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Province says 'heavy lifting' done on new family doctor funding model, but negotiations continue

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Progress has been made on a new compensation model for family doctors, with the Alberta Medical Association (AMA) hopeful for a fall rollout.

On Wednesday, Health Minister Adriana LaGrange said the province and the AMA have agreed on a framework for the new model that will help Alberta keep and attract family doctors.

The new blended model will allow some doctors to move away from the current fee-for-service model.

The current model, said the AMA, has left many family practices struggling financially under rising demand and inflationary pressures on overhead and administrative costs.

"They have to run these small businesses … They have to pay all the overhead for the staff, for their lease, everything," AMA president Dr. Paul Parks said. "Inflation has really, really taken off on those practices, while that funding hasn't kept up with it."

The new framework will include compensation based on panel size and complexity, as well as funds for other administrative costs and time spent indirectly on patient care.

"It has some payment for the kind of care that you do when the patient's not in front of you," Parks said. "My colleagues tell me how they look at labs at 10 o'clock at night if there's a critical lab for their family practice patients." 

LaGrange promised an updated model in October, and while rates and panel size requirements have not been finalized, the minister said the "heavy lifting" was finished.

"We still have to go to rate review, there are other things that have to be done, but for all intents and purposes, we have agreed on a funding model that we can support moving forward," LaGrange said.

Under a stabilization program starting earlier this year, only doctors with more than 500 patients were eligible, and Parks said there are concerns that smaller practices could be left out of the new model depending on the final minimum panel size.

The province said it's working with the AMA to make sure those providers can "join the new model."

The new framework will also include comprehensive care agreements, moving to more in-person appointments and commitments to the provincial Central Patient Attachment Registry.

Before the plan can roll out, recommendations for pay rates will have to be agreed upon and submitted to LaGrange. She expects to have those recommendations by the fall.

AMA optimistic

The Alberta NDP health critic Dr. Luanne Metz responded to the announcement, saying there were "no amends made" and calling for a faster turnaround.

“Alberta is in this situation because the UCP made changes to physicians compensation that made it nearly impossible for family doctors to keep practicing in the province," Metz said.

"In January, 61 per cent of family physicians indicated they might have to close their practice within the year, and now family physicians likely won’t see any additional support from this government until fall at the earliest." 

According to the AMA, $67 million of $200 million in stabilization funding has been given to family doctors as part of the Transitional Funding Program. LaGrange said part of a three-year $57 million funding package for primary care support has also been released.

Dr. Noel Grisdale has been a family doctor in Black Diamond, Alta., for 25 years. He's optimistic about the new model – less so about waiting until the fall.

He said primary care in Alberta has "gone backwards" since 2020, and he's worried about how many more doctors will leave before the new framework comes into effect.

"We're losing (doctors) to places that have a model of care that we're talking about," Grisdale said. "We're not there, and every day that we don't get there, we potentially lose physicians.

"We also have medical students who are looking at what kind of work they want to do … and for every day that we don't have a good model in place, they look to other provinces or they look to not even doing that kind of care."

Parks said he's optimistic about the work being done and that he's hopeful the new model will come into effect before the end of the year.

"We're making commitments that we're going to be the most competitive and that we're going to continue to work collaboratively to get those rates right," Parks said.

According to LaGrange, a new funding model for nurse practitioners is also in the works, but no details or timeline was offered Wednesday.

In 2023, Premier Danielle Smith promised that every Albertan would have a primary health-care provider by the next election.

The province estimates there are around 700,000 Albertans without a family doctor, while the opposition puts that number at 800,000.

LeGrange said Alberta added 215 family doctors and rural generalists in the past year.

With files from The Canadian Press

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