A group of 25 Cochrane doctors have collectively penned a letter to MLA Pete Guthrie in hopes that Guthrie will influence the provincial government on their behalf.
The letter details their angst over recent actions by the UCP to unilaterally abolish the province’s contract with its medical doctors which could lead to “poorly considered changes to Alberta’s health care system”.
While some changes have been reversed, temporarily, there are other proposed changes that are set to take effect on Wednesday, Apr. 1. The doctors are fearful that primary care in Cochrane will be negatively impacted.
“By tearing up our contract, your government has lost the trust of physicians and we are concerned that you will move forward with these changes after the current crisis abates,” read the letter referring to the current COVID-19 pandemic.
The current master agreement with physicians ended March 31. The former contract was terminated by the UCP in February amid negotiations with the Alberta Medical Association (AMA). A Feb. 27 letter from AMA president Christine Molnar indicated that health care in the province faces a cut of more than 20 per cent. She added that these changes largely affect rural Alberta.
The 2020 budget indicates that physician compensation and development accounts for about 25 per cent of the health budget, the equivalent of around $5.4 billion annually. The government announced a new funding framework after the physician contract was terminated, which it said will save the province around $2 billion. These numbers are expected to remain level.
MLA David Shepherd, Opposition Health Critic, read the doctor’s letter on his Twitter account on Saturday, Mar. 28 and garnered positive feedback and support for the province’s frustrated doctors. Shepherd also met with doctors in Canmore recently and heard that the UCP’s cuts will damage Alberta’s healthcare system.
“A lot of these steps are going to seriously impact people’s access to quality comprehensive primary care. That’s our front line,” Shepherd told the Cochrane Eagle.
“Especially now in the midst of this global pandemic COVID-19. We need our family doctors to be prepared, to have resources they need, to be able to operate their clinics and keep people out of the emergency rooms and keep them out of the hospitals where we need to keep these resources free for people dealing with the coronavirus.”
Dr. Candice Knoechel has been practicing in Cochrane for six years now. She said not only is working through the current pandemic stressful, but access to personal protective equipment is limited and she and other doctors are unsure on when more will become available.
She said non-urgent services are limited so family doctors are managing complex patients in the community with more uncertainty than ever before.
“Just because there’s a viral pandemic raging it doesn’t mean that diabetes, influenza, ear infections, heart failure or the endless list of health conditions family doctors manage on a day-to-day basis are slowing down in the least,” Knoechel said.
“Patients need their doctors now more than ever.”
Knoechel says she’s unsure on how family medical clinics - like every other small business in Alberta - will continue to stay viable. Dr. Olga Konwisorz has practiced in Cochrane for the past three years and is fearful that she might have to lay off her receptionist staff as the clinic’s income has been reduced by 75 per cent.
“What money is coming is not enough to cover rent, utilities, supplies and staff costs,” Konwisorz said. Dr. Kerri Johnstone, who has practiced in Cochrane for two years, says clinics will likely close and physicians will move to other provinces.
“It sure is awful working double overtime and making a quarter of the pay while putting our families and selves at risk,” Johnstone said.
Knoechel is expecting the birth of her son any day now and she’s currently on maternity leave doing administrative work from home. She had arranged for an Ontario-based locum to cover her leave, but when the Alberta government announced the funding changes, the locum backed out.
“While I was upset to have this happen, I couldn’t really blame them for not wanting to take on six months of work in a province where the status of healthcare was so uncertain for the foreseeable future,” Knoechel said. She was able to find coverage until July, but the position is still vacant between July and December.
She says she’s scared for the people of Cochrane as multiple doctors have retired over the past year and in the long term more doctors will leave if they can’t keep their clinics operational.
“Cochrane has been in need of doctors since I started my practice here almost two years ago. Since that time, we’ve lost more doctors than we’ve gained and the people of Cochrane are feeling the pinch,” Knoechel said.
Knoechel says she and other doctors know that cuts need to happen and have tried to work with the government to implement changes.
“The discussions with the UCP have felt combative and become only progressively more so over time since they terminated our contract unilaterally and forced these changes without careful consideration of anything more than the short term bottom line.”
Shepherd said the UCP’s addition of $500 million extra dollars to support front-line health professionals in the coronavirus crisis - in addition to the $20.6 billion allocated for healthcare in Budget 2020 - will bring the province up to where they should be to handle population growth and inflation.
“So there’s really not any significant dollars being devoted to what is probably the most significant health care crisis we’ve seen in our province in some time,” he said referring to the current pandemic. “This is absolutely not the time to be having a fight with doctors.”
Family clinics across the province have adapted to the pandemic in various ways including offering ‘virtual visits’ to keep their patients and themselves safe from exposure to the coronavirus. Knoechel says virtual care doesn’t replace in-person assessments and doctors worry that proper attention to patients’ individual needs aren’t being met.
MLA Pete Guthrie told the Cochrane Eagle the UCP agrees with doctors that virtual visits need to be available to all physicians and patients and the government has agreed to pay them at the same rate that they pay for an office visit. He said Health Minister Tyler Shandro made that commitment in an announcement on Mar. 23.
“Physicians are being compensated for unlimited phone or video consults at the same rate as an office visit, $38 per visit,” Guthrie said. “This change was made to help physicians minimize risk to patients and to themselves, and keep their practices as economically viable as possible.”
While virtual visits are the safest option in the current pandemic climate, Johnstone says these virtual visits can be complicated on how a patient receives care. She explained that a recent call with a patient should have taken 25 minutes, but because she was exposed to someone who had tested positive with the coronavirus Johnstone had to make additional phone calls and extra arrangements. She said the call took her three times as long.
Local doctors were forced to cancel a town hall meeting with the community that was scheduled for Mar. 18 at the Cochrane Alliance Church because of the outbreak. In place of the town hall, a group of local family doctors have recorded personal videos that talk about their challenges on the website cochranedocs.ca.
With files from Chelsea Kemp of the Rocky Mountain Outlook.
