Physician Cost-Cutting

[msommers]

Surprised this isn't a discussion here yet. The UCP is trying to cut healthcare costs, I get it. But the way they're going out it is incredibly short-sighted and not actually helping anyone or saving money -- it's all about optics and it's bad. MDs are already getting multiple recruitment letters to go to other provinces in light of these cuts. It's not encouraging for physicians and overall it's not helping patients.

https://www.cbc.ca/news/canada/calga...nges-1.5471475

Also a very good read and worth it in its entirety.

https://wildeandrandom.wordpress.com...r-health-care/

[ExtraSlow]

From a local Pediatrician clinic:

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IMPORTANT MESSAGE FROM THE PEDIATRICIANS OF THE CHILDREN'S HEALTH CLINIC
The provincial government has recently proposed cuts to health care which will severely affect the ability of community pediatricians and family doctors to provide the quality of care that you have come to know. Because of the changes that are being imposed on doctors we will not be able to spend as much time with your child as before. Our most vulnerable patients, including children with mental health, developmental, and behavioural issues and those living in rural areas are at highest risk.

We will also not be able to provide telephone assistance from our nurse if these changes are made.

This will result in less effective medical care and longer wait times. More patients will be forced to go to emergency departments and urgent care centers. This will prevent timely access to medical care for those who need it most and will increase the cost of health care in the province.

The proposals are short-sighted and counter-productive. The government is making decisions based on flawed analysis and is bypassing normal negotiations with physicians. These changes will be implemented on April 2020 and will significantly affect your child’s medical care.

If this is concerning to you, we ask that you contact your MLA, the Minister of Health (Tyler Shandro), the office of Premier Kenney, or the media to express your concerns and help protect the future of healthcare in this province.

Thank you for your support.
Sincerely,
The Doctors of the Children’s Health Clinic:

[kJUMP]

^^that's where my wife works. they're all incredibly upset with the government's position on funding. esp because their patient population in that area (SE/forest lawn) is at a baseline more complex, these cuts hit them even harder.

one of her colleagues gave an interview on CBC radio yesterday morning. skip ahead to 8:50 for the interview.

https://www.cbc.ca/listen/live-radio...ay-february-27

voicing your disbelief and disgust to your local MLA about this would go a longgg way.

[ExtraSlow]

I generally consider things like this as union sabre rattling, and if there one group I distrust more than politicians, it's unions. But I like doctors, so I'm clearly conflicted.

[Cagare]

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^^that's where my wife works. they're all incredibly upset with the government's position on funding. esp because their patient population in that area (SE/forest lawn) is at a baseline more complex, these cuts hit them even harder.

one of her colleagues gave an interview on CBC radio yesterday morning. skip ahead to 8:50 for the interview.

https://www.cbc.ca/listen/live-radio...ay-february-27

voicing your disbelief and disgust to your local MLA about this would go a longgg way.

I heard that interview. Since you have some first hand perspective could you possibly say what the compromise is here? I never quite heard from physicians what they were suggesting to save on costs and I was curious to know what other opportunities there were. There was no discussion on that in the interview.

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I generally consider things like this as union sabre rattling, and if there one group I distrust more than politicians, it's unions. But I like doctors, so I'm clearly conflicted.

There is a amount of truth to most union or professional organizations in situations like this. I cannot say I trust doctors more than I trust a union per say. I would say it comes down the individual. I know good and bad doctors, same as I know good and bad union employees.

[Cagare]

To add to this conversation, it's a long read but fascinating none the less

https://www.theatlantic.com/magazine...ts-bad/380785/

My doctor back in Ontario was this way. Very impatient, indifferent, etc. I have found the same detachment with a lot of doctors. I think the situation we are now in adds to that feeling. They will lose some empowerment over their practice in this case.

[tirebob]

Everybody is always going to look out for themselves, doctors, lawyers, union members, politicians etc... Doesn't matter who it is. I want to see shit brought back into check for the tax payer. I am okay with cuts to do this.

