Alberta health minister spars with critics over rural doctor recruits

Alberta’s health minister is challenging claims by a group of doctors in central Alberta that his government’s cuts to fees are behind two physicians bowing out of jobs in Drayton Valley. 

Doctors in Drayton Valley say two new hires backed out after government axed agreement

Dr. Branden Ayotte in Drayton Valley says government cuts are creating uncertainty in rural family practices. (Peter Evans/CBC)

Alberta's health minister is challenging claims by a group of doctors in central Alberta that government cuts to fees caused two physicians to bow out of jobs in Drayton Valley.

On Tuesday, doctors from Shale Medical Clinic and Claro Medical Clinic told Edmonton media that two potential hires — one from Ontario and one from Red Deer — were set to take up practice in their town but backed out after the government announced changes to doctors fees in February. 

During question period in the Alberta legislature Wednesday, Health Minister Tyler Shandro said his office got a call from doctors. 

"I actually had physicians from Drayton Valley coming, reaching out to me — the physicians who are in charge of retention and recruitment of physicians in that municipality — reaching out to me and saying that that is misinformation and that is not true," Shandro said during question period in the legislature. 

The Pembina physician recruitment and retention committee is a volunteer group based in Brazeau County. A spokesperson for Shandro told CBC News the minister was referring to a member from that committee.

Shandro's comments were in response to David Shepherd, NDP MLA for Edmonton-City Centre, who suggested that doctors recruited to Alberta were "changing their minds and staying home." 
Health Minister Tyler Shandro refutes the Drayton Valley doctors' claims that new recruits refused to join clinics because of government cuts. (Legislative Assembly of Alberta)

"The brain drain would be bad enough under normal circumstances," Shepherd said, referring to the province's need to brace for possible coronavirus cases.

Shepherd accused the minister of driving doctors out of Alberta when it cancelled the master agreement with the Alberta Medical Association, effective March 31. 

"This minister chose to tear up the province's contract with doctors and plunder our health care system into chaos," Shepherd said. 

Drayton Valley doctors

Dr. Ryan White, one of three doctors who run the Shale Medical Clinic, said he's confident at least one doctor backed out because of the government's changes.

"I don't know where he's getting the false information from," White told CBC News in response to Shandro's comments. 

White pointed to a Twitter exchange between his fellow physician and the prospective hire. 

"That is a big warning sign — a big red flag to me — in terms of what is going to happen," White said Tuesday. "We cannot recruit doctors as international medical graduates, we cannot entice Canadian grads to want and come and work in Alberta." 

Starting April 1, physicians will be paid less for complex patient visits after the government ended the master agreement with the AMA. 

The rate for a complex visit, on top of the $41 fee for a basic visit, goes down to $9 from $18 and will be removed altogether by April 2021. 

    The health ministry said the Alberta government will introduce a new alternative relationship plan (ARP) in 2020 with "built-in transition benefits to encourage physicians to move from fee-for-service to a three-year contract."

    Physicians like White say they'll have to look at other ways to make up the difference in income as they still have bills and employees to pay to run their clinic. 

    "How do you keep your business viable, how do you keep your business open, how do you continue to pay your staff?"

    White and fellow Claro Medical Clinic physician Dr. Branden Ayotte said they'll have to consider shorter visits to fit in more patients. 

    "It means I'll be able to do a lot less per visit," Ayotte said. "I like to get to know my patients to address them as a whole person and not just as a single problem walking through the door."

    Ayotte said he currently sees about 125 patients a week, and with no more fees for complex visits, he'll consider seeing 180 to 200. 

    On its website, the health ministry said the decision to cut fees for complex visits is meant to avoid "cost overruns of $2 billion in the next three years due solely to physician compensation."

    If left unaddressed, these costs would impede efforts to reduce surgical wait times, improve mental health and addiction services, and expand the number of continuing care beds. 

    Ayotte lamented that the cuts were coming just as the municipality was succeeding at recruiting more doctors to the area.

    "It's dark days for Alberta right now," he said. "Alberta is likely to see a return to the kind of services that we were able to provide during the Klein days during the cuts that occurred back then."