Alberta Politics
Alberta Health Minister Tyler Shandro (Photo: Screenshot of Government of Alberta video).

Apparently desperate, health minister tells College of Physicians and Surgeons it can’t let doctors quit

Posted on July 16, 2020, 2:48 am
8 mins

Tyler Shandro’s on fire!

Not in a good way, though.

There was a strong signal yesterday that Alberta’s health minister has completely lost control of the fight he’s picked with the province’s physicians.

Yesterday’s AMA newspaper advertisement (Image: Alberta Medical Association).

It turns out that while the minister and the government’s paid social media trolls were disputing the results of a poll by the Alberta Medical Association showing nearly half the province’s physicians were thinking about leaving, Mr. Shandro was demanding the College of Physicians and Surgeons change its rules to make it harder for disgusted physicians to quit.

That sure doesn’t sound like a man who believes his own propaganda!

The AMA is the doctors’ collective bargaining association, which negotiates their compensation. The College is their regulatory body, responsible for ensuring physicians abide by the standards of their profession.

Last February, Mr. Shandro tore up the AMA’s contract and announced he was imposing a deal on Alberta’s physicians that rural and family doctors said would significantly cut their incomes.

It’s been pretty much open warfare between the United Conservative Party government and the province’s 10,000 doctors ever since — right in the middle of a deadly global pandemic.

I haven’t seen any polling that suggests how Albertans feel about this — but it can’t be good.

The AMA went to court in April, challenging the constitutionality of the government’s contract breaking and seeking $250 million in damages for its members.

Individual doctors responded by talking about leaving the province — and in some places doing just that. In at least 10 rural communities — the UCP’s electoral heartland — all the docs have either withdrawn from service or announced they’re about to leave.

Turns out if you’re a rural doctor, lots of places in Canada and elsewhere in the world would be delighted to hire you. They’ll even promise to treat you with respect! Who knew?

Last Thursday, the government filed its statement of defence in the AMA’s suit, and the UCP’s army of political staffers mocked the doctors’ chances in court.

The next day the AMA published a poll it had commissioned showing 42 per cent of all Alberta doctors docs were thinking of leaving, quitting or retiring early. Of that group, 49 per cent said they were pondering quitting or planning to leave. Almost 90 per cent of the 1,470 respondents said they would change their practices one way or another.

Mr. Shandro and the government’s trolls went nuts. Supposedly to back up his claim Alberta’s doctors are overpaid, Mr. Shandro threatened last week to publish their salaries on a special medical “Sunshine List.”

That one also went over like the proverbial lead balloon. To many Albertans it sounded more like revenge and bullying. Docs were furious.

When individual physicians took to social media to challenge the government, they were viciously trolled by UCP staffers.

Yesterday, the AMA took out large newspaper advertisements across the province offering an olive branch to the government, a deal “for the good of Albertans” that would bow to the government’s demand for three years of no funding increase — but keep binding arbitration to resolve disputes that can’t be settled at the bargaining table.

But also yesterday, thanks to a report by the CBC, we learned that behind the scenes, Mr. Shandro’s plan was just to make it harder for doctors to quit. As for the UCP’s beloved free market? Forget about it!

In a letter sent June 18, he directed the College to change its standards of practice for physicians by July 20 to stop Alberta doctors from leaving their practices en masse, the CBC reported.

His letter told the College it must “prohibit an entire group of physicians from withdrawing at the same time. This could be identified as ‘job action’ rather than a closure of a medical practice.”

Doctors should be required to give three months’ notice before leaving a practice, Mr. Shandro’s letter states. Never mind that the Canadian Charter of Rights and Freedoms gives full mobility rights to all Canadians — and that the Notwithstanding Clause doesn’t apply to that part of the Charter.

And if the College won’t cooperate, the minister threatened, he would use his powers under the Health Professions Act to force it to change its rules.

The College, sensibly, stalled. If nothing else, it’ll give them a chance to call their lawyers.

Its leaders asked for, and got, an extra 30 days to consult their members and the ministry officials about how this might work. No doubt they also hope the grownups will show up and send Mr. Shandro to his room.

If Alberta’s physicians were furious before, they’re likely apoplectic now. Some of those who were staying put out of loyalty to their patients during a pandemic may now rush for the exits in the next 30 days to beat the new rules out of town.

Mr. Shandro’s latest announcement also likely means their practices will lose value.

One doctor told the CBC sticking around with these rules would be like indentured servitude. It’s hard to dispute that characterization when Mr. Shandro’s letter states, “if alternative resources and/or arrangements are ineffective … the College can require that some or all physicians involved in the withdrawal of services must continue to provide services until effective alternative resources and/or arrangements have been created.”

What’s next? Sending out Mr. Kenney’s nascent provincial police force to track down runaway doctors and drag them back to rural Alberta?

Someone must have told Mr. Shandro that a war with the doctors would be good, and easy to win. He was misinformed.

If you had any doubts the Kenney Government’s War on Doctors isn’t going very well, yesterday’s desperation play should confirm it.

22 Comments to: Apparently desperate, health minister tells College of Physicians and Surgeons it can’t let doctors quit

  1. Bill Malcolm

    July 16th, 2020

    Interesting. The AMA ad looks very good and on point.

    kenney and his UCP are so hidebound they imagine being nothing more than strutting little ideological provincial pols that who can just order something and “it will be done”.

    I know you know this, Mr Climenhaga, but a few lines describing the difference between the CPSA and AMA may not be absorbed by a casual reader of the blog post. I have expanded the expnation somewhat below.

    All major professions in Canada have provincial legislation whereby their members are regulated for standards of practice by a college, bar association or professional engineers association. These bodies determine who can legally practise their profession in a jurisdiction, and are the ones who administer sanctions in case of proven malpractice. In this case we’re talking the College of Physicians and Surgeons of Alberta. This regulation of professional standards by an oversight body carries the weight of law and is delegated that power by provincial government Acts. I have no idea whether government can legally tinker with a specific regulation of the body, because that would/might mean rewriting the Act that establishes the authority of the regulating authority in the first place. Shandro seems to think he can do so.

    The AMA is merely the unified group of legally practising doctors and surgeons who band together to negotiate wage scales from their unitary titular employer, the provincial government. Lawyers and engineers do not necessarily have such groups; it varies by province and workplace or by federal employ. The AMA could thus be regarded as a de facto union because it negotiates remuneration on its members’ behalf.

    My brother was a doctor until medical problems caused his retirement at a stroke, bad pun. Even he was unclear of the difference between the regulating body and the group of licensed doctors acting as fee negotiators on his and the rest of the docs’ behalf. So I imagine the general