SUNDRE — A roller coaster ride of forced changes to health care and sudden, unapologetic reversals from the health ministry has not inspired local doctors to change their decision to withdraw services from the local hospital.
“I’m almost getting whip lash at how much has changed, and then changed again,” said Dr. Michelle Warren, who co-owns the Moose & Squirrel Medical Clinic in Sundre with husband Dr. Rob Warren.
Health minister Tyler Shandro recently announced some reversals and holds on, among many other things, controversial changes that, despite months of warnings by the Alberta Medical Association, had been imposed on physician compensation after the governing UCP unilaterally tore up the master pay agreement between the province and doctors.
“When I am certain that this government is done meddling, and we’ve got stability, then I can look at whether or not it makes sense to resume those services,” said Warren.
“But we can’t bounce around like a yoyo. We have to wait until we know we have certainty.”
Adding insult to injury, the minister had during a press conference laid the blame squarely at the feet of physicians, who had long before the COVID-19 pandemic been warning about potential repercussions, she said.
“The biggest thing was his inability to say, ‘I made a mistake.’ He tried very hard to foist blame onto the Alberta Medical Association,” she said.
“But the evidence is there in black and white and in print from December onwards, that he was being told — Alberta Health was being told — that imposing these changes is going to cause significant unintended consequences for urban and rural (practices), and don’t do it. And he did it anyway.”
As the consequences, Shandro was warned about began to happen and physicians started to abandon services, change their practices, or outright planned to pull up stakes and leave the province, she said the minister subsequently ended up placed in the position to reconsider those changes.
“When he reversed those changes, or put other changes on hold, he never once said, ‘I’m sorry, I was wrong,’ which is what he should have done, because that doesn’t paint him in a good light,” she said.
The continued absence of certainty as well as an arbitrated agreement with the government has not fostered much faith among physicians, she said.
“I have seen more uncertainty in health care, and how health care is delivered, since December, than I have experienced in 20 years of practice.”
Because of the way things have been handled by the government, Warren said she has experienced a litany of glitches and more difficulties with payments as their clinic attempted to adapt.
She’s even seen rules change without any notification, with Alberta Health imposing changes in billing codes that physicians are only discovering when they get rejections.
“We take photocopies of the bulletins as they come out, and so I can prove that these have changed over and over and over again,” she said.
The health minister has changed his mind not once, not twice, but several times, she added.
“I don’t know that he’s not going to turn around on July 1 to make changes yet again. And so the only thing that I have control over is not the minister, not how he decides he’s going to attack health care going forward…but what I can control is how I’m going to run my clinic.”
Once a master pay agreement with the Alberta Medical Association has been reached and certainty reestablished, then they will be able to look at resuming services at the hospital, she said.
“I would love nothing more than to be continuing to look after my admitted in-patients in Sundre on July 1. I would love nothing more than to continue working in the emergency room, because I enjoy that work, and I feel it’s good to give back to the community,” she said.
However, “change in a business takes time,” she said.
Those decisions involve considerations such as, but not limited to, factoring in front-end staff, nursing, as well as allocating time at their satellite clinic in Caroline, she said.
“All of that takes time to set up and organize and to create. It doesn’t happen overnight — it can’t be changed on a whim, and then changed back on whim.”
Dr. Rob Warren expressed similar reservations.
“We haven’t seen anything yet that would lead us to believe we could trust the government to base business decisions around,” he said.
Although the physicians at this time don’t plan to resume services at the hospital, they will instead aim to enhance the care delivered at their clinic, he said.
“There’s too much instability in our situation to change everything every time the minister changes his mind. We’re creating our own stability by focusing on our clinical work.”