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Welcome to the Alberta Medical Association’s Section News – an opportunity for sections to report on their challenges  and objectives. This service helps sections communicate with all AMA members as well as physicians in their own specialties. Your feedback is encouraged. Please contact Agnes E. McIntyre, Administrative Assistant, Section Services: T 780.482.2626; TF 1.800.272.9680; email agnes.mcintyre@albertadoctors.org.

April 2012

Primary Care Alliance ◊ Section of General Practice Dr. Ann R. Vaidya, President T 403.873.2352 F 403.873.2364 gppres@albertadoctors.org ◊ Section of Rural Medicine Dr. Allan S. Garbutt, President T 403.562.8804 F 403.562.2905 srmpres@albertadoctors.org ◊ PCN Leads Executive Dr. Allan L. Bailey T 780.962.9888 baileymd@telusplanet.net ◊ Alberta College of Family Physicians Dr. Paul W.A. Humphries, Past President T 780.488.2395 acfppres@acfp.ca The Primary Care Alliance (PCA), which includes the Section of General Practice, Section of Rural Medicine, the Primary Care Network (PCN) Physician Leads Executive and the Alberta College of Family Physicians (ACFP), issues a joint Section News submission about current issues affecting general practitioners.

All comments and feedback on the PCA Section News submission should be emailed to Ms Nella Papaianni, Manager, General Practice Liaison (nella.papaianni@albertadoctors.org). ‘‘ Dr. Allan S. Garbutt: AMA’s president-elect

nominee

Dr. Allan S. Garbutt, a family physician based in Crowsnest Pass, is the Alberta Medical Association’s (AMA’s) nominee for 2012-13 president-elect. The Nominating Committee selected Dr. Garbutt at its March 9 meeting. If other candidates step forward, the AMA Constitution and Bylaws allows for an election by mail-in ballot. Check the May 10 MD Scope for the call for nominations. An active AMA member, Dr. Garbutt is presently serving as: • President, Section of Rural Medicine • Representative Forum delegate • Member, Primary Care Alliance Board and Forum • Member, Section of General Practice Executive • Member, Primary Care Network Physician Leads Executive • Member, Physician Advocacy Group His contributions to the association and the profession have been recognized with the AMA’s Long Service Award (2010) and the distinction of AMA Member Emeritus (2011).


The 2012-13 president-elect term begins September 22 at the adjournment of the Representative Forum/ annual general meeting in Edmonton, when the current president-elect Dr. R. Michael Giuffre becomes president. ‘‘

approval, establishing a shared Governance Committee, developing a project work plan, finalizing a communications strategy, and aligning the framework with the new Alberta Netcare protocol. • Quality assurance: Delegates received an update on the College of Physicians and Surgeons of Alberta’s plans for quality assurance procedures. The main goal of this initiative is to ensure that physicians are competent throughout their career by providing feedback, supporting continued learning, and facilitating performance management.

Executive committee meeting

The Section of General Practice held their executive committee meeting on March 15, 2012. From negotiations to allocation, members discussed a variety of issues that have since been addressed or have evolved. Details on some of these issues are discussed below under the Representative Forum section.

‘‘ Negotiations and draft interim agreement

‘‘ Spring Representative Forum (RF)

The main issue of the day for both RFs was negotiations. At the spring RF, delegates received an overview of the agreement in principle (AIP) that was reached with Alberta Health and Wellness. They and the Board of Directors overwhelmingly endorsed the direction in establishing principles and a foundation for a short-term agreement as negotiations continue for a long-term, master agreement. On March 31, a special meeting of the RF was held to review a draft interim agreement based on the foundation of the AIP. Delegates received a thorough briefing and then provided their clear advice to the AMA Board of Direction on how to move forward. As mentioned in the March 21 and April 5 issues of the President’s Letter, this interim agreement is structured for two years, with a possibility of a third.

