Dear Members,
Alberta Premier Danielle Smith, in a video posted on social media, has confirmed the government’s intention to introduce legislation under the Alberta Health Care Insurance Act (AHCIA) that would allow physicians to operate in both the public system and private stream of services. This announcement follows the November 18 story in the Globe and Mail reporting on this draft legislation and builds on the Government of Alberta’s recent announcement permitting privately purchased MRI, CT, and other diagnostic scans.
We shared discussions and concerns on the diagnostic testing proposal in our October 31 message to members, which generated several thoughtful and constructive responses from members. Your comments directly informed the letter that the ACFP sent to Minister LaGrange, and we are grateful for your engagement and expertise as these policy developments unfold.
Given the potential implications of this latest announcement for family medicine, we want to summarize what we know at this time and outline how the ACFP will be proceeding as more information becomes available.
WHAT WE KNOW SO FAR
1. Draft legislation exists but has not been released publicly, and the summary shared in the video posted on social media is not comprehensive.
Without the legislation itself, analysis remains limited.
2. The legislation will introduce privately paid services alongside publicly funded services.
This aligns with earlier government actions allowing Albertans to purchase selected diagnostic tests privately, while insured follow-up care remains available when medically indicated.
3. Concerns from the October 31 ACFP message remain relevant.
Preventive care is a core tenet of family medicine. It is most effective when delivered within a longitudinal relationship with a family physician and primary care team who understand a person’s values, goals, and health history.
Family physicians are medical experts who help patients interpret evidence-based guidelines and apply them in a way that is appropriate for the individual.
When diagnostic tests occur outside this longitudinal relationship:
- Results may be difficult for patients to interpret without expert guidance
- Unnecessary or inappropriate investigations become more likely
- The risk of harm caused by additional, unwarranted follow-up increases
- System costs rise due to investigations that may not add value to patient care
- Care can become fragmented and less coordinated
These principles remain central as additional privately accessed models are explored.
4. The AMA has noted that increased diagnostic access requires safeguards.
These include maintaining quality, ensuring transparency, and protecting integration with primary care – areas that the ACFP will also be watching closely.
Other organizations have raised similar concerns about this proposed legislation, including:
- Canadian Medical Association (CMA)
- Alberta Medical Association (AMA)
- Friends of Medicare
- Canadian Health Coalition
- Canadian Doctors for Medicare
- Universities of Alberta and Calgary’s Medical Students’ Associations
WHAT WE WILL BE WATCHING
As we await release of the legislation, we will be examining how any proposed changes may influence:
- The delivery of preventive care within a longitudinal, relationship-based context
- The ability of medical experts – family physicians – to guide appropriate investigation and management
- The coordination of care and follow-up within a Patient’s Medical Home
- Additional pressures or administrative burdens experienced by family physicians and their teams
- Equitable access to care for Albertans
- Risks of unnecessary investigations or fragmented care
These will be central lenses through which ACFP assesses any emerging hybrid public–private model.
NEXT STEPS FOR THE ACFP
We will:
- Review the legislation as soon as it is publicly released
- Engage with partners to understand operational, clinical, and system-level implications
- Evaluate proposed changes through the grounding principles of longitudinal relationship-based care and preventive health
- Consider impacts on practice burden, coordination of care, diagnostic pathways, and patient experience
- Reach out to Ministry contacts and other relevant parties to gain a better understanding of who is being consulted on this work, and whether ACFP could provide additional avenues to connect with impacted stakeholders
- Develop a clear ACFP position once the full scope of the policy is understood
WE WANT TO HEAR FROM YOU
Your insights from daily practice remain essential. We encourage you to continue sharing your observations and concerns with us. Your perspectives help guide our advocacy and ensure that the lived realities of family medicine inform policy discussions. Please send your comments, questions, and concerns to acfppres@acfp.ca.
Thank you for your ongoing leadership and commitment to your patients and communities.
Sincerely,
Melanie Hnatiuk, MD, CCFP, FCFP
President
Alberta College of Family Physicians
