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Physician IT

Alberta doctors’ agreement would re-start POSP funding

EDMONTON – The Alberta government, regional health authorities and the Alberta Medical Association intend to re-start funding of the Physician Office System Program (POSP) as part of the latest compensation package offered to the province’s doctors.

As stated on the Alberta government’s Health and Wellness website, the proposed agreement commits funding to the continuation of the POSP, providing for the continued computerization of physician offices.

Over 3,300 Alberta physicians are enrolled in the POSP, but entry into the program ended in March 2006. Reactivation of funding will make it possible for additional doctors in Alberta to receive incentives for computerizing their practices.

As well, early participants in the program have voiced concerns about how they will pay for upgrades, maintenance and on-going training once their funding runs out.

The Alberta Medical Association’s board is recommending its membership vote for the financial agreement. The ratification process is expected to take seven to eight weeks because of the time it takes to mail the tentative agreement and a ballot to each physician, and then have the ballot returned.

The main thrust of the proposed agreement, which will be ratified by some 7,100 Alberta physicians and medical residents, would provide increases of 4.5 percent per year [retroactively] from April 1, 2006 to March 31, 2008. Increases to specific fees will be determined through the tri-lateral allocation process.

The largest increases are to the physician services budget, which funds fee-for-service payments and alternative relationship plans. Total funding in these areas will be $1.7 billion in 2006-07 and $2 billion for 2007-08.

“The trilateral relationship, which is unique in Canada, allows the three parties to jointly address complex and difficult situations that continue to emerge,” said Dr. G. N. (Gerry) Kiefer (pictured above), President of the Alberta Medical Association (AMA). “For example, this tentative agreement addresses Alberta’s physician shortages with the new Retention Benefit and the Clinical Stabilization Initiative that focuses on under-serviced areas and communities in crisis.”

The tentative agreement contains $103.5 million over two years dedicated to three innovative features which focus on retention and recruitment initiatives to help meet the increasing demand for more physicians in Alberta.

A new retention benefit will recognize physicians for the number of years that they have practiced in Alberta. This will reflect physicians’ terms of service in the province.

The unique circumstances of communities under pressure and under-serviced areas will be addressed through the new clinical stabilization initiative.

These communities will be dealt with on a case-by-case basis. A provincial framework for under-serviced areas is to be finalized by June 2007.

As well, special funding has been designated to address extraordinary increases in practice costs. Details on how it will be distributed are yet to be finalized.

Primary care initiatives, an innovative approach to offering team-based primary healthcare, will also receive ongoing support under the tentative deal. Currently, there are 19 Primary Care Networks in the province serving over one-million people.

Soaring rents, labour costs and real estate prices in the oil-rich province were one of the chief concerns in the talks – which stretched over the last 18 months – with the government and regional health authorities.

The thousands of people moving to Alberta for a piece of the red-hot economy only added to the stress. Alberta has a shortage of 1,000 physicians, and it is causing treatment delays and making it impossible for some people to find a family doctor.

Dr. Kiefer has suggested in the past that the doctor shortage will increase to 1,500 over the next few years unless the government offers physicians fee increases big enough to cover their rising costs.

A pediatric orthopedic surgeon at the Children’s Hospital in Calgary, Dr. Kiefer explained it is hard to attract doctors when they face higher office expenses and an increased cost of living in an inflated economy.

“Of course, these overhead costs are driven by Alberta’s oil and gas tsunami,” said Dr. Kiefer. “”I believe the proposed agreement goes some way in addressing these overhead costs, although I would acknowledge some physicians may feel it is still inadequate in this regard.”

Alberta doctors last received a raise in October 2005, when their fees were increased by 3.5 per cent. Because the current round of talks took so long, the latest agreement would only last until the end of next March. Dr. Kiefer said the medical association will send out a letter of intent to negotiate next month and the whole process will start again.