(March 16-17) and Special RF (March 31)

In an unprecedented move, the AMA held two meetings of the Representative Forum (RF) in March. Representatives from the Section of General Practice, Section of Rural Medicine, PCN Leads Executive, ACFP (via Section of General Practice delegates) were in attendance at both forums. Highlights included: • Session with Health and Wellness Minister Fred Horne: At the spring RF, delegates had an opportunity to listen to and interact with Minister Fred Horne in an in-camera session. He emphasized his government’s commitment to engaging physicians in creating a more accessible health care system. Delegates raised many issues with the minister, including physician intimidation, access to long-term care, and alternate forms of physician remuneration. • Information Sharing Framework: RF delegates were given an update and report on the provincial Alberta Health Services (AHS)‑Electronic Medical Record (EMR) Information Sharing Framework (ISF). At the present time, the ISF is limited to and focused on physicians using an AHS-EMR in an ambulatory clinic setting. RF delegates supported the framework and draft agreements which includes the Memorandum of Understanding (MOU), Governance Committee Terms of Reference, Information Sharing Agreement, Information Management Agreement, Information Exchange Protocol, Physician Participation Agreement, and Physician Notice of Termination. The next steps moving forward are: seeking board

Alberta Medical Association

In her April 5 letter, AMA President Dr. Linda Slocombe states: “It is an interim agreement only, designed to give us time to negotiate a new master agreement featuring the full range of structures, relationships and programs that we need to see in the long term. In the meantime, however, the draft agreement provides some rate increases for physician fees/payments along with very important continuance and recognition provisions that the AMA has not received before.” ‘‘ Business Costs Program (BCP) and Retention

Benefit (RB)

Under the draft interim agreement, the Business Costs Program (BCP) and Retention Benefit (RB) program would be discontinued. The funds from the two cancelled programs, which amount to $120 million per year, will be not be lost 2

April 2012 Section News


– instead, they will be redirected to the Physician Services Budget (PSB) (within the SOMB or existing programs), from which they will be allocated back to physicians. The AMA will be working with the different sections to structure this allocation and subsequent payments to physicians in a way that mimics as closely as possible the payments physicians would have received before. Many family physicians have sent e-mails and voiced their concerns that the loss of these programs will impact their finances. These concerns were presented at the special RF by representatives of the Section of General Practice.

• PCNs are the first transition from traditional family practice to a world where every Albertan has a medical home. FCCs may well be part of the primary care neighborhood, but they must be integrated with evolving PCNs. The alternative is fragmentation or duplication of care and destructive competition. The PCA and the AMA will be monitoring this development closely and continue to speak publicly in favor of appropriate investment in primary care and doing what is right for patients. Please continue to watch for updates on this matter in upcoming issues of the President’s Letter.

Please continue to watch for updates in upcoming issues of the President’s Letter.

‘‘ Election advertising and public advocacy

‘‘ Family care clinics (FCCs)

Despite receiving a cautionary letter from the chief electoral officer, the AMA Board of Directors has agreed to continue with its non-partisan advertising for the remainder of the current provincial election campaign. This was stated in the April 5 issue of the President’s Letter.

In a separate President’s Letter sent April 5, Dr. Slocombe also addressed the recent election promise that the Progressive Conservative (PC) party would create 140 family care clinics (FCCs) over three years. Although the AMA initially supported the concept of the initial pilot-project clinics in order to monitor and observe their performance, Dr. Slocombe has expressed concerns that a “true and valid evaluation” would now be impossible should this election promise be fulfilled.

The AMA has developed four ads, which are posted on our website: • “Health care needs your voice” • “We’re not waiting to reduce wait times” • “What are your ideas for improving access to family doctors?” • “Who do you want looking at your personal health information?”

The PCA has been working with AMA senior staff in developing a response that touches on many of the concerns raised by family physicians. Some of the key messages include: • Alberta’s 40 PCNs, serving 2.8 million Albertans, have transformed the primary care landscape. Yet there has been no meaningful engagement of family physicians or the health care teams in our PCNs who successfully deliver care every day. While the AMA was invited to send a physician to an evaluation and monitoring committee, the premier’s announcement seems to suggest that the verdict is already in on FCCs as far as government is concerned. • No one seems to be able to explain clearly what FCCs really are or how they will fit with PCNs. • PCNs have been measured and evaluated as thoroughly as any comparable groups in our current system, and the weight of evidence is showing that PCNs are moving in the right direction.

