'It's a bit shocking': Alberta doctors concerned about potential changes to health-care system

Dr. Paul Parks, president of the Alberta Medical Association (AMA), discusses proposed changes to health-care delivery in the province.

This interview has been edited for clarity and length.

Michael Higgins: In a video from a recent UCP town hall in Drayton Valley, Danielle Smith discussed plans to transfer control of underperforming hospitals from Alberta Health Services (AHS) to third parties.

It comes as doctors raise concerns over staffing levels at Alberta hospitals, a situation they call critical.

This video on social media on plans to transfer control of hospitals, as head of AMA, what's your takeaway?

Dr. Paul Parks: It's definitely concerning in the sense of wanting to know what's the plan, what is the big, broad picture around how we're going to coordinate. If there are different health authorities or different clinical service providers, how are we going to coordinate and cooperate and integrate those?

So what's the plan? It's a bit shocking to learn about it this way, but the other piece that I would say that I'd strongly want to emphasize is, right now, some of the major criseis and issues in our acute-care system, the people who are managing it and administrating the hospitals can't fix it. It's Alberta Health and the government who can. They need to act on plans that will stabilize the health-care system, the funding models and the things that are out of control of the health authorities. So we really need to work with government on that to move forward on that piece.

MH: The suggestion that competition and fear will drive AHS administrators to improve performance or risk losing control to another operator, how does that trickle down to health delivery on the front lines?

PP: I would say fear is not a good way to operate anything, especially where morale is really low. I'm not sure that's what the premier was hoping to go for, I don't think. I actually think what's really critical to not miss right here is, in Alberta and in the Edmonton zone, we already have two health authorities. We have Covenant Health, and we have Alberta Health Services. Objectively, demonstrably, Edmonton zone does worse on all patient outcome measures than Calgary zone when comparing head-to-head, and one of the big issues is because we have two health authorities and they can't integrate and cooperate as well.

We have redundancies. We have two administrators, two CEOs, two boards. We have lots of confusion already. We have a model that's kind of showed proof over years that that hasn't worked.

What I will say is the idea of competition in a single- payer, publicly funded health- care system doesn't work. The government would just be competing against itself. It would have one health authority trying to compete against another health authority for the same workforce in the province. We need coordination, we need integration. We don't need competition when it specifically comes to delivering publicly funded health care.

MH: AMA is back in the headlines and drawing attention now to what you've described as being a building crisis in general internal medicine. What is that? What role do the doctors involved here play in the system?

PP: It's important to understand the general internal medicine specialists are the lifeblood of taking care of the complex medical patients in the hospital that require admission. USo usually, the multiple problems, like diabetes and a stroke or lung disease or you name it, but the complex sick patients in our hospital for years, this has been building.

We've really been struggling with trying to incent both the physicians and the teams around them that can take care of the really crazy increasing volumes we've had in Alberta. Two-hundred-thousand new people a year. In the last year to two years, we're hitting 400,000 new people. We really are having struggles in our hospitals. For these teams, where they would normally take care of 20 patients, they're taking care of 35 patients on overflowing wards and really struggling.

We've given the government and the minister of Alberta Health a hospital stabilization plan that will change some of the funding and some of the team based care. We gave that to the government in December 2023 and we haven't made progress on trying to move on that hospital stabilization piece, and because of that, we're entering into our fall season, which is normally extremely busy for volumes of sick patients in our hospital. We're entering it in the summer already overcrowded and overflowing.

MH: From emergency surgeries being diverted, to this issue of acute care stabilization, you've been raising the alarm over many months on a multitude of fronts. To what degree is the government responding to those concerns in a meaningful way?

PP: There are a couple pieces there. One, we have started to establish a working collaborative relationship, repairing that relationship is critical. There are two concurrent crises going on and we've never wavered from that.

There's a major issue around access to family medicine in the community and the family medicine specialist, I think we're extremely close with the minister and the premier of announcing a game-changing funding model for family medicine that will make us the star in Canada for that. I think it will be very helpful.

But that's one crisis. The other is the acute care stabilization, and these issues overlap, but the solutions are very different. We did give Alberta Health a stabilization plan in December 2023, and we haven't been able to move on one piece of that. That takes care of things like the general internal medicine specialist, things like our anesthesiologists, who run our operating rooms and our charter surgical facilities.

It takes care of all of these specialists that work and do the difficult, after- hours, unpredictable, unscheduled care. And Albertans, I know they think that care is going to be there and available for them when they hear their loved ones get sick and they need hospital care. We're really struggling to provide that in a safe and timely manner.