EDMONTON -- Nearly all doctors, resident physicians and medical students who voted in a referendum say they have lost confidence in Health Minister Tyler Shandro after months of heated negotiations and no agreement.

About two thirds of the Alberta Medical Association's members cast a vote over the last week – some 8,900 people.

Of those votes, just 1.5 per cent reported confidence in the minister, while 97.8 per cent voted no confidence.

Fifty-seven abstain votes were also cast.

AMA president Dr. Molnar called both the participation and results remarkable.

“The results couldn’t be clearer from Alberta doctors. They don’t have confidence in the minister of health and his ability to do what is right for this public health care system. And they do not trust him.”

The association's next move is to turn to a higher authority: Premier Jason Kenney.

“He is the leader in our province. We are asking him for help.”

Molnar didn't specify what she was asking of Kenney other than a meeting, except to explicitly say the AMA was not seeking Shandro's firing or portfolio switch.

“The public health care system as we see it is being changed in ways that are not inclusive of physicians and other health care workers, and that’s very difficult to work with. We’re hoping the premier will take an interest and help us with a personal hand in finding a solution."

Kenney did not respond to the request for a meeting in a news conference Wednesday morning, but repeated the government's months-long stance that it was elected to reduce physician costs.

He told media Shandro was doing "a fantastic job" navigating the negotiations and the COVID-19 pandemic.

"We simply don’t have the money. And there’s a question of fairness here as well. The 10,800 physicians who are one quarter of one per cent of the Alberta population represent 10 per cent of the total expenditures of the Government of Alberta – and that's fine," he commented.

"We are fine with compensating them at the highest level in Canada and the highest level in Alberta history, but in this face of an economy that has shrunk by 20 per cent, we cannot say that one quarter of one per cent of the population can benefit from continued increases and compensation."

Shandro's press secretary said he had nothing to add.

Molnar did not say what action the AMA would take next if Kenney would not sit down with her.

The decision to hold a confidence vote was made at an emergency AMA meeting on July 18.

Last November, the United Conservative government asked doctors for feedback on 11 proposed changes, some of which were tentatively set to take effect in February.

Some changes were pulled back at the start of the COVID-19 pandemic, but the government has maintained health care spending needs to be held at its current level.

In the months since, the AMA says it has made several proposals to Shandro and his ministry – but none, the government says, which have helped the government hold the current line.

After publishing an offer in the newspaper to get the minister's attention, the AMA issued a referendum.

According to the ad, the AMA was willing to accept a three-year physician budget cap of $4.57 billion annually, explore new payment models, and work with government to improve the health care system. In exchange, it wanted government to cover the costs of new physicians, restore AMA’s right to binding arbitration, and continue to pay for programs and grants like maternity/paternity benefits and the physician health program.

The government says it does not consider the ad a proposal as it wasn't formally made, and it still would see spending increases to cover physician number growth.