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<\/p>\nEdmonton could begin seeing surgical cancellations and other impacts to patient care in the next few weeks, a group of physicians warn in a letter to two of Alberta\u2019s health ministers.<\/p>\n
The letter, obtained by CBC News, was sent on Feb. 11 to Primary and Preventative Health Services Minister Adriana LaGrange and Hospital and Surgical Health Services Minister Matt Jones.<\/p>\n
It was sent by surgical hospitalists in Alberta Health Services\u2019 Edmonton Zone, a group of doctors that provide support and care for surgical patients.<\/p>\n
The letter warns that the doctors believe the end of the funding model currently in place for hospitalists will cause \u201cimmediate, unavoidable surgical cancellations\u201d at hospitals in the Edmonton Zone. Those cancellations would need to begin in mid-March \u201cfor patient safety reasons,\u201d the doctors write.<\/p>\n
\u201cPatient care would fragment into ad hoc, site-specific arrangements, increasing reliance on already overburdened ER, surgical teams, internal medicine, and ICU (intensive-care unit) services.\u201d<\/p>\n
The authenticity of the letter was confirmed to CBC News by the three hospitalists who authored it on behalf of their group, but they declined further comment.\u00a0<\/p>\n
CBC News sent a list of questions to the press secretaries for LaGrange, Jones and Premier Danielle Smith.<\/p>\n
\u201cAlberta\u2019s government remains committed to collaborating with physicians to maintain stable, continuous patient care as legacy stipend arrangements and related inequities are addressed,” Maddison McKee, LaGrange\u2019s spokesperson, wrote in a statement.<\/p>\n
The statement did not address questions about the hospitalists\u2019 concerns regarding compensation or the potential for health-care disruptions.<\/p>\n
Dr. Paulose Paul, an orthopedic surgeon who has worked in the Edmonton Zone since 2002, said he and his colleagues are reliant on hospitalists to do their work.<\/p>\n
\u201cAs physicians, our group is always committed to providing and delivering safe, effective care for patients that need orthopedic surgery,\u201d said Paul, who was previously the zone lead for orthopedic surgery.<\/p>\n
\u201cIt seems hard to imagine that that job is going to be easier when you remove such a significant portion of our day-to-day workforce.\u201d<\/p>\n
Stipends critical for hospitalists<\/p>\n
Surgical hospitalists attend to patients who are in hospital for surgery. This support allows surgeons \u2014 who often work at multiple hospitals \u2014 to focus on surgical duties rather than post-procedure care or time-consuming tasks such as patient discharge.<\/p>\n
In their letter, the hospitalists say they are predominantly family physicians, although their group has \u201calways included internists, surgeons, emergency physicians and other specialists.\u201d<\/p>\n
Hospitalists have for more than a decade been compensated through a combination of a stipend and the ability to bill for services (known as fee-for-service).<\/p>\n
In a 2017 brief during arbitration with AHS, the Alberta Medical Association wrote that stipends accounted for \u201can estimated 40-50 per cent of total earnings\u201d for most Edmonton hospitalists.<\/p>\n
WATCH | Edmonton doctors warn surgeries could be cancelled over hospitalist pay issue:<\/p>\n
Edmonton doctors warn surgeries could be cancelled over hospitalist pay <\/p>\n
A letter sent by a group of doctors to two Alberta cabinet ministers last month, which was shared with CBC News, warns of possible surgery cancellations if a deal isn’t in place by April 1 to compensate hospitalists. Natasha Riebe has the details.<\/p>\n
But the provincial government has sought to move away from this funding model and towards \u201calternative relationship plans,\u201d<\/a> or ARPs.<\/p>\n \u201cWe are hearing from physicians who have received letters indicating that their stipend contracts will terminate by March 31, 2026,\u201d AMA president Dr. Brian Wirzba wrote in a public letter to members in December.<\/p>\n \u201cAMA legal counsel has previously confirmed that once such contracts end, physicians are not obligated to continue providing services that were previously compensated by stipends.\u201d<\/p>\n The result may be a situation where most of the roughly 65 Edmonton Zone hospitalists \u2014 each of whom is often responsible for dozens of patients on a given shift \u2014 are no longer doing that work.<\/p>\n \u201cCome April 1,\u201d write the authors of the letter, \u201c in the absence of a contract or reasonable alternative, the majority of surgical hospitalists do not intend \u2014 and under the terms of their existing agreements are not permitted \u2014 to continue working.\u201d<\/p>\n Hoffman challenges government on issue<\/p>\n The issue was raised last month in the legislature<\/a> when Opposition NDP health critic Sarah Hoffman pressed LaGrange and Jones on the impending April 1 deadline.<\/p>\n \u201cWhat assurances can the minister for hospitals offer patients that their surgeries will proceed beyond April 1 in public hospitals as scheduled when it\u2019s clear that the plan in place is going to cause chaos?\u201d she asked.<\/p>\n Jones responded by citing the \u201crecord number of surgeries last year \u2014 318,000.\u201d<\/p>\n Hoffman noted that \u201csome of the impacted doctors are sitting in the gallery today. They helped me write these questions.\u201d\u00a0<\/p>\n She asked Jones if he would meet with them during a break. He declined.<\/p>\n That exchange took place on Feb. 26, two weeks after Jones and LaGrange received the letter from the hospitalists.<\/p>\n Program should be \u2018put on a pedestal,\u2019 doctor says<\/p>\n The prospect of surgical cancellations at multiple hospitals because of the end of hospitalists\u2019 contracts comes as one Edmonton facility enters its 20th month of such disruption, stemming from a different issue.<\/p>\n When resident physicians were withdrawn from on-call shifts at the Royal Alexandra Hospital in July 2024, scores of surgeries were cancelled or postponed. That situation remains unresolved, as listed<\/a> on the AHS website.<\/p>\n