Alberta Medical Association President Dr. Christine Molnar (Photo: David J. Climenhaga).

A big fight with Alberta’s doctors might have seemed like a good idea when the United Conservative Party’s strategic braintrust came up with the plan a few weeks ago. But that was then. This is now.

With the docs primed for action, their constitutional lawyers loaded for bear, full-page advertisements appearing in community newspapers throughout the province, widespread reports of physicians pulling out of deals to practice in Alberta and heading for Vancouver Island instead just as COVID-19 makes its debut in Calgary and Edmonton, look for the Kenney Government to execute a humiliating climbdown, perhaps as early as this week.

Alberta Health Minister Tyler Shandro in the Legislature (Photo: Legislative Assembly of Alberta/Flickr).

Talks between the Alberta Medical Association and the government, which went off the rails on Valentine’s Day when the government tore up its decade-old periodically renewed deal with the doctors, are suddenly back on.

Late yesterday, AMA President Christine Molnar issued a statement saying, “I am pleased to advise you that discussions continue next week with the Alberta government in an attempt toward a physician agreement that provides value for patients, fairness for physicians and affordability for the system.”

Someone is probably working overtime in Health Minister Tyler Shandro’s office right now, Scotch-taping the pieces of the agreement with the docs back together again. Expect never to hear the term “complex modifier” spoken in public again by an official of this government.

Former Progressive Conservative cabinet minister Lyle Oberg (Photo: LinkedIn).

It’s always a big mistake to pick a fight with physicians — they have power, influence, money to spend and friends in high places. It takes a special kind of stupid to think you could force many of them — family physicians in particular — to take a 20-per-cent revenue cut over four years and get away with it politically unscathed.

And that’s without a global pandemic bearing down on Alberta to scare the beejeepers out of voters, who, you can count on it, have been letting their MLAs and Mr. Shandro know what they think. What was said can’t have been pretty.

Just the same, Premier Jason Kenney seemed willing to take on the docs until the novel coronavirus reared its spiky head, a potential political grim reaper if ever there was one, and started heading our way. Never one to miss an opportunity to blame someone else, Mr. Kenney is now pointing to COVID-19 as a key reason his government’s tax cuts for billionaires aren’t producing the plethora of jobs he promised they would during last spring’s election campaign.

In her statement, Dr. Molnar said this week’s discussions will be carried on by a “small working group” made up of four representatives each from the government and the AMA.

The government’s members are:

  • Dr. Kabir Jivraj, an anesthetist, former Alberta Health Services executive and former AMA president who founded AgeCare Investments Ltd., a private, for-profit long-term care provider based in Calgary
  • Dr. Lyle Oberg, physician and former Progressive Conservative minister in the cabinets of premiers Ralph Klein and Ed Stelmach who later switched to the Wildrose Party and has dipped his toe in the legal cannabis business
  • Feisal Keshavjee, a Calgary accountant who is managing director of a “boutique health strategy consulting firm”
  • Ivan Bernardo, a Calgary lawyer formerly a partner with Miller Thomson LLP who is now “principal advisor” to Mr. Shandro

The AMA members are:

  • Dr. Darryl LaBuick, director of Covenant Health’s Youville Home in St. Albert and a past president of the AMA’s Family Medicine Section
  • Dr. Michael Giuffre, a Calgary cardiologist and former AMA president
    Lobbyist Hal Danchilla (Photo: David J. Climenhaga).
  • Mike Gormley, executive director of the AMA
  • Hal Danchilla, Conservative lobbyist and early backer of Mr. Kenney’s UCP leadership bid whose Crestview Strategy biography boasts he has “shaped, advised, managed, directed or informed” … “almost every political event in Alberta over the last 30 years” (except a few between 2015 and 2019, of course).

“Hopefully these upcoming discussions will replace the need” for further actions by the AMA, Dr. Molnar said genially in her statement yesterday.

“I want to say thank you to the physician social media community for their tireless advocacy and passion for patient care,” she gracefully continued. “Thanks also to every member who worked on a town hall, spoke to media, MLAs or local officials, drafted letters or contacted the AMA to offer your support.”

“Finally,” Dr. Molnar concluded, surely resisting the temptation to crow, “we can all appreciate the Albertans who have also joined in the debate, bringing a variety of perspectives.”

Mr. Shandro meekly tweeted “I thank the Alberta Medical Association … for the recent message committing to keep discussion professional and civil and to move forward in a positive and productive manner.”

If he’s lucky, the AMA will allow him to save a little face when the deal is done.

The government will still have public sector unions to kick around, however, so don’t expect the chaos in health care to end in time for the start of Alberta’s coronavirus season.

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10 Comments

  1. From the treasure trove of strategic political documents inherited from the PC’s, the UCP seems to have found and kept the one that said “do not close rural hospitals”, but the one that said “don’t mess with the doctors” must have somehow been lost in all the tumult and pillaging.

    Like a cat that has had its whiskers singed once, the UCP is probably not likely to play with fire again, at least not with the doctors. I am sure some soothing and reassuring things will be said in order to eventually come to some sort of deal. It will be quite amusing to watch the UCP climb down, while pretending not to. However, I am not sure the damage can be completely undone. I think the UCP may have created an enemy of the doctors and there will certainly not be much trust in the future.

    While the UCP does not need the support of most of the different groups in the health care system to try implement what it wants to do, making enemies of almost everyone will surely make it this much more difficult, if not impossible.

  2. Would be interesting to hear what Shandro’s father, Dr. Bud Shandro, a retired ENT specialist, has to say about this mess.

