Alberta's oil rich sand
is driving up cost of living |
After years of rising office costs
and living expenses coupled with mostly stagnant salaries,
Alberta physicians are now voting on a proposed two-year,
trilateral agreement with the province and its nine
health regions that, if ratified, will give them a 9%
raise over the next two years. This deal would also
provide them with retention and office-cost relief bonuses.
The Alberta Medical Association
(AMA) is recommending that the more than 7,000 physicians
in the province sign off on the plan. "We're very pleased
and we believe it is worthy of the members' consideration,"
says AMA president Dr Gerry Kiefer. "It will make Alberta
an attractive place to practise and an attractive place
to stay."
SPIRALlING
COSTS
Alberta has not been an attractive place to practise
in some physicians' eyes lately. Anecdotal reports saying
that large numbers of doctors are leaving the province
have alarmed the family medicine community and the local
media. Among the reasons cited by doctors for the attrition
are the rising office costs and the increasingly difficult
task of retaining staff at sustainable wages. Dr Kiefer
adds that those problems have been made worse by the
uncertainty of being without an agreement with the province
for the last 18 months. "Physicians have not wanted
to come to this province because the costs of moving
in and housing have gone up without a fee increase that
reflects that in what you earn," say Dr Kiefer.
Dr Chris Bockmuehl, the head of
community family medicine in Calgary Health Region,
surveyed 110 doctors over the past several months and
published a brief summary of his findings in a physician
newsletter. The doctors he spoke to reported increases
of between 25% and 250% in their leasing costs and total
overhead costs shot up between 20% and 50%.
In October 2006, the National
Review of Medicine heard from Dr Diana Turner, a
Calgary GP, who complained that doctors were being driven
out of business by the rising overhead costs. "The bottom
line is that we can't be competitive with the jobs available
to people in commercial industries, information technology,
the oil industry," she said. "They can all pay five
dollars more an hour, and we can't compete. Booms are
great for companies that are booming but for the rest
of the economy it's pretty hard."
Dr Kiefer has heard the same staffing
complaints from many other physicians: "If you have
a good secretary, they can literally walk across the
street to any oil patch and see a substantive increase
in pay."
SKY-HIGH
COSTS
Dr Kiefer, who practises as a pediatric orthopedic surgeon
at the Children's Hospital in Calgary, sympathizes with
of family physicians' plight. "Physicians in Alberta
have experienced huge increases in office costs. There
are people who have leases who have seen costs for buildings
double," he says. "If you are going to re-negotiate
a lease in any part of the province, whether it is Calgary,
Edmonton or Grande Prairie, the lease costs have skyrocketed."
"My business costs have gone up
as well to cover the costs of inflation and supplies,"
he says. "Everyone has faced increased business costs."
DEAL
OR NO DEAL
The deal proposes a 4.5% fee increase for physicians
retroactive to October 1, 2006 and another 4.5% increase
April 1 of this year. But that's only a portion of it.
The proposal, which Dr Kiefer admits is immensely complex,
includes a number of other important components.
To address the drain on physicians'
resources caused by rising office costs, the proposed
agreement includes a Clinical Stabilization Initiative,
worth $56.5 million over two years. The money is intended
to be split between under-serviced areas (like Fort
McMurray in the north, where the government has had
to fly in locums at exorbitant costs to the health system
just to ensure minimum coverage for residents) and practices
in financial crisis due to office costs. The exact criteria
that will be required to qualify for relief is still
in negotiations, says Dr Kiefer, but it will be based
on supporting cases where business costs compromise
physicians' ability to deliver care.
Physicians would receive a retention
benefit for practising in the province, beginning next
February, according to the length of time they have
spent in Alberta. Physicians who have worked in Alberta
for one to five years would get $4,000; six to 15 years,
$6,000; 16-25 years, $8,000; and the bonus would reach
a maximum of $10,000 per year for doctors who have remained
in practice for 26 years or longer.
CRISIS
MANAGEMENT
The plan has its critics, who have spoken out publicly
in the Calgary dailies. Harvey Voogd, the coordinator
for the anti-rivatization lobby group Friends of Medicare,
has questioned the amount of money being provided to
doctors in bonuses. Laurie Blakeman, the provincial
Liberals' health critic, criticized the absence of recruitment
and training initiatives and funding. A Calgary Herald
editorial touched on a similar point, urging increased
medical school enrollment, though the paper came out
in favour of the proposal.
Most scathing was NDP health critic
Ray Martin, who told the Calgary Sun, "We're
in this position because of a lack of planning by this
government for many, many years and now we have to pay
the price." He called the proposal "crisis management,"
though he conceded that his party will support the agreement.
COUNTING
BALLOTS
The final tally of the vote won't be known for at least
another month, but Dr Kiefer is already planning to
start negotiations soon on the next three-year agreement.
He plans to ask the province to begin negotiations on
a long-term master agreement in June.
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