AMA's new president prepared for 'significant advocacy'

Michael Higgins: What are you prepared for as you transition into this role of Alberta Medical Association president?

Dr. Shelley Duggan: I think it's fair to say we're prepared for some significant advocacy.

We are seeing that our health system is really not functioning well anymore. We've got crises both on the family medicine, primary care aspect and then we've got crises in acute care.

Both of these pillars need to be stabilized and we really need the government to listen to us and to act.

MH: What will be your approach to advocating for your profession?

SD: I think the most important thing for advocacy is having patients understand what's happening in the health care system and really having them speak out to their elected officials.

We find that's the most important thing that our elected members will respond to.

One of the advocacy strategies we do have is a patient's first portal, where we have over 50,000 Alberta patients.

They do things like writing letters to their MLAs, and speaking out about the expectation that health care is there for them when they need it.

MH: In your first letter to AMA members you write that you're prepared to fight with everything you have. Can you explain that?

SD: It's important to note that some of us are pretty long in the tooth and have been practicing for a long time and we'd like to see health care stabilized so that our patients are well looked after.

So as the AMA, we've got a sort of multi-pronged strategy in terms of getting patients to understand what's wrong with the healthcare system, getting patients to understand what we've put forth to government, so that we can ensure some stabilization and some retention of physicians.

We need government to understand how complex and how in trouble the health care system is so you'll be seeing us both in media doing interviews like this, we've got an advertising campaign coming out next week, and we are giving patients materials to help inform them as well.

We just need to be very vocal so that we can fix what all Albertans think should be there when they need it.

MH: You land in this role at a very critical point so what is your read on why the government has yet to lock in on the new payment model for physicians? What remains unresolved from your perspective?

SD: When we talk about our two proposals that we gave to government, both the PCCM and the Acute Care Stabilization package, we've actually worked through most of the details.

So when it comes to the PCCM, that document is complete. We went to our joint committees, we hammered out the details and the rates.

So all that's left to be done there is a signature and Treasury branch to support it.

We on the AMA side have already been working on implementation and we're ready to go as of January to get our physicians enrolled in this.

The Acute Care Stabilization, although we have not had significant interest, the government has not interacted with us, I will say, because we certainly have been vocal about it. We have done the bulk of the work, we know what it's going to cost, and we need government to sit down with us and get approval for it.

So on our part, we've done the work. We need government to sign.

MH: You’ve made the statement that you are sincerely afraid that Alberta's health system is ready to collapse. What makes this agreement such a turning point?

SD: From a primary care focus, if we can stabilize our family physicians, that's prime number one because that's where most patients interface medicine the most, and that's where a lot of things can be done to keep patients out of hospital.

So this new payment model will help retain our family doctors and we heard on the weekend from one of our delegates that her office is likely going to close in the next couple of months.

And her, alongside her other physicians, that will be another 5,000 Albertans without a family physician.

We even heard a story of another family physician who took on 100 or so extra patients from a colleague who left and those patients were brokering deals.

One gentleman said, ‘you've taken me on, but my 90-year-old mother needs you more. Will you trade her?’ Heartbreaking stories like that. We need that to stabilize and then we need acute care to stabilize.

If you think of a scenario, you're seeing your family physician and maybe that family physician diagnoses you with cancer.

Then you may need to move on to the acute care system where you might need surgery, chemotherapy, radiation, and we just don't have enough of any of that.

As you've seen heartbreaking stories of patients who don't even get therapy before they die. So when we say that the system is collapsing, it truly is.

Patients are dying and we anticipate this to get worse as we move into respiratory virus season.

MH: Among the commitments listed in that that first letter to members of the association you say the AMA will counter misinformation with facts and figures. What will you be watching for? Where do you expect misinformation to come from?

SD: We get told a lot of things, for instance, our family physicians are the highest paid in the country, and that's simply not true.

We've got now B.C., Saskatchewan, and Manitoba, who have all signed new compensation models with their family physicians and so Alberta is quite under all those provinces.

Provinces where you know our members may move to. If you take into account inflation, population, and population aging, the physicians are underfunded by over $730 million.

We've got stats, and we've got a whole team behind us to show that health care has just not been prioritized for some time.