Alberta health minister tables legislation to make doctors' billings public

As the fight over physician pay escalates, Alberta Health Minister Tyler Shandro has proposed individual physicians be legally required to publicly disclose their billings. 

Amendment would require physicians to reveal how much they bill the province

Health Minister Tyler Shandro tabled the amendments to Bill 30, the Health Statutes Amendment Act, in the legislature Tuesday during a late-night session. (CBC)

As the fight over physician pay escalates, Alberta Health Minister Tyler Shandro wants individual physicians to be legally required to publicly disclose their billings. 

Shandro tabled the amendment to Bill 30, the Health Statutes Amendment Act, in the legislature early Tuesday during a late-night session in the legislature.

The amendments to the proposed bill would compel doctors to disclose "amounts payable" they receive for publicly funded health services.

"We want Albertans to have the facts on health care spending, including the $5.4 billion a year we spend on physician services — that's one-quarter of the health care budget and 10 per cent of the budget of the entire Government of Alberta," said spokesperson Steve Buick.

The move would effectively create a sunshine list for Alberta practitioners, ensuring doctor's names and pay are posted online for the public to see, the same way high-paid public service employees are.

B.C., Ontario, Manitoba, New Brunswick, and Newfoundland already disclose physician compensation, but Alberta will go further, Buick said.

"There is little transparency around payments to physicians, so we're going to give more information than any other province, including gross payments as well as number of days worked and numbers of patients and total visits, to give some basis for comparison of income relative to workload," he said.

The new legislation, which was debated throughout the night, is being proposed following months of discord between the province and physicians after negotiations over a master agreement unravelled earlier this year. 

Shandro first threatened to make pay disclosure mandatory earlier this month following the release of a survey from the Alberta Medical Association suggesting 42 per cent of Alberta doctors are planning to leave the province due to changes in how they are paid. 

In response, Shandro denied that any doctor's exodus was imminent and told the AMA to "stop playing games." He said Albertans should "know the facts" about how well Alberta doctors are compensated compared to their Canadian counterparts. 

Some physicians have raised concerns about public disclosure of their billings because they say the figures don't  accurately represent their take-home pay. Doctors pay for staff, clinics and equipment out of their fee-for-service billings, costs that are not accounted for in their billings. 

Buick said the province recognizes that payments to physicians are not the same as take-home income.

Physicians' income reflects total billings, overhead expenses, hours worked, and taxes, he said.

The move comes after the government terminated the master agreement with the AMA in February. At the time, the health minister said ending the agreement was a necessary move because the province was at an impasse with doctors over how to reduce costs and improve service in the $20.6-billion health system. 

If passed, Bill 30 would allow doctors who so desire to move away from the fee-for-service model, where they bill for each patient visit, and instead sign contracts and be paid salaries.

The bill would cut approval times for private surgical facilities, allow the ministry to contract directly with doctors and allow private companies to take over the administrative functions of physician clinics. 

The AMA filed a lawsuit against the government in April, alleging Shandro's actions breached physicians' Charter rights. The province filed its statement of defence earlier this month.

With files from Michelle Bellefontaine


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