EDMONTON 鈥� The new president of emergency medicine for the Alberta Medical Association says ER physicians already coping with long hours, staff shortages and jammed waiting rooms are also being obligated, in some cases, to work for free.
Dr. Warren Thirsk says Premier Danielle Smith鈥檚 government has yet to follow through on a promise to reimburse emergency room doctors for so-called "good faith" payments.
"There's been lots of excuses, but the bottom line is no one has actually received a penny for those suspended good-faith payments," Thirsk said in an interview.
"On average, every emergency physician in this province is out thousands of dollars for free work."
Good-faith payments reimburse ER doctors when they see patients who don鈥檛 have identification and can鈥檛 prove an Alberta Health Care Insurance Plan billing number.聽
Thirsk said the United Conservative government stopped those payments when it ripped up the master agreement with the AMA in early 2020. He said it promised to bring back those payments when the two sides agreed to a new deal in September 2022.
But to date that hasn鈥檛 happened, he said.
"I'm legally and morally bound to look after you (if) you鈥檙e unidentified (as a patient)," said Thirsk, an emergency room doctor at Edmonton鈥檚 Royal Alexandra Hospital.
"(And) I鈥檓 going to look after you because it鈥檚 the right thing to do no matter what the problem is."
He said ER doctors are paid per patient, and the amount also depends on the diagnosis.聽
"When the contract was signed (in 2022), one of the conditions was they were going to fix the good faith (payments) right away," said Thirsk.
鈥淎nd then they found red tape.
鈥淓ven now we haven't been paid for good-faith billings.鈥�
Andrea Smith, spokesperson for Health Minister Adriana LaGrange, said the province remains committed to reinstating the good-faith payments.
"Alberta Health has been working on system updates to allow for retroactive payments and this policy is expected to be implemented in the near future," said Smith in a statement.
Provincewide delivery of medical care is handled through Alberta Health Services, with an annual budget close to $17 billion.
AHS, in a memo to staff made public this week, said it is forecasting a budget deficit and is seeking 10 per cent cuts to overtime and outside service delivery to help balance the bottom line.
Alberta, like other jurisdictions, is facing long waits for care and overcrowding in emergency wards.
Thirsk, an emergency room doctor for 25 years, said the problems are founded in a system that views health workers as costs rather than investments.
He said emergency doctors are routinely asked to cover off vacancies and shortages in other jurisdictions, particularly at the hospital in Red Deer.
"It's become a regular thing. We probably get once a month an AHS email asking us to cover a shortfall in Medicine Hat, in Lethbridge, in different cities," he said.
"I think that all the emergency departments across the province are stressed out and are just overcapacity. And I think that that's unfortunately the new situation normal.
"There's probably very few emergency physicians who haven't seen a patient seriously harmed or even die from the gaps in the system, and it's frustrated all of us. There's nowhere to take this."
Asked about the general sentiment he hears from ER colleagues, Thirsk replied: 鈥淭hey want out. Everyone wants out. People are desperate to get out. (They ask) 'How can I get out? What else can I do? This isn't fun anymore.' Those are the quotes I hear right now.鈥�
He said he has little faith a massive restructuring of Alberta Health Services will solve the problem.
This year, Smith鈥檚 government aims to dismantle Alberta Health Services to create four agencies linked to specific areas of care 鈥� such as acute care and primary care 鈥� all answering to LaGrange and cabinet.
Thirsk said the province is creating silos in what needs to be an interdependent system linked to patients rather than specialties.
鈥淎s a front-line worker who has no resources to look after the patients in front of me and is apologizing for that every day, I find it incredibly frustrating that we will drop $80 million into an administrative reshuffle,鈥� he said.
鈥淕iving four silos just means you鈥檝e got four different ways to say, 'It鈥檚 their problem, not mine.'
鈥淲e're on the Titanic, and we're rearranging the proverbial deck chairs.鈥�
This report by The Canadian Press was first published Jan. 11, 2024
Dean Bennett, The Canadian Press
