Purported bullying of doctors by health-care officials in Alberta is a systemic problem that demands a public inquiry, the Canadian Medical Association (CMA) and Alberta Medical Association (AMA) said in a joint statement.

The groups told the Health Quality Council they believe that government intimidation of physicians who speak out about patient care is a pervasive problem that must be addressed.

The CMA and AMA outlined nine recommendations, including a call for the development and enforcement of rules to prevent officials from punishing outspoken doctors. They also said that Alberta's ombudsman should be empowered to deal with complaints from physicians about unfair treatment, and be able to report directly to the legislature.

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Dr. Linda Slocombe, the head of the Alberta Medical Association, says the centralization of Alberta Health Services administration has led to misunderstanding and distrust. Alberta Medical Association

In a letter to members of the Alberta Medical Association, Dr. Linda M. Slocombe, president of the AMA, said she and the CMA were prompted to take action this week after hearing "many individual stories" about an "environment of intimidation" for doctors who advocate for patients.

"Physician input has not been sufficiently utilized in recent years," Slocombe said in her letter. "The system evolved into one where even constructive criticism was feared and ignored and disengagement of physicians became the norm."

The CMA and AMA made the joint submission before the council, which is reviewing problems in the province's health-care system.

Dr. Raj Sherman, the leader of the Alberta Liberal Party, told CBC News on Tuesday he shares Slocombe's concerns and supports a full public inquiry into the matter.

Contracts terminated

Slocombe's letter "corroborates everything that I was saying while I was in government," Sherman said on the CBC's Alberta At Noon radio program.

"As you know, when we dissolved the [health] region, immediately they brought in something called the code of conduct. It was probably the most effective silencing measure not only for doctors but for nurses and all health staff."   

In the letter, Slocombe writes the AMA has heard from "a significant number of members who related instances of intimidation experienced in the course of advocating for patients — and the severe personal and professional impact these events carried."

"All this brings us to the inevitable question: Do the AMA and CMA believe that systemic intimidation of physicians has occurred in Alberta?

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Dr. Raj Sherman, the leader of the Alberta Liberal Party, says he supports a full public inquiry into the matter of doctors advocating for their patients.

The simple, unequivocal answer is "Yes." Our members have strong feelings that it does occur."

The council noted in its second interim review last month that some physicians have described "life- and career-changing outcomes" after having made advocacy efforts. The council is to deliver its final report to the legislature by late February.

Among the methods of intimidation reported to Dr. John Cowell, the council's chief executive, were: The withdrawal of hospital privileges, feelings of being ostracized by peers, and having contracts terminated or changed.

"Some [doctors]

have elected to leave the province to seek work elsewhere," the interim report said.

Alberta Health Services says it is considering starting a hotline to deal with physicians' complaints, and that it aleady has bylaws in place to deal with claims of administrative bullying.

With files from The Canadian Press