[mr2mike]

Public sector is immune to organic, business economic cycles.
They need to be implemented some how.

[JustinL]

Doctors for the most part understand the need for cuts and are on record saying this. The problem is this is a restructuring of the incentive package that disincentivises spending more than 15 minutes with a patient. So for a patient that has 20 minute worth of problems, the doctor can eat the cost and run late, or make the patient come on 2 different days for 2 15 minute appointments. 2 appointments costs the system more, costs the patient more, and makes treatment less efficient.

[Cagare]

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Doctors for the most part understand the need for cuts and are on record saying this. The problem is this is a restructuring of the incentive package that disincentivises spending more than 15 minutes with a patient. So for a patient that has 20 minute worth of problems, the doctor can eat the cost and run late, or make the patient come on 2 different days for 2 15 minute appointments. 2 appointments costs the system more, costs the patient more, and makes treatment less efficient.

But what have they proposed on their end to cut costs?

[kJUMP]

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I heard that interview. Since you have some first hand perspective could you possibly say what the compromise is here? I never quite heard from physicians what they were suggesting to save on costs and I was curious to know what other opportunities there were. There was no discussion on that in the interview.

thanks for asking. this is a complex issue with no easy and clear solution.

what i will say is that unilaterally terminating a contract and imposing fee cuts/freeze in funding along with publicly shaming all physicians is not the right approach. the doctors are unified and we have demonstrated cost savings and efficiencies in the system when tasked to do so during the negotiations of prior agreements.

i do agree that we have to be mindful of the taxpayer in this current economic reality.

[vengie]

Canada: Politicize all of the things.

[ExtraSlow]

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Doctors for the most part understand the need for cuts and are on record saying this. The problem is this is a restructuring of the incentive package that disincentivises spending more than 15 minutes with a patient. So for a patient that has 20 minute worth of problems, the doctor can eat the cost and run late, or make the patient come on 2 different days for 2 15 minute appointments. 2 appointments costs the system more, costs the patient more, and makes treatment less efficient.

Wasn't that the case previously? I've seem a sign in multiple Dr offices saying only a single issue will be dealt with per appointment due to billing.

[JustinL]

There is a billing code add-on for appointments that run beyond 15 minutes. It's not as much as another 15 minute appointment with another patient. That add-on code is the one that doctors are up-in-arms about as it's getting chopped down over the next year. It will affect for the most part the doctors that currently don't have a 15 minute hard cut-off policy.

I'm not a doctor, so I'll let the beyond docs explain more clearly than I can.

[dirtsniffer]

I've experienced multiple drs tell me they could only discuss the issue I was booked in for.

[Buster]

Doctors' skills are highly transferable. Why dont they moved somewhere else? Why the complaints?

[dirtsniffer]

Im fairly sure drs in AB are paid more than anywhere else in the country

[ExtraSlow]

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Doctors' skills are highly transferable. Why dont they moved somewhere else? Why the complaints?

No no no, you misunderstand the altruistic nature of humans that traps them in undesirable professions.

[Misterman]

So what is the ACTUAL problem here? Is the correct entity at blame? This seems very comparable to education, but I don't know the behind the scenes details. For example, in education the government needed to make cuts, so they did. The problem is not the cuts themselves, it is the way Alberta Education is directing these cuts and hitting front line workers so that some exec who is being paid 10 times market value does not take a cut. So the blame is wrongly placed on someone like Jason Kenney or Doug Ford.

Is this the same as healthcare, where it's an overall expected and necessary funding cut? Or is it top brass of government directly changing doctors billing practice to AHS?

[Neil4Speed]

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Public sector is immune to organic, business economic cycles.
They need to be implemented some how.

Exactly. Rates need to be aligned with non-rate set job differentials. Doctors in Alberta should be paid higher than the rest of Canada at a differential that is is roughly on par with non-medical fields.