Alberta
Province says Alberta family doctors will be the best-paid and most patient-focused in the country
Dr. Shelley Duggan, president, Alberta Medical Association
New pay model, better access to family doctors |
Alberta’s government is implementing a new primary care physician compensation model to improve access to family physicians across the province.
Alberta’s government recognizes that family physicians are fundamental to strengthening the health care system. Unfortunately, too many Albertans do not currently have access to regular primary care from a family physician. This is why, last year, the government entered into a memorandum of understanding with the Alberta Medical Association (AMA) and committed to developing a new primary care physician compensation model.
Alberta’s government will now be implementing a new compensation model for family doctors to ensure they continue practising in the province and to attract more doctors to choose Alberta, which will also alleviate pressures in other areas of the health care system.
This new model will make Alberta’s family doctors the strongest-paid and most patient-focused in the country.
“Albertans must be able to access a primary care provider. We’ve been working hard with our partners at the Alberta Medical Association to develop a compensation model that will not only support Alberta’s doctors but also improve Albertans’ access to physicians. Ultimately, our deal will make Alberta an even more attractive place to practise family medicine.”
“We have worked with the Alberta Medical Association to address the challenges that primary care physicians are facing. This model will provide the supports physicians need and improve patient access to the care they need.”
The new model is structured to encourage physicians to grow the number of patients they care for and encourage full-time practice. Incentives include increases for:
- Maintaining high panel numbers (minimum of 500 patients), which will incentivize panel growth and improve access to primary care for patients.
- Providing after-hours care to relieve pressure on emergency departments and urgent care centres.
- Improving technology to encourage using tools that help streamline work and enhance patient care.
- Enhancing team-based care, which will encourage developing integrated teams that may include family physicians, nurse practitioners, registered nurses, dietitians and pharmacists to provide patients with the best care possible.
- Adding efficiencies in clinical operations to simplify processes for both patients and health care providers.
As a market and evidence-based model, it recognizes and pays for the critically important work of physicians, including the number of patients seen and patient complexity, as well as time spent providing direct and indirect care.
“Family medicine is the foundation of our health care system. This model recognizes the extensive training, experience and leadership of primary care physicians, and we hope it will help Alberta to attract and retain more family medicine specialists who provide comprehensive care.”
Additionally, family physicians who are not compensated through the traditional fee-for-service model will now receive higher pay rates under their payment model, known as the alternative relationship plan. This includes those who provide inpatient care in hospitals and rural generalists. Alberta’s government is increasing this to ensure hospital-based family physicians and rural generalists also receive fair, competitive pay that reflects the importance of these roles.
“This new compensation model will make Alberta more attractive for physicians and will make sure more Albertans can have improved access to a primary care provider no matter where they live. It will also help support efforts to strengthen primary care in Alberta as the foundation of the health care system.”
“Family physicians have been anxiously awaiting this announcement about the new compensation model. We anticipate this model will allow many primary care physicians to continue to deliver comprehensive, lifelong care to their patients while keeping their community clinics viable.”
Quick facts
- Enrolment in the primary care physician compensation model will begin in January with full implementation in spring 2025, provided there are at least 500 physicians enrolled.
- The alternative relationship plan rate has not been updated since it was initially calculated in 2002.
- The new compensation model for family doctors is the latest primary health care improvement following actions that include:
- A $42-million investment to recruit more health providers and expand essential services.
- A new rural and remote bursary program for family medicine resident physicians.
- Additional funding of $257 million to stabilize primary care delivery and improve access to family physicians.
- Implementing the Nurse Practitioner Primary Care Program, which expands the role of nurse practitioners by allowing them to practise comprehensive patient care autonomously, either by operating their own practices or working independently within existing primary care settings.
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By Ron Wallace
The federal government has doubled down on its commitment to “responsibly produced oil and gas”. These terms are apparently carefully crafted to maintain federal policies for Net Zero. These policies include a Canadian emissions cap, tanker bans and a clean electricity mandate.
