Alberta doctors concerned over budget cuts in midst of COVID-19 pandemic
This article was previously published for the Calgary Journal.
Alberta doctors are becoming increasingly concerned over cuts to health funding in the recent budget that are taking effect just as the COVID-19 pandemic is hitting the province. Some physicians are already taking steps to lay-off staff or reduce services.
Last month the government terminated its funding agreement with doctors and said it would impose its own funding structure starting April 1. That provoked an outcry from physicians who said it would lead to worse care and more emergency room visits.
An open letter from more than 30 concerned doctors in Southern Alberta published earlier this month indicated doctors’ increased concerns for “higher reliance on the ER.”
“We anticipate unplanned intermittent rural ER closures due to a shortage of physician coverage, similar to those experienced elsewhere in Canada. This will mean more visits from rural communities by patients seeking emergency care,” the letter said.
Dr. Fozia Alvi, a family physician, agrees. She says emergency rooms across the province will likely see an increase in the number of visits. Alvi, who runs two clinics in Airdrie, says she’s already facing difficult challenges in light of the recent budget cuts.
"With these cuts, [we are] possibly having less frontline staff,” Alvi said, adding she gave notices to three of her employees earlier this week.
“I said, ‘I won't be able to afford you guys.’ I just can't afford it because I can't keep on paying staff and maintaining the clinic [and] not getting payment,” she said.
Another issue Alvi believes will put a strain on the health system is the government’s changes to how doctors bill for patients with complex needs. Starting in April 2021, doctors will not be able to bill more for complex cases until 25 minutes instead of the current 15 minutes.
“It takes us a while actually to go over all these charts and then speak to the patients, get their consent and have them make informed decisions,” Alvi said. “It's almost impossible to see patients in 10 minutes.”
Family physician, Dr. Fozia Alvi says her clinics located in Airdrie have already seen the impact of budget cuts, including laying off three staff members. Photo courtesy of Fozia Alvi.
Alvi says there are also concerns about doctors pulling out of clinics in rural areas, adding she’s concerned this will create further challenges for individuals living in these areas. Alvi says patients, especially elderly people, will have to travel to Alberta's larger centers for care.
“There are lots of doctors leaving, especially in the small rural towns because they don't feel they should stay there,” Alvi said. “It does not make any sense for the government to cut funding on the frontline workers. It's going to cost them more because those doctors [will] shut down their clinics early.”
CTV News reported Friday that seven family physicians at the Stettler Hospital and Care Centre handed in “their resignation for emergency room practicing privileges.”
COVID-19 puts doctors in tough positions
Last week, the government and Alberta Medical Association agreed to resume contract talks.
But Alvi says her clinic is running low on supplies in the midst of the COVID-19 pandemic and she worries how this will play out for other doctors and clinics in the province.
Risk levels for COVID-19 remain low in the province, according to the Government of Alberta. As of Friday afternoon, Alberta had 23-confirmed cases of COVID-19, while Canada has roughly 152 confirmed cases.
She adds a lot of doctors, like herself, who run clinics are also business owners who will be affected.
“Lots of my colleagues say that we are frontline workers and if we take two weeks off sick and we have to self-isolate ourselves — who is going to obtain our employees? Who is going to run our clinics? Because we can't afford to take two weeks off. We don't have insurance like the government employees do—this is chaos.”
While sitting in her office for the phone interview, Alvi paused shortly to take a question from one of her colleagues at the clinic.
“My colleague said he does not have any hand sanitizer at home and asked if he could take one. I said, ‘We are completely out.’”
Alvi added her clinic in Airdrie is out of hand sanitizer and face masks, adding she’s using the face mask she wore yesterday.
She also says her colleagues and herself have likely been exposed and that it could have serious effects on her clinics.
“I was telling my colleague this morning that I'm sure that we [were] exposed somewhere in the last three days. So, let's wait for the symptoms. If we get any symptoms then we will have to self-isolate,” Alvi says.
The open letter penned by Southern Alberta emergency physicians also expresses concern over a “coming pandemic.”
“The elephant in the room right now is the inevitability that health care workers in Alberta may soon be overwhelmed by the response to a coming pandemic. As always, we will rise to the occasion and provide the best care we are able to. Please Premier Kenney, Minister Shandro – can we deal with one freight train crashing into our healthcare system at a time?”
Alvi agrees with the other Alberta doctors’ calls for the government to put the budget cuts on hold but isn’t optimistic that it will happen.
“Lots of my doctors have written [that they] think the government should put everything on hold for now, but I don't think it will be put on hold. We are not getting any good news from the government right in the middle of this pandemic,” Alvi says.
In the midst of the COVID-19 pandemic, many people are worrying, Alvi says, and she advises people to stay updated on current information, but also advises everyone to be calm and to follow the proper procedures.
And it appears there are high volumes of concerned Albertans. Alberta Health tweeted early Friday that 811 is experiencing high volumes of calls and are “are training additional clinical staff and they are continuing to come on board to provide dedicated additional COVID support.”
According to the Government of Alberta: If you have symptoms and recently traveled outside Canada or were exposed to someone who has COVID-19, stay home and call Health Link 811 for instructions. Do not go to the ER.
If you need immediate medical attention, call 911 and inform them that you may have COVID-19.