Alberta doctors push back against government's 'divide-and-conquer' strategy

The association representing Alberta's doctors is preparing for a protracted battle over pay, bargaining rights and the reformation of the province's health-care system.

In a letter sent May 5 to Health Minister Tyler Shandro, members of the Alberta Medical Association made it clear the association "remains as our exclusive representative in all matters concerning dealings with the Alberta government.

"We will not be entering into any discussions without representation from the AMA," stated the letter, signed by nearly 60 representatives of doctor subgroups within the organization.

Even though no negotiations are currently scheduled between the doctors and the government, the association's president said the letter sends an important message in light of what she calls Shandro's "divide-and-conquer" strategy.

"It is unfortunate that it has come to pass that we have to collectively and overtly publicly declare that we are unified," Christine Molnar said in an interview. 

Molnar said some of Shandro's actions and statements have attempted to bypass the AMA and negotiate directly with some doctors. The letter was prompted, in part, by Shandro's statements at a late April news conference during which he reversed a series of changes that affected pay for rural doctors.

This came after doctors in Lac La Biche and several other communities threatened to withdraw hospital services.

"He went out of his way on multiple occasions in that press conference to blame the Alberta Medical Association, in no uncertain terms, as if it was as the [AMA] that had created the environment that caused the whole situation in the first place, when it was the minister of health himself," Molnar said. 

Government pushes forward with changes

In an emailed statement, Shandro's press secretary, Steve Buick, said,  "We are not surprised that a lobby group's own representatives support the lobby group."

Physician compensation has been maintained at its current level of $5.4 billion a year, he said.

Buick said the government would move forward with a new funding framework and that Shandro would not back away from developing new ways of paying doctors. 

Molnar said that, so far, those changes have been arbitrarily imposed on doctors. 

Late last year, the government passed legislation giving itself the authority to unilaterally end a negotiated master agreement with the AMA. In February, Shandro exercised that legislated authority, ending the agreement and enacting a series of fee changes that were later reversed.

Molnar said Shandro did not listen to concerns from doctors who said the changes would threaten the economic viability of family practices, particularly in rural Alberta.

She said Shandro has rejected numerous offers by the AMA, including a five-per-cent pay cut, to help cut costs.

"We have made a number of proposals to the government, including proposals that included significant across-the-board savings cuts in the schedule and medical benefits," she said. 

"All of the proposals that we have put forward to the government have been rejected."

'Top-down approach'

Molnar said doctors are tired of the hostile and authoritarian attitude of Shandro and the UCP government.

"It's not just in health," she said.

"They're taking a very top-down approach. You know, 'it's my way or the highway' approach. If you're not stepping in line to the music, you're part of the enemy host, it would seem."

"And you know health care thrives in a co-operative environment. If you want to make changes in health care, you need to do it collaboratively and you need to partner together to make those changes happen."

With no chance of collaborative change, the AMA launched a $250 million lawsuit against the government last month, which claims a denial of their charter rights during negotiations.

Molnar said it may take two years or longer for the legal case to be heard. In the interim, she said, "We plan to be out there, we will be loud, we will be clear, we are not going to sit back and let the AMA be bulldozed by the government."