Sundre clinic physicians got emotional in a video posted online revealing the clinic’s plan to discontinue obstetrics, acute care and emergency department citing cuts to rural compensation.
The physicians at the Moose and Squirrel Medicalgot together in a video conference to make the announcement to their community about the changes that the clinic is making in order to keep its doors open after the new funding model kicked in April 1.
The master agreement between physicians and the government ended March 31. Conversations that have been ongoing since late last year, which also included the Alberta Medical Association, the bargaining arm for doctors, have failed.
Starting April 1, physician compensation will remain at its current level of $5.4 billion a year. But the changes are expected to prevent $2 billion in added costs tied to physician services over this current fiscal year and the three after that.
Dr. Robert Warren, a physician at the Sundre medical clinic said the cuts impact rural medicine and rural practitioners.
“It’s almost as though it was designed to have maximum impact on rural doctors, because the cuts applied heavily to docs who practice in clinics and then again in another set of cuts who work in rural emergency departments and hospitals,” he said.
The four physicians that got online collectively said it’s “devastating” to be announcing the the news to the community.
The physicians have come to the conclusion that the only way they can stay open is to give up on some of the care at the clinic.
In the coming weeks, the clinic will no longer deliver babies.
“We will still look after you in the clinic, we will provide you maternity care, we will look after your delivery when you return to your homes, but the actual labour and delivery we will no be able to offer,” said Dr. Vesta Michelle Warren at the clinic.
The clinic will no longer be able to look after patients in the emergency department in about 90 days.
”That means our physicians will no longer be working in the Sundre emergency room, or looking after patients when they’re admitted to Sundre hospital, this is the model you see practice in the city all the time,” she said.
“We’re devastated that it’s come to this, but this is the consequences of the government’s decision and if we don’t react or change we won’t be here at all,” she said.
In an emotional note Dr. Jena Smith said she understands Albertans just like the rest of the world are feeling isolated, and may be out of jobs, bound to their homes.
“It’s completely unbelievable to me that this is the time the government chose to put healthcare cuts in place,” she said.
Around late March, around 800 doctors signed and sent an open letter to the UCP government asking the province to delay the proposed health-care changes.
In their letter, physicians say it’s not the time to under-resource doctors.
“COVID-19 is spreading like a wildfire in this province,” the letter said.
“Physicians and medical support staff are performing beyond their means and are doing so with fewer resources.
The clinic physicians came to the conclusion after having many conversations throughout March.
Warren said he predicts many rural doctors across the province would be wrestling with the similar decisions as a result of the government cuts. What that would look like would be upto inidvidual clinics.
The key change, which has also been the focus of a fiery dispute between doctors and the government, will be to a billing designation known as complex modifiers.
Under Alberta’s fee-for-service model, doctors could bill $41 as a base fee for each patient visit no matter how short or how long.
A decade ago, Alberta added in an extra fee — called a complex modifier — to recognize that some patients have multiple or complex issues and doctors should be compensated for overly long visits.
If a visit went more than 15 minutes, doctors were able to extend it 10 minutes and bill the province a complex modifier fee of $18, for a total of $59.
As of April 1, the fee is halved from $18 to $9, for a new total fee of $50.
The Sundre physicians said with that model, the doctors can’t afford to provide care at the town’s hospital.
“The reality is we weren’t able to figure out a way that we could adapt to these cuts and still provide the same comprehensive care we’re used to, we’re just not able to, so that puts us in a terrible situtation to pick what we can continue to do,” said Warren.
On Sunday Health Minister Tyler Shandro said there will be no reductions or cuts to the Sundre Hospital or to other health care services.
“If these physicians choose to voluntarily give up their privileges, we will immediately bring in replacement physicians to provide those services,” he said.
The Alberta government will also begin exploring permanent solutions to augment and stabilize physician services in Sundre over the longer term.
“The government of Alberta has already cancelled changes to complex modifiers and introduced unlimited virtual/telephone call visits paid at the same rate as an office visit,” the minsiter said. “We have worked with the Alberta Medical Association on these items in good faith.”
The Sundre clinic serves over 4,000 patients in Sundre and Caroline areas.
Smith noted it will be a difficult time to attract physicians to Sundre under the new working conditions the government has put in place.
With files from The Canadian Press