Rural doctors exempt from overhead billing as Shandro rolls back changes
Published Friday, April 24, 2020 8:21AM MDT Last Updated Friday, April 24, 2020 5:50PM MDT
EDMONTON -- Alberta is rolling back more billing changes to fees and adding millions of dollars in extra cash to stop rural doctors from pulling back from hospital duties.
Tyler Shandro says the changes total $81 million, including adding cash top-ups to doctors who work in rural and remote areas.
They also address two main concerns that have prompted some rural doctors to announce recently that they must cancel hospital duties because they can't make a living under fee changes unilaterally imposed by Shandro in March.
Shandro said one of those rule changes - to no longer allow rural doctors to bill for overhead when working in a hospital - had unintended consequences.
"I've heard from my colleagues, from rural physicians, as well as from rural leaders all across the province, that this policy forces physicians and hospitals to make choices that reduce access,” Shandro said Friday. “This was never our intention.”
Shandro said there will be $57 million more for rural service top-ups.
He said rural doctors will are allowed to once again claim overhead for hospital work. Urban doctors will also be allowed to do the same pending a review on whether that policy is necessary in large centres.
He is also rolling back reductions in the provincial subsidy for medical liabilities, which rural doctors have said make it impossible to pay for coverage to work in obstetrics.
The announcement adds to other recent rollbacks on Shandro's March changes. A plan to change fees for longer patient visits - called complex modifiers - has been scrapped and other rollbacks on physician salary top-ups, called clinical stipends, have been deferred.
The announcement is set against a backdrop of poisoned relations between Shandro and the doctors' representative, the Alberta Medical Association, after Premier Jason Kenney's government passed Bill 21 late last year giving it the power to unilaterally end the negotiated master agreement with the AMA.
Earlier this year Shandro did just that, cancelling the master agreement while simultaneously implementing the controversial changes, some of which he is now rolling back.
The AMA is taking the province to court, alleging breaches of charter rights because they were not given access to third party arbitration.
Christine Molnar, head of the AMA, said in a statement that Shandro's announcement was a positive step during the COVID-19 pandemic but said, “We need long-term solutions to real challenges, not one-time ad hoc decisions. We need a partnership between physicians and government.”
A group speaking for Alberta's rural doctors said in a statement that the fundamental issue of trust remains broken.
“We suspect these politically expedient announcements and partial rollbacks will not be enough for most physicians faced with the need to reduce hospital services in July, since we know they can be reversed again at any time,” said the Rural Sustainability Group.
“Albertans know we cannot trust this government to uphold its word or its contracts.”
Dr. Samantha Myhr, part of the Sustainability Group and one of seven doctors giving up hospital privileges in Pincher Creek, said the announcement doesn't change her mind.
“I'm still going through with it,” said Myhr, who said she can't be sure the benefits granted today won't be gone tomorrow.
“What happens a few months down the line?” she said.
Ed Aasman, a doctor in Rocky Mountain House who has already cancelled his hospital privileges, said trust was shattered when Kenney's government passed Bill 21.
“That's (about) power. That's not leadership,” said Aasman.
David Shepherd, health critic for the Opposition NDP, echoed the rural group statement, saying trust with Shandro is broken beyond repair.
“Tyler Shandro knifed rural Albertans and our rural doctors in the back, and now he's offering them a Band-Aid,” said Shepherd.