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Alberta Health Minister Tyler Shandro.

The Canadian Press

Alberta Health Minister Tyler Shandro says it’s not true that doctors are quitting or withdrawing services in large numbers because of changes to fees and billing.

Mr. Shandro says in a statement that the reports are nothing more than a bargaining tactic in the pay dispute between the government and physicians.

Mr. Shandro has sent a letter to the College of Physicians and Surgeons asking for stricter rules to prevent doctors quitting in large groups in smaller and rural communities and leaving potential gaps in care.

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He says he is not asking for the changes because doctors are quitting, but to head off threats of departure being used in bargaining.

The United Conservative government and doctors have been at loggerheads ever since Mr. Shandro cancelled a master agreement with the Alberta Medical Association in February and instituted changes to billing fees and rules.

As a result, many doctors, particularly in rural areas and smaller communities, have said they can no longer afford to work in hospitals as well as keep up their practices.

Some of the billing changes were reversed in subsequent months.

Mr. Shandro says health officials know of only one physician – in Ponoka – who has submitted paperwork to leave this month.

He said nine physicians in Sundre gave up their privileges to work in the hospital, then switched to “locum” status, which allows them to get paid differently but still work there.

“In a number of other communities, physicians have said they intend to voluntarily give up their privileges, but they have not done so, and (Alberta Health Services) is working with them to maintain services,” Mr. Shandro said Thursday.

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“Of course physicians continue to come and go for their own reasons. Hundreds do every year. But the actual impact on smaller hospitals from the termination of the (master) agreement has been non-existent.

“The claim that physicians are voluntarily giving up their privileges to practise in local hospitals or are leaving the province in large numbers is a false narrative.”

Mr. Shandro’s June 18 letter to the College of Physicians and Surgeons was revealed this week after the college discussed it and posted it online. The body has asked for an extension to a July 20 deadline for action.

Mr. Shandro’s letter reminds the college that patients, particularly those in rural areas, have a right to timely access to care and that the college has to do more to make sure that happens.

To that end, Mr. Shandro wrote, the college needs to take numerous steps, including prohibiting entire groups of physicians from withdrawing services at the same time or, if they do, making arrangements to cover off any subsequent gaps in care.

Opponents, including NDP health critic David Shepherd, are accusing Mr. Shandro of heavy-handed tactics to hem doctors in: preventing them from getting a better deal in Alberta and hindering them from leaving for greener pastures.

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Mr. Shandro said that is not true.

“The changes that we’re asking the [college] to consider are not a response to any large number of physicians leaving because they aren’t leaving, now or in the future, as far as we know,” he said.

“We’re not asking [the college] to consider banning physicians from leaving or changing their practices. We’re only asking them to consider setting some conditions on how physicians change their practices or talk about doing it, in the context of bargaining.”

The medical association is taking the province to court over the abandoned agreement, alleging breaches of charter rights because the AMA was not given access to third-party arbitration.

Last week, a survey by the AMA suggested more than 40 per cent of physicians had at least considered looking for work elsewhere in Canada. It also found 87 per cent were making changes to their practices, including layoffs, reduced hours and early retirement.

Mr. Shandro has said $5.4-billion earmarked in this year’s budget for doctors’ salaries is the best in Canada, but must be kept at that level to keep health care sustainable.

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