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The Alberta government has ratcheted up its battle with doctors by threatening to put individual billing figures online for the public to see, while the Alberta Medical Association says an internal survey shows that compensation negotiations have become so toxic a “physician exodus” may be looming.

The COVID-19 pandemic hasn’t slowed a push from the governing United Conservative Party to rein in health-care spending, including doctors’ fees, which the government says are the highest in Canada. Doctors say the battle has gone beyond dollars and cents, and is about the province’s heavy-handed negotiating tactics.

All Canadian governments, including Alberta, face sharp-edged financial reckonings as a result of the pandemic. “Our economy has been dealt the body blow of the coronavirus recession, the biggest collapse in energy prices in history, and all of that on top of five years of economic stagnation,” Alberta Premier Jason Kenney said on Friday.

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Health Minister Tyler Shandro said doctors should look favourably at the government’s plan to hold their overall compensation to $5.4-billion for this fiscal year, or near 10 per cent of total spending. Other provinces, he suggested, are unlikely to offer better.

More than 40 per cent of Alberta doctors have considered leaving province, survey suggests

Kenney says Alberta doctors’ pay must be ‘managed’ post-pandemic

“That commitment is looking more generous by the day, considering the fiscal situation in this province and this country. But we stand by it,” Mr. Shandro said in a statement on Friday.

He added: “The government is also exploring introducing physician compensation transparency, as exists for public servants in Alberta and physicians in a number of other provinces.”

Alberta publishes only the range of physician billing totals, by specialty.

Christine Molnar, president of the Alberta Medical Association, said publishing doctors’ billing revenues would need to include recognition that the numbers don’t represent take-home pay. Totals include costs such as staff, rent and cleaning that can eat up 40 per cent to 75 per cent.

Dr. Molnar said the larger issue is the breakdown in trust between doctors and the government. Alberta physicians, she said, have no idea what the government will unveil next. “At this point, it’s not about money,” she said. “It’s about the environment that has been created here is increasingly hostile and authoritative.”

For the survey, the medical association asked the province’s 10,000 practicing physicians about their intentions in late June and early July, and nearly 1,500 responded. Of those, 42 per cent said they are considering looking for work in another province, or plan to do so. Others said they may leave the profession or retire early.

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The headline on the association’s news release on Friday said: “Looming physician exodus from Alberta caused by failed provincial funding framework.” Mr. Kenney said Friday that according to the Alberta College of Physicians and Surgeons, the number of physicians leaving service has not increased.

The fight began in earnest in February, when Mr. Shandro used a new law to terminate the province’s long-standing agreement with the AMA. Some of the billing changes that particularly angered doctors have been rolled back during the pandemic.

The medical association still took the province to court, alleging breaches of its agreement and its charter rights because it was not given access to third-party arbitration. The government’s statement of defence says the doctors’ group is not entitled to arbitration under the charter.

Doctors and the opposition NDP have also expressed concern about legislation the UCP introduced this week that would further change how doctors are paid, and how private companies participate in health care.

David Shepherd, the NDP’s health critic, said the government is pleading poverty while accelerating its plan to cut corporate taxes. Mr. Shandro has become a polarizing figure, Mr. Shepherd added.

“This is no longer an issue of compensation. This is an issue of trust.”

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With reports from The Canadian Press and James Keller

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