BONNYVILLE – Local physicians are standing up against proposed changes that could negatively impact their patients, and are encouraging residents to do the same.
On Wednesday, March 11, doctors from Bonnyville, Cold Lake, St. Paul, and Lac La Biche came together at the Bonnyville Seniors’ Drop-In Centre to share what the reality could be for the region if the new provincial physician framework comes into effect.
“The meeting was a result of (the doctors) reaching out to say ‘you know what? We’ve got an issue with the latest budget, and we’d like to clear the air’ and they were asking for help… It allowed us to put the spotlight on rural health,” detailed MD of Bonnyville Reeve Greg Sawchuk.
Dr. Travis Webster, physician at the Bonnyville Medical Clinic, explained the provincial government and Alberta Health Services (AHS) walked away from negotiations on Feb. 20 and announced the 11 changes to the funding model for doctors.
“The physicians are aware and accepting that cuts are needed in healthcare, there’s no doubt about that,” he noted. “Where we became upset and saw that there’s issues affecting our region is these cuts disproportionately affected primary care and even more so rural primary care.”
Some of the changes include removing physician overhead subsidies from all hospital-based services, capping the number of office visits to 65 (excluding rural locations), reducing the number of days physicians have to make claims to 90 from 180, and requiring patients 74.5 years and older to pay for driver’s license medical exams, among others.
Each of the 12-member panel stressed how the amendments would further put healthcare in the area at a disadvantage and prevent recruitment.
“The government is quick to say Alberta doctors are some of the best compensated physicians in the country, yet in rural we struggle to fill vacancies,” noted Bonnyville physician Dr. Hendrik van der Watt. “Currently for towns north of Edmonton, there are over 40 vacant positions for physicians. In our region alone, we have 11 open positions we’re struggling to fill.”
A concern for Bonnyville-based Dr. Jonathan Barnard was how it would impact the length of appointments.
“As a group, we might have to limit visits to one or two concerns at a time. In a community where wait times are already a significant barrier, this will lead to one visit being stretched over several visits with lengthy waits in between,” he detailed. “To try and mitigate this, to try and ensure timely follow up and access, we might see physicians reduce their (practice) sizes, which means… more patients using the walk-in and emergency room (ER) to get appropriate care and more patients falling through the cracks of an already burdened healthcare system.”
Barnard also sees the removal of physician overhead subsidies as having negative impacts because doctors bring administration work to their clinic to “follow-up on results and referrals more effectively and safely.”
The obstetrics department in Bonnyville could be shut down as a result of the changes, stated Dr. Theresa Watson, a physician at the Bonnyville Medical Clinic.
“What this means for moms is they might have to travel, hopefully to surrounding communities, and if they’re unfortunate, trips to Edmonton. This is currently the reality of our everyday practice.”
She added, “We’ve worked really hard to build a robust obstetrics program, but these cuts will jeopardize our ability to offer safe and sustainable care to our community. If this does happen, this does threaten that our program may have to shut down and this will be devastating for us as doctors, as well as for all our patients.”
St. Paul faces similar threats to their emergency department. Dr. Hester Gordon described the cutbacks “as the last straw for some of my colleagues.”
“I can tell you there’s some doctors that are going to pull out of the emergency department in St. Paul, and we can’t afford that as it is. I can also tell you that there’s clinics that are going to close in St. Paul,” she continued.
Recruitment could also take a hit, which Town of Bonnyville Mayor Gene Sobolewski has already seen first-hand during his involvement in trying to attract doctors to the area.
“When we first started the recruitment process, we were getting paid or we had allocations pay for recruiters to go out of the province or the country. But, then that slowly started to wean away so the municipality stepped up and we started to provide funds, especially to doctors, because they come in here and they don’t have a credit rating and the whole bit.”
Van der Watt has heard from possible recruits that they won’t apply to positions in Alberta because of the issues surrounding the funding.
“None of us want to leave this community, but we may be forced to do so. This uncertainty and the purposed changes are harming our ability to recruit new physicians. Yes, this problem was there before these changes were proposed, but these changes aren’t helping. We can’t afford any more obstacles. When I hear or see something like this, it raises the question for me; is our government thinking about rural Alberta when they decide these things?”
All of those in attendance were encouraged by the physicians and local officials to reach out to the province to voice their concerns.
“The government wants to hear from the doctors and from you,” noted City of Cold Lake Mayor Craig Copeland. “You’re the people that may have elected the UCP party, and I encourage you to write to the MLAs in your area and just tell them this isn’t what, if you supported them, you voted for.”
Dr. Keeve de Villiers, physician at the Bonnyville Medical Clinic, added, “My hope is that hearing some of this, you would be able to leave here and take the message to where it counts. Unfortunately, the government has chosen not to listen to us, to the people who, I believe, had the interest of the community at heart, and the people who are able to affect that is you.”
Bonnyville resident Holly Breau hoped all of the attendees took the meeting seriously.
“If you’re not scared, you’re not listening. But, the good news is you have a voice. You have the ability to speak, you can call your MLA, you can write a letter, and let your voice be heard,” she exclaimed.
Jennifer Cory, a local nurse practitioner who was in the audience, said she’s already seen wait times for specialists go from six weeks to six months due to the cuts.
“It’s going to affect us in many ways, and you’re going to be travelling for it. You’re going to be paying $100 in gas every time you drive to the city and we’re going to be devastated in this area.”
A major aspect the doctors wanted to be shared with the government is the differences between rural and urban healthcare.
“They really need to acknowledge that rural is important,” stated Dr. Dean Hanson, Bonnyville physician. “Our medicine is different and that’s not acknowledged with these changes. These changes are implemented across the province of Alberta… and there’s no differentiation for a rural practice and that’s the problem. Your message needs to be that rural is different, and it’s time to start treating rural medicine as different. Acknowledge that we’re different and needed, otherwise everything is going to collapse.”
