and Pincher Creek.

"This is just the beginning of the wave. It is coming," Shepherd said. "And doctors will not continue to work under a government that continues to attack them.

The online survey was open from June 24 to July 3. The AMA says a comparable margin of error for a probabilistic sample of this size would be accurate within plus or minus 2.4 percentage points.