  3. Watch for the UCP government to fold like a cheap suit, now that COVID-19 has been detected in Alberta.

    Conservatives under Jason Kenney are obstinate, intransigent and more often than not politically obtuse, but one thing they do understand is the political fallout from mismanaging health care during a potential pandemic. Maybe the docs will be able to figuratively smack the UCP brain trust across the head so they realize that “go home, wash your hands and die” is not a suitable message for public consumption during a potential healthcare crisis.

  4. I have come to the conclusion that the UCP don’t bother to follow the news at all when they formulate policy. How can it be that they did not see the coming coronavirus crisis? Mere mortals have been reading about it since mid-January. If they had done likewise, kicking doctors to the curb with a pandemic on the doorstep might not have seemed like such a good a idea a couple of weeks ago. They need to eat crow (not pangolin or bat) to turn this thing around, now that COVID-19 has come home to roost.

  5. One of the more fortunate side effects of this government’s ham-fisted approach to negotiations with the physicians’ pseudo-union, was the matter of trying to get physicians — especially primary-care physicians, aka “family doctors” — off of the clearly dysfunctional fee-for-service compensation system, which virtually every non-physician expert on how to improve our primary care system agrees is an absolute necessity.

    If they had gone into this asking the AMA to work with them on a collaborative approach to weaning doctors off of FFS, which is nothing more than a high-priced form of piecework more suitable to some sweatshop in the developing world making widgets, clothing, or parts for the latest whizbang device from Apple, perhaps they might have had more success. Even many physicians themselves, especially newly minted ones, recognize that FFS is not well suited to the needs of the modern health care system, and many doctors openly state they don’t really don’t want to be entrepreneurs, they want to be caregivers.

    1. Typo: I had intended to write “unfortunate side effects” … not sure how “un” got deleted. Autocorrect gremlin I guess.

  6. Now that the UCP have decided to ignore the debacle of the “War Room” and the wide shockwaves of that pile of stupid, one would have thought that they would have learned their lessons by now. But when your cult-leader is an angry little man, you tend to be emotionally invested in his nonsense more than your own better judgement. Kenney committed himself to waging war against all medical professionals in Alberta and he’s determined to do it.

    Now, that the price of oil is beginning to look like its headed downward for the even longer term, Kenney has decided that the race for the bottom is on. The bottom seems to be the bottom of anything: standards, ethics, diplomacy, you name it. There’s a new mindset in Alberta and it’s completely dedicated to getting your own way and damn what others may think.

    Kenney has endorsed and will likely help bankroll Erin O’Toole’s bid for the CPC leadership. (All that War Room cash isn’t going to spend itself, now.) And the Tool will promote everything that Andrew Scheer promoted during the 2019 election — that being Alberta has been robbed forever; Alberta is the best part of Canada; Alberta is the only part of Canada that matters; Quebec is the thief; the Energy Corridor is your only hope, so DO IT, GODDAMN YOU ALL!

    Kenney has this talent for making everyone angry and crazy, so we can expect to see the shenanigans turned up to eleven. Of course, Peter MacKay will be elected, because the Harper era was such a disaster and everyone will want Alberta to shut the hell up. And MacKay’s promise of an immediate election will never happen because the Liberals, NDP, and Le Bloc have no interest in helping the CONs. Simple as that.

    What will Kenney do then? I guess he will return to Alberta and kick some more nurses and doctors, grant another fat tax cut to people who don’t need it, and throw more tantrums at PMJT until his head explodes. He better be wearing his brand new Saville Row tailored suit, because it’s important to be well-dressed when you’re looking stupid.

  7. As a doc, I am not optimistic that this is the climb down that you suggest, but rather another tactic by the government. In any case, if docs are spared the rod, then we should continue to advocate against this government that has attacked our patients on AISH, other public sector workers. and people with addiction.

  8. If I were a doctor who had undergone the rigorous and prolonged education and training required to enter the profession, I would have long high-tailed it out of Alberta. The Kons, and there is little to differentiate this group of grifter-yokels from those of the Klein era, have treated healthcare as they have every other facet of society, specifically rewarding insiders and attacking people who actually work. This is old news, but then again, there’s nothing new under the sun. I think that the lady in question should be lauded, the way anyone who exhibits exceptional talent and skill should be, and when it comes to grifting the people of Alberta, to paraphrase Klein’s homage to Diamond Jim Dinning, M. Meade was the Wayne Gretzky of grifters:

    “Paddy Meade, former CEO of Alberta Health Services, got $1.3 million in severance, even though she worked only eight months of a three year contract with the health superboard, according to documents the Liberals received after months of asking for them from the Stelmach government.

    “Taxpayers have every right to question this government as to why they continue with these lavish payouts at a time when we’re restricting and eliminating access,” Hugh MacDonald, the Liberal finance critic, said Wednesday.

    He’s calling on Health Minister Ron Liepert to explain the severance package, as well as a $257,000 bonus paid to Meade after she was on the job less than a year.

    Meade was a deputy minister of health before moving to the health superboard, which is now trying to eliminate a deficit of more than $1 billion.
    Meade is now working in the Northwest Territories as the deputy health minister.”

    Setting up the superboard, getting a job on it, and then splitting to the tune of $1.5 million after eight months. That is some Ronnie Biggs Great Train Robbery grifting. Alberta Kons, making the world safe for Kaiser Permanente.

  9. This looks more like a Klein era carve up of public medicare than anything else to me. When medicare was introduced into Saskatchewan most of the docs went on strike with the help of the big American insurance companies. In the end the docs got what they wanted and what no union has ever supported: payment on the basis of piece-work. Great for the specialists but exploitative for the GPs. Perhaps I’m too suspicious, but this may not turn out well for the docs and even less so for the public.

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