Family medicine in Alberta is no longer on the brink of collapse, "it's crumbling around us as we speak," Dr. Paul Parks, president of the Alberta Medical Association, said during a press conference on Jan. 23.
Last week the AMA surveyed family medicine specialists and rural generalists to assess the state of primary care in the province, and "the results show that it isn't just bad, it's dire," Parks said.
Ninety-one per cent of family doctors are worried their practice won't survive. Without immediate support, one in five family specialists said their practice won't last six months, and about the same amount felt their finances could sustain their practice for up to a year. Eight percent said they couldn't make it another three months, survey results indicate.
A majority of physicians also said they will reduce the comprehensive care they provide to help cut costs.
"Those doctors they love what they do. They trained long and hard to become family specialists," Parks said. "But now that circumstances are facing them, they're making very difficult decisions because they feel it's no longer possible to provide that kind of care.'
The problem facing Alberta's primary care doctors is complex, and has been building for years, but at it's core is an "antiquated fee for service model" that threatens the financial viability of family practices. The model no longer works for providing comprehensive care needed by Albertans, Parks said, and inflationary pressures are hitting doctors offices like every other business.
Family physicians in Alberta on average make around $340,000 a year, and they are paying over $250,000 in "fixed costs just to start their business," Parks said.
Alberta's Minister of Health Adriana LaGrange has committed to considering the AMA's proposal for an updated comprehensive care model in the context of the 2024 budget, Parks said, but action is needed now to save family practices.
In December, the government of Alberta announced $200 million in funding to help primary care and rural doctors, with the first half expected to be distributed early this year. This money, which come from the federal government as part of a funding agreement with the province, has yet to reach struggling physicians, Parks said.
"Not one cent that has been promised is even going to come before the spring... You heard today that there are practices who don't have that kind of time."
AMA is asking that these funds be immediately flowed to physicians to stabilize primary care, and that doctors receive ongoing support until a new care model can be implemented.
Over half of doctors, 61 per cent, said they were considering leaving the Alberta healthcare system, either for other provinces or early retirement. Other provinces have already made major investments in primary care and changed how primary care is funded, which risks luring more physicians away from Alberta for more stable environments, Parks said.
"We are we are absolutely at an Alberta disadvantage at this point in terms for our family medicine practices," he said.
"It's abundantly clear that this isn't the environment that's going to recruit more physicians and more family specialists into our province. And we're already struggling with keeping our learners here, our students and our resident physicians, to keep them in this province."