Following meetings in Saskatoon in early June between Prime Minister Mark Carney and Canadian provincial and territorial leaders, the federal government expressed renewed interest in the completion of new oil pipelines to reduce reliance on oil exports to the USA while providing better access to foreign markets. However Carney, while suggesting that there is “real potential” for such projects nonetheless qualified that support as being limited to projects that would “decarbonize” Canadian oil, apparently those that would employ carbon capture technologies. While the meeting did not result in a final list of potential projects, Alberta Premier Danielle Smith said that this approach would constitute a “grand bargain” whereby new pipelines to increase oil exports could help fund decarbonization efforts. But is that true and what are the implications for the Albertan and Canadian economies?
The federal government has doubled down on its commitment to “responsibly produced oil and gas”. These terms are apparently carefully crafted to maintain federal policies for Net Zero. These policies include a Canadian emissions cap, tanker bans and a clean electricity mandate. Many would consider that Canadians, especially Albertans, should be wary of these largely undefined announcements in which Ottawa proposes solely to determine projects that are “in the national interest.”
The federal government has tabled legislation designed to address these challenges with Bill C-5: An Act to enact the Free Trade and Labour Mobility Act and the Building Canada Act (the One Canadian Economy Act). Rather than replacing controversial, and challenged, legislation like the Impact Assessment Act, the Carney government proposes to add more legislation designed to accelerate and streamline regulatory approvals for energy and infrastructure projects. However, only those projects that Ottawa designates as being in the national interest would be approved. While clearer, shorter regulatory timelines and the restoration of the Major Projects Office are also proposed, Bill C-5 is to be superimposed over a crippling regulatory base.
It remains to be seen if this attempt will restore a much-diminished Canadian Can-Do spirit for economic development by encouraging much-needed, indeed essential interprovincial teamwork across shared jurisdictions. While the Act’s proposed single approval process could provide for expedited review timelines, a complex web of regulatory processes will remain in place requiring much enhanced interagency and interprovincial coordination. Given Canada’s much-diminished record for regulatory and policy clarity will this legislation be enough to persuade the corporate and international capital community to consider Canada as a prime investment destination?
As with all complex matters the devil always lurks in the details. Notably, these federal initiatives arrive at a time when the Carney government is facing ever-more pressing geopolitical, energy security and economic concerns. The Organization for Economic Co-operation and Development predicts that Canada’s economy will grow by a dismal one per cent in 2025 and 1.1 per cent in 2026 – this at a time when the global economy is predicted to grow by 2.9 per cent.
It should come as no surprise that Carney’s recent musing about the “real potential” for decarbonized oil pipelines have sparked debate. The undefined term “decarbonized”, is clearly aimed directly at western Canadian oil production as part of Ottawa’s broader strategy to achieve national emissions commitments using costly carbon capture and storage (CCS) projects whose economic viability at scale has been questioned. What might this mean for western Canadian oil producers?
The Alberta Oil sands presently account for about 58% of Canada’s total oil output. Data from December 2023 show Alberta producing a record 4.53 million barrels per day (MMb/d) as major oil export pipelines including Trans Mountain, Keystone and the Enbridge Mainline operate at high levels of capacity. Meanwhile, in 2023 eastern Canada imported on average about 490,000 barrels of crude oil per day (bpd) at a cost estimated at CAD $19.5 billion. These seaborne shipments to major refineries (like New Brunswick’s Irving Refinery in Saint John) rely on imported oil by tanker with crude oil deliveries to New Brunswick averaging around 263,000 barrels per day. In 2023 the estimated total cost to Canada for imported crude oil was $19.5 billion with oil imports arriving from the United States (72.4%), Nigeria (12.9%), and Saudi Arabia (10.7%). Since 1988, marine terminals along the St. Lawrence have seen imports of foreign oil valued at more than $228 billion while the Irving Oil refinery imported $136 billion from 1988 to 2020.
What are the policy and cost implication of Carney’s call for the “decarbonization” of western Canadian produced, oil? It implies that western Canadian “decarbonized” oil would have to be produced and transported to competitive world markets under a material regulatory and financial burden. Meanwhile, eastern Canadian refiners would be allowed to import oil from the USA and offshore jurisdictions free from any comparable regulatory burdens. This policy would penalize, and makes less competitive, Canadian producers while rewarding offshore sources. A federal regulatory requirement to decarbonize western Canadian crude oil production without imposing similar restrictions on imported oil would render the One Canadian Economy Act moot and create two market realities in Canada – one that favours imports and that discourages, or at very least threatens the competitiveness of, Canadian oil export production.
Ron Wallace is a former Member of the National Energy Board.
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