Doctors outraged in pay fight with province

The battle between the Alberta Medical Association (AMA) and the province over the government's imposed pay settlement has raised the ominous spectre of future job action by doctors, including those who practise in rural communities.However, while money is the central issue of the current unrest it is not the primary factor for many doctors who choose to work in a rural setting, says a Central Alberta physician recruiter.“When we talk to doctors, particularly young ones, about coming to this area, it is all about community. Very seldom is it about money,” said Gerald Ingeveld, chairman of the Sundre Health Professional Attraction and Retention Committee.His group has just finished a lengthy process in attracting nine new doctors to the rural Central Alberta community to replace six physicians who are leaving the community.“They (doctors) come and stay here because they like Sundre, and rural medicine,” he said.However, the current dispute has galvanized widespread solidarity within the province's medical community, from both urban and rural physicians, who are collectively angry at the provincial government for imposing the pay settlement on Nov. 16 following an impasse in negotiations that began 20 months ago.Dr. Michael Giuffre, president of the AMA, is calling on the provincial government to get back to the bargaining table and reach a negotiated deal by Dec. 31.If a deal can't be reached by then the province must commit to a dispute resolution process, said Giuffre, who did not specify last week what any “job action” might be.Last week, the AMA rejected the imposed pay settlement announced by Alberta Health Minister Fred Horne.The minister said he was implementing key elements of a recent offer to the AMA, including a one-time lump sum payment, annual increases to fees, and continuing increased support for Primary Care Networks.Horne said the total estimated value of the government's initiative is $463 million over four years, an amount vigorously contested by the AMA which countered the provincial initiative will cost doctors more than $200 million.As well, the minister said the Business Cost Program (BCP) will be extended for an additional year to the end of 2013-14, while the Retention Benefit Program (RBP) will end March 31, 2013.Horne said the combined funding of nearly $120 million for these programs will be reinvested in physician supports related to family practice and primary health care.The RBP supports the retention of physicians by rewarding their continuous years of service to Albertans.“The Retention Benefit is an extremely important program for all physicians, urban or rural, secondary, tertiary or primary care. No pensions exist for physicians and the doc population is aging and should be supported to continue patient care where possible,” Giuffre told the Gazette through an AMA spokesperson.“We have not heard from rural physicians that the program is more important there than for their urban counterparts. I am quite sure it may support some rural physicians to stay in practice longer, but not necessarily more than for their urban counterparts.”Ingeveld said the provincial RBP does not impact Sundre's ability on a financial level to recruit new doctors to the community although he did add his committee will have to review the province's imposed settlement to the AMA to determine whether there could be any future adverse ramifications.“Our community does not get any funding,” said Ingeveld of the province's financial assistance in rural recruitment. “But we will have to study this more.”He said Sundre, being a rural community, does receive expense reimbursement from the Alberta Rural Physician Action Plan (RPAP), an independent not-for-profit company, when potential doctors visit the community during the recruitment process.