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Dr. Linda M. Slocombe

April 5, 2012

Dear Member:

In this letter:

AMA will continue to publish non-partisan election ads. Promise of 140 family care clinics (FCCs) flies in theface of health quality councils

No. 1 recommendation.

Election advertising

The Alberta Medical Association (AMA) will continue with its non-partisan advertising for theremainder of the current provincial election campaign, the Board of Directors has agreed.

The decision follows a letter from the chief electoral officer who cautioned that the AMAs ad,Health care needs your voice, could be in contravention of provincial legislation that limitsthird-party political advertising to $30,000 during a provincial election.

The AMA has developed four ads, which are posted on ourwebsite:

1. Health care needs your voice.2. Were not waiting to reduce wait times.3. What are your ideas for improving access to family doctors?4. Who do you want looking at your personal health information?

140 family care clinics

An election promise from the PC party to create 140 family care clinics (FCCs) over three yearsflies in the face of the No. 1 recommendation from the recent report of the Health Quality

Council of Alberta (HQCA). Moreover, there is no evidence to support this explosion in thenumber of FCCs from the three pilot-project clinics which just opened.

In its recent report, the HQCA recommended the government and Alberta Health Services:

undertake no further major restructuring in Albertas health care system without firsthaving a clear rationale for the change including a transition plan that specifies the potentialramifications to safety and quality of patient care, the well-being of front-line providers, andthe overall integrity of the health care system.

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The Presidents LetterApril 5, 2012Page 2

Lets be clear:

140 FCCs in just three years will mean massive change at a time when those within thehealth care system are looking for some stability. And, there is no transition plan.

The overall integrity of the health care system will be challenged. What will happen tocontinuity of care? Where will the staff come from?

As for the well-being of front-line providers, there has been no engagement of familyphysicians and no engagement of the health care teams associated with the 40 primarycare networks (PCNs) that now provide care to 2.8 million Albertans and involve 90% ofall family doctors. Nor was the AMA involved in the design and implementation of thepilot-project clinics.

The AMA supported the pilot-project clinics because our (mis)understanding was that theirperformance would guide their future. Now, out of left field, comes this announcement just

hours after the pilot-project clinics opened their doors thereby making a true and validevaluation impossible.

On the other hand, the value of PCNs has been demonstrated in an independent $1.9 millionevaluation by Malatest Program Evaluation & Market Research. As my predecessor,Dr. Patrick J. (P.J.) White wrote in his June 15, 2011, Presidents Letter: Primary care networkshave changed the face of primary medical care. Next is to have PCNs change the face ofprimary health care. Lets build upon what weve already achieved.

What will happen to the family doctors office?

This has left family physicians and PCN health care teams and staff bewildered and anxious fortheir futures.

Will FCCs enjoy a favored child status in terms of government funding, and resourcesand support from Alberta Health Services?

What will happen when an FCC sets up shop next door to a current physician clinic?(A medical office in Calgary announced its closing because an FCC pilot project wasopening nearby.)

FCCs will be open 7 a.m. 9 p.m. Many family physician offices currently haveextended office hours as well as physicians being on-call 24 hours a day and could beopen longer if they had more resources.

Preventive medicine Many family physicians and PCN health care teams currentlyoffer preventive medicine and they would like to do more. The AMA has made anumber of proposals for this to happen, but government has consistently rejectedour ideas.

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The Presidents LetterApril 5, 2012Page 3

As for health professionals, the FCCs just like PCN health care teams will be staffed bynurse practitioners, registered nurses, licensed practical nurses, social workers, mentalhealth counselors, psychologists, pharmacists, dieticians, physiotherapists, family physicians

and others.

At FCCs, a patient will not always be seen by a physician. This already happens within PCNs,but the government has balked at AMA proposals to expand the delivery of care by other healthcare professionals within the physicians office and within a PCN.

Annual funding for each FCC is set at $5 million. This establishes a new benchmark forsupporting primary care in Alberta, a standard that should be applied fairly throughout thehealth care system, e.g., funding and resources for family physician offices and for PCNs.

Primary care for the 21st century

Health and Wellness Minister Fred Horne has been consistent and adamant in his support forPCNs. What is confusing and not so clear is the governments intention for the future ofprimary care, including the role of the family physician and the relationship between PCNsand FCCs.

Over the past decade family physicians have changed the face of primary care throughout theprovince. Their leadership, innovation and entrepreneurship created health care teams and, indoing so, revamped the delivery of primary care for the 21st century. The medical home hasthe support of family physicians and the evidence to proceed.

Albertas primary health care system cannot afford unnecessary (and costly) duplication andfragmentation. Alberta cannot afford to further alienate physicians. Alberta should not beexperimenting with an untried and unproven concept that could threaten the viability of thefamily doctors office.

Albertans have too many bad memories from erratic and impulsive changes in the health caresystem, whether it was a hospital being blown up in Calgary or a monopoly being createdthrough Alberta Health Services. One cannot simply impose 140 new clinics on top of theexisting system. Albertans dont need another history lesson in how not to pursue change.

Yours truly,

Linda M. Slocombe, MDCM, CCFPPresident