As Dr. Omid Pour-Ahmadi arrives at the SantiMed Family and Walk-In Clinic in northeast Calgary each day, he is greeted in line with patients. Some patients have been waiting for hours.
According to Pour-Ahmadi, the maximum number of patient visits per day that each doctor can pay for in full means patients need to arrive early if they want to be seen.
On Monday, all doctors at the clinic were at capacity by 2:00 pm, and staff closed their doors early.
“It’s hard. It’s really hard,” he said.
Earlier Monday, Health Minister Jason Copping announced that the visitation restrictions would be removed, at least temporarily, until March 2023 while the government assesses the impact of the changes. It should cost about $22 million a year.
“The intention was to promote quality care and safety for patients and physicians,” Copping said at a virtual press conference on Monday. We believe the impact of this will be limited and outweighed by the need to support patient access.”
The United Conservative government introduced caps along with other changes unpopular with doctors when it unilaterally terminated its master contract with the Alberta Medical Association (AMA) in February 2020 and imposed a new one. .
The contract stated that doctors who saw more than 50 patients in a day would be paid half the fee for any additional work, and those who saw more than 65 patients would not be charged at all. . This was supposed to be a cost-cutting measure to prevent physician burnout.
Copping said Monday it caused problems.
For example, a specialist such as an ophthalmologist can quickly increase the number of billable visits by performing multiple tasks per day per patient.
Meanwhile, doctors say inflation has pushed up operating costs for clinics, while billing codes have remained relatively flat.
AMA president Dr. Fredrykka Rinaldi said Monday that some doctors have gone out of business, closed clinics, moved, or took on lower-risk jobs.
Finding a family doctor in Alberta has become increasingly difficult. Some clinics have tried to extend their hours into the evening to meet demand.
“If you ask doctors to work after hours, they’re already hitting their daytime caps…we’re not Florence Nightingale,” Rinaldi said.
Copping said patients who can’t get into clinics are turning to more expensive and overstocked emergency rooms.
Copping said the government will raise the cap as soon as it can update its medical billing system. This should get more patients into primary care waiting rooms and out of emergency rooms, he said.
Copping says he won’t commit to extending the changes beyond March next year until they’re effective.
Other open issues
Many controversies remained unresolved when the AMA signed a new agreement with state governments in September. The parties promised a strike committee to negotiate the details later.The deal promised the government to revisit the cap issue within 60 days of signing the deal.
Dr. Mareli Powell, who practices in both Fox Creek and Edmonton, said he was “very pleased” that visitation restrictions were lifted for now. said it showed improvement.
However, Powell said the change should be permanent soon.
“The fact that this is being re-evaluated does not assure doctors that this is a stable state to practice in and that is what is needed at this stage,” Powell said.
According to Powell, a long-term solution to the growing demand is to improve doctor retention in Alberta and recruit more doctors.
Under the agreement, doctors will receive a lump sum of 1% cash to recognize their efforts during the pandemic, with pay increases of about 1% every three years.
The agreement also promised doctors and the government to review and adjust fees for all services by 2025, and postponed discussions on paying for virtual visits.