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March 25, 2020
Dear Partners and Advocates:
We currently face a situation that is unprecedented for many of us. Not only are there challenges to the public health care system, but we are also tackling the ever-increasing demands the COVID-19 pandemic brings to our ability to deliver care. Through all of this, family physicians across the province are committed to the well-being of their patients and communities and want to do their best to deliver high-quality care.
The Alberta College of Family Physicians (ACFP) represents more than 5,200 family physicians, family medicine residents, and medical students across Alberta. In these challenging times, we feel the voice of family physicians on the front lines needs to be heard and represented to ensure our ability to continue to deliver care across the province. Family physicians collectively provide 70% of health care services across the province (as noted in the PEER Evidence Pertaining to Healthy Primary Care Workforce document). Most family physicians are small businesses that are contingent upon remuneration from the government to pay operating costs to support not only the delivery of health care but also sustainable employment in Alberta’s communities.
Over the past week, the pandemic crisis has impacted how care can be safely and responsibly delivered in communities. Clinics are having to consider letting go of essential employees and resources while physicians, who are sacrificing their own well-being, continue to work day-and-night to serve the needs of their patients. Adding to this, the current billing arrangements will not sufficiently support the service levels required and even with the newly announced virtual allowances, clinics are at imminent risk of closing their doors.
While long-term we understand that negotiations between government and family physicians regarding funding will continue, the time for that is not now. Right now, the focus must be on enabling family physicians to continue to meet the health care needs of all patients and communities across the province, whether it is for mental health, chronic disease management, or acute concerns, as well as contributing to the COVID-19 response. We need to enable this care to be provided in person, virtually, by telephone, or by any means necessary.
Family physicians have built a trusting relationship with their patients and have an awareness of the health, family, and community factors that impact their well-being. We need to enable them to continue to fulfil the health care needs of their patients through every stage of life.
To continue to provide care safely and effectively, family physicians across the province are in need of immediate resources:
1.Sustainable funding to enable clinics to continue to operate.
- Family physician funding must be preserved. Virtual options should be made available at a funding comparable to in-person office visits. This will ensure care can be provided to all patients and so that social distancing and self-quarantine measures required to flatten the curve can be respected.
- Short-term quarantine funding to ensure clinics can remain operational and cover expenditures including rent and staff if a physician faces self-quarantine.
- Continuous replenishment of one-use personal protective equipment for physicians, patients, and clinic staff. Supply is scarce and supply chains are not consistent across the province, putting some communities at risk. Sites that care for vulnerable populations (i.e. Indigenous communities, safe consumption sites, homeless shelters, etc.) also need to be adequately supplied with personal protective equipment.
- We need to bolster capability to provide virtual care including telephone and telehealth visits and programs provided by physician offices and Primary Care Networks including maternal, chronic disease management, clinical pharmacy, and behavioral health consultations.
- Investments in private enterprise such as Telus Babylon need to be redirected to enable those that have been providing care to our communities to continue to do so. The ability to maintain continuity of care in practices is important to maintaining good health outcomes for Albertans. Redirecting scarce funds to private enterprise focusing on episodic care will undermine health outcomes in the province.
Our colleagues at the Alberta Medical Association (AMA) have by all accounts approached negotiations with an intent to protect health care delivery while being responsive to the fiscal challenges faced by the province. Now more than ever, it is important we recognize that the health and well-being of Albertans is not a political game and will require everyone cooperating in good faith to ensure that the health care needs of our province are being met.
Attempts to undermine primary care has been a source of unneeded stress and distraction when the focus needs to be on maintaining high quality health care delivery. Our family physicians want to continue to deliver comprehensive, ongoing care within our medical homes to patients and families that we have gotten to know, and with whom we have built trusting relationships. As we face a pandemic that presents a challenge unprecedented to many of us, we need to remember we are all in this together and we must continue to support each other and work collaboratively if we are going to face this challenge successfully.
Vishal Bhella, MD CCFP
Terri Potter, BA PMP CAE