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Doctors are adding their voices to the chorus of criticism against the UCP government in response to proposed health care cuts.

In mid-November, the government proposed several cost-saving measures to the Alberta Medical Association.  

While neither the province nor AMA would provide a copy of the proposals, CTV News obtained a copy a document drafted by the association outlining the changes suggested by the government, as well as AMA’s concerns.

The paper reveals the Alberta government is considering, among a total of 11 proposals:

  • Capping the number of patients a doctor can see each day to 65;
  • De-insuring driver medical exams for drivers over 75 years of age;
  • De-insuring diagnostic imaging services referred from uninsured practitioner referrals;
  • Not paying doctors overhead costs if they work in an AHS facility;
  • Adjusting how doctors are paid, suggesting instead doctors be paid the same whether they spend 30 minutes with a patient or 15. The government has also proposed similar rules for specialists, so that they are paid the same for a 45-minute visit as a 14-minute visit.
  • Discontinuing clinical stipends to AHS-contracted doctors; and
  • Delisting Comprehensive Annual Care Plans.

Alberta is currently in the midst of renegotiating the AMA's agreement—or doctors' master pay plan.

In a letter posted on the AMA website on Nov. 30, association president Dr. Christine Molnar called the recent developments "deeply concerning" and, in the AMA's view, outside of contract negotiations. 

In her estimate, 85 per cent of the cuts—or roughly $224 million—would affect comprehensive primary care, or family physicians.   

While the AMA is still asking for feedback from its members, Molnar's initial reaction is that the changes would negatively affect Albertans.

"These cuts are seemingly random and they don't really fit in with an over-arching health policy plan," she told CTV News.

The proposals, coupled with Bill 21—which, if passed, would give the province the power to cancel the master pay agreement—has, in Molnar's words, painted a grim picture.

"Our biggest concern is that our relationship is inactive, basically, or not effective," Molnar said. 

The province vows the proposals, if implemented, would not harm the ability of family doctors to give comprehensive primary care.

"Alberta is a great place for doctors to work and nothing in our proposals will change that," government spokesperson Steve Buick wrote in a statement. 

"We spend $5.4 billion a year on physicians; our spending is out of line with other provinces and we need to make some modest reductions to get costs in line."

A review done by a government-mandated panel earlier this year found Alberta doctors on average make $107,000, or 35 per cent more than doctors than in other comparative provinces. It noted a key factor is that Alberta doctors are paid "fee for service."

However the government said it is "committed to the Medical Home model and our Primary Care Networks… It’s not about how much physicians are paid."

Although doctors have expressed concern about their own jobs, Molnar said she is worried about what the proposals could mean for patients.

"This is a 15-year step backwards for family doctors, and a big concern is on rural doctors... The effects on rural care are outstanding and there will be adverse impact on rural care," she said.

Discussion over the proposals will continue at the bargaining table.

The feedback AMA hears from its doctors on some of the proposals will be submitted to Alberta Health by Dec. 20. The association says it needs more time to respond to all proposals.

The criticism by AMA follows news that unions across Alberta are expecting to lose thousands of positions over the next three years as the government finds efficiencies. On Friday, unions representing public employees, nurses, and other health care professionals estimated up to 7,400 positions could be affected by measures proposed by the Alberta government.