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'Feeling powerless:' Two family doctors explain why they're leaving Alberta

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EDMONTON — Dr. Amy Tan has worked as a family physician in Alberta for 16 years.

Tan, who practices at a teaching clinic and provides palliative care in Calgary, had planned to keep working in the province for many more — at least until her 11-year old son finished high school.

But she said her plans changed in the spring when a prolonged and bitter dispute began between the United Conservative government and the province's doctors.

Tan, also an associate professor at the University of Calgary's Cumming School of Medicine, is taking a new job in Victoria on Nov. 15.

"I'm very grateful I have the choice, when I know a lot of my colleagues and other Albertans don't," Tan said in a phone interview from Calgary.

"The truth of the matter is I wouldn't have pursued other opportunities had it not been for what's going on."

Tan said she loves her work in Calgary, but it couldn't buffer her from the political fight — particularly during the COVID-19 pandemic.

The dispute started in February when Health Minister Tyler Shandro tore up a master pay agreement with the Alberta Medical Association.

Total physician compensation remains flat at $5.4 billion in the government's 2020-21 budget, but a new funding framework changes how doctors are paid. 

Doctors have said it will force hundreds of clinics across the province, particularly in rural areas, to reduce staff or close. 

Some changes were reversed during the pandemic, but a July survey by the medical association showed at least 40 per cent of physicians have considered moving out of the province.

Shandro has called it questionable that doctors would leave for other provinces, where they would earn less money. His press secretary, Steve Buick, added this week that he doesn't believe the "rhetoric" that doctors are leaving.

"There is no trend of overall losses of doctors," Buick said.

The College of Physicians and Surgeons of Alberta said it does its annual registration at the end of December, so it doesn't have current statistics. Buick said Alberta Health has access to the college's quarterly figures, which he said show the number of doctors working in Alberta hasn't changed.

"Hundreds come and go every year," he said. "Overall, we've had net gains."

In 2019-20, he said, 382 doctors left Alberta and 644 started — for a net gain of 262. The latest data through June shows the same trend of net increases, said Buick.

He also provided an Alberta Health Services risk assessment from Sept. 25 that showed 80 rural doctors had provided a notice of intent to leave, but said only 12 of them have given formal notice.

"We do not expect shortages overall or in any specific community, apart from the normal staffing challenges in smaller centres," Buick said.

Still, the Alberta College of Family Physicians said it's hearing from an increasing number of doctors who are weighing their options.

"Physicians don't feel like they are a valued part of the team," said executive director Terri Potter. "They've been told publicly that they are greedy. 

"Physicians are just feeling powerless."

The advocacy organization, which represents about 5,200 family doctors, has started an online campaign to showcase the importance and value of their role.

Potter said some doctors have taken steps to get licences in other provinces and others have decided to retire two or three years early.

"There will be a lot of movement," said Potter, who noted many who are leaving did their medical training in Alberta. "I really worry there will be a bit of brain drain."

Dr. Cian Hackett, a family physician, moved to Sylvan Lake, and started working in Rimbey two years ago after graduating from the University of Alberta. He said he planned to stay in central Alberta until retirement.

"When the government changes started coming out, my wife and I talked about would we consider moving to a different province," he said. "We decided for the time being to split our time between Alberta and Ontario."

Hackett said he and his wife, who's a nurse, plan to move to Ontario after the pandemic ends.

"We don't see an Alberta that matches our values — one that values public health care and education, vulnerable populations," he said. "We've stopped seeing it as a place with an economic or moral future when we think of raising a family."

Hackett said he's not only concerned about the lack of stability for his practice without a master agreement, but also the government's moves to reduce supervised drug consumption sites and review eligibility criteria for the Assured Income for the Severely Handicapped.

"There's no shortage of job opportunities — all of which pay well," he said. "The government wants to make it about physician pay.

"At a certain point, it becomes about other things."

Tan, who also did her training in Alberta, said the pandemic has been stressful enough for doctors and attacks from the government have made it worse.

"I only had so much fight in me left and I needed my bandwidth back to actually do the work, to contribute to society in the way I want to."

This report by The Canadian Press was first published Oct. 2, 2020.

Colette Derworiz, The Canadian Press

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