Alberta Medical Association

The PCA, along with the AMA, encourages all members to download and print copies of the ads to put up in their offices. ‘‘ PCN Physician Leads/MLA engagement

Since January, many PCN Physician Leads have met with their MLA to discuss the value of local PCNs. Briefing notes were provided to assist with these meetings and shared with all PCNs. A session on advocacy of PCNs was also undertaken at the most recent PCN Leads Forum. ‘‘ PCN Physician Leads Forum – March 2-3

The PCN Physician Leads Forum was held on March 2-3, with 47 PCN physicians representing 31 PCNs across the province. For the first time, 20 PCN Executive Directors joined the PCN physicians on March 2. Topics discussed at the Forum included: 3

April 2012 Section News


Liberal candidate Dr. David Swann is seeking re‑election in the Calgary-Mountain View constituency.

• Concept of the medical home model • Governance (AMA, PCA and PCN – today/future) • Roles and responsibilities (NPC board member and an executive directors) • Engaging allied health providers • Advocacy for PCNs • Primary care funding proposal • Negotiations (status and recent funding announcement) • PCN zonal meetings (first meetings ever within the Central, North and South Zones) • Election of the Calgary Zone PCN Executive Representatives • Family care clinics • Succession planning • System audit of PCNs

• Phone: 1.800.661.9201 (Alberta Liberal Party toll‑free) • Email: dswann@albertaliberal.com • Website: http://reelectdavidswann.com/ Edmonton psychiatrist Dr. Peter Rodd is running for the Wildrose Alliance Party in the Edmonton‑Manning constituency. • Phone: 1.888.262.1888 or 403.769.0999 • Email: peter.rodd@wildrose.ca • Website: http://peterrodd.ca/

Section of Neurosurgery Dr. John H. Wong, President ‘‘ Alberta Neurosurgical Society meeting

In addition, a Primary Care Funding Working Subcommittee was established with representation from both physicians and executive directors. PMP will support this working subcommittee which will look at developing proposals to access the $75 million fund for primary care. The mandate of the working subcommittee is to help disseminate information to physicians so that they understand the fund and how to access it, and to develop proposals that impact PCNs more collectively.

The Section of Neurosurgery will be holding its annual Alberta Neurosurgical Society meeting at the Fairmont Lake Louise Hotel, April 27‑28. The invited speaker will be Dr. Andy Parrent from Western University. The academic sessions are open to all parties, but attendance at the associated annual Business Meeting is limited to provincial section members. There will two dinners. Details to follow soon.

‘‘ Provincial election

• Fairmont Chateau Lake Louise 111 Lake Louise Dr Lake Louise AB T 1.403.522.1566 F 1.403.522.1679 http://www.fairmont.com • Guest room reservation Group Block Code: 0412ALBE _009 OR ask for the Alberta Neurosurgical Society

There are a number of ways for physicians to be involved in the provincial election. Watch local media for information on all-candidates’ debates happening around your community, attend and raise local or provincial concerns. Write a letter to your local newspaper. Support the candidate of your choice by campaigning or by donating financially. Join a political party.

• Group room rate is $199 per night plus taxes, etc. • Cutoff date for room reservations: March 28

‘‘ Three physicians – two incumbents and one

newcomer – are running in this election.

Please contact the hotel today if you have not made your reservations.

Dr. Raj Sherman, leader of the Alberta Liberal Party, is seeking re-election in the Edmonton-Meadowlark constituency.

For further details, please contact Linda Menzies-Burrows: Linda.Menzies-Burrows@ albertahealthservices.ca (T 403.944.1259).

• Phone: 1.800.661.9201 (Alberta Liberal Party toll‑free) • Email: office@albertaliberal.com • Website: http://www.albertaliberal.com/

Alberta Medical Association

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April 2012 Section News


AMA Section News - April 2012