Doctors in St. Albert and area are not feeling well.
The Alberta government announced Friday it will impose a four-year compensation plan worth an additional $463 million to doctors in the province.
But Darryl LaBuick, a physician at Grandin Medical Clinic, said family doctors can expect a ten per cent cut to their budgets resulting from reductions to business and retention benefit programs.
LaBuick is president of the St. Albert and Sturgeon Primary Care Network, a team of health professionals who work collaboratively to improve aspects of primary care.
The St. Albert and Sturgeon Primary Care Network employs 60 doctors in 15 clinics.
“In a time where we still have challenges maintaining community family practices, they essentially cut the budget,” he said.
The decision to impose the settlement came after 20 months of contract talks between the province and its doctors. All previous talks had failed.
In a letter to the Alberta Medical Association Friday afternoon, its president Dr. Michael Giuffre wrote that he was extremely disappointed.
“You will hear in the media about the money being offered … it is being characterized as a good news story, but I assure you that if the news was good, I would be standing beside the minister and enjoying our joint success,” he wrote.
In a later interview, Giuffre said his biggest worry was that the minister only chose to talk about funds going into the system, but not about those going out of it.
The settlement includes an annual increase tied to the cost of living until 2016, as well as a one-time lump sum payment of 2.5 per cent to each physician equaling their billings for the period of 2011 and 2012.
Giuffre said no comments were made about payments in coming years.
The Business Cost Program will be extended until the end of 2013-14. The program was designed to lower doctors’ overhead costs.
The Retention Benefit Program will end March 31, 2013.
The funding of both programs came to $120 million, which will be reinvested in physician supports related to family practice and primary health care.
Giuffre said the minister never clarified whether any of the funds would be returned to family physicians.
Until now, benefits from these programs made a difference of $30,000 in overhead costs for a family doctor per year.
LaBuick said the cuts to the programs were much more significant than the increases offered through the settlement.
“It will be a loss, a ten per cent loss. Despite these “increases,” most physicians will experience a ten per cent loss in their income,” he said.
“It will affect our ability to hire staff, it will affect our ability to pay rent, it will affect our ability to run our businesses.”
The plan also offers a continuation of the one-year $12 per-patient support for Primary Care Networks, as well as annual increases to fees.
Giuffre said this money is not directed at family doctors, but used to offset the costs for hiring other medical staff such as nurses, nurse practitioners or pharmacists.
LaBuick’s main concern is that money cut from programs that benefit doctors in independent practice would be invested in family care clinics.
According to the Alberta Health website, family care clinics provide individual and family-focused primary health care programs and services.
Patients at family-care clinics don’t require a physician appointment to get access to other services, such as diagnostic or laboratory tests, referrals to other physicians or other levels of care.
The website further explains that other primary health care providers, such as Primary Care Networks (PCNs), provide similar services that are physician-led.
LaBuick said the only family care clinic in Edmonton receives about five times the funding for the same number of patients that he manages at his clinic.
“We run comprehensive primary care, we take care of things that they envision family care clinics to do,” he said.
“But we work with a fifth or a sixth of the funding that they are pouring into the family care clinic right now.”
While the minister’s letter to doctors read that they are the best paid in the country, LaBuick said they were also paying more in overhead costs.
“We may be statistically the best paid but we also statistically have high overhead because of staff that have higher costs of living,” he said.
“And we have leases that are more expensive because we live in Alberta … . They are playing a bit of a word game.”
Giuffre said the minister never had intended to negotiate, nor are doctors happy about calling it a settlement.
To them, he said, it’s an imposed settlement.
“He went in with a set of preconditions and he had his mind that doctors would have to settle for this because he is giving them no choice,” he said.
“He thought he was empowered with a majority government and strong mandate and that he was going to come in and tell the physicians what’s good for them.”
