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The Alberta government’s attempts this weekend to reverse a policy that doctors warned would push many of them out of their practices hasn’t helped restore their confidence, physicians say.

The provincial government has made unacceptable mistakes, Canmore physician Liana Hwang said.

“If I had a doctor who continually kept sending the wrong prescription for the wrong medications to the pharmacy on my behalf, I would probably go looking for a new doctor,” she said.

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The dispute started after the provincial government walked away from negotiations on its agreement with Alberta doctors in February and then announced billing changes in March that rural doctors said would make it difficult for them to continue in their practices.

The Alberta Medical Association is suing the province, arguing that doctors’ charter rights were violated by not having access to third-party arbitration.

Last week, a group of rural doctors released a survey showing 44 Alberta communities would be affected by changes doctors would have to make, including withdrawing some services.

On Friday, Alberta Health Minister Tyler Shandro rolled back some of the policies, including reversing decisions to cut subsides that help doctors with the fees for their medical liability coverage and prevent rural doctors from charging overhead for their clinics while they are doing hospital work.

Mr. Shandro said change on overhead had unintended consequences.

“I’ve heard from my colleagues, from rural physicians, as well as from rural leaders all across the province, that this policy forces physicians and hospitals to make choices that reduce access,” he said Friday. “This was never our intention.”

He also faced heavy criticism after posts on social media revealed on the weekend that the government on April 24 had made 141 communities ineligible for the Rural and Remote Northern Program (RRNP). The program compensates doctors who work in isolated, under-served communities.

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On Sunday, Alberta Health said that this was an error. Mr. Shandro tweeted that the list would be corrected.

“We’ll keep working with physicians and communities to support rural recruitment and retention,” he said in the tweet.

Rural physicians say provincial policies make it hard to attract and keep doctors, which damages communities’ health care systems. If critical services are cut, access to care will suffer and lead to preventable suffering and death.

“If you lose a certain number of doctors or fail to recruit new doctors because of political uncertainty, you cannot keep the community functioning. Some services will have to be cut,” said Heather Shonoski, a Peace River physician.

“If we close our emergency department, people will die. If we stop providing obstetrical care, we will have babies and mothers die. We will have strokes that won’t get treatment that could otherwise be treated.”

The Rural Sustainability Group, an organization for Alberta’s rural doctors, said the provincial government’s unwillingness to work with the Alberta Medical Association produced a climate of uncertainty.

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Edward Aasman, a physician in Rocky Mountain House and spokesperson for the Rural Sustainability Group, said doctors need stability to work, “especially during a pandemic.”

The time doctors spent navigating how they would cope with the new policies, said Dr. Shonoski, gave those in communities where health care is already stretched thin less time to fight COVID-19.

Vicci Fourie and Samantha Myhr, also spokespersons for the Rural Sustainability Group, said the policy changes were an unneeded distraction. Dr. Fourie said he wished the government would “work with us, not against us ... for the betterment of health for rural Albertans and all Albertans.”

“We’re just very concerned about the future of health care in Alberta,” Dr. Myhr said. “We just want to get back to being doctors.”

Dr. Hwang said doctors will not regain their trust in the provincial government unless the medical association can represent their interests in decision making.

She said that the best outcome would be if the previous agreement was reinstated and groundwork laid for negotiation of a new contract.

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“In the past, the Alberta Medical Association has had to work with other governments and we’ve always been able to reach an agreement in the past,” Dr. Hwang said. “I don’t know why it has fallen apart.”

With a report from The Canadian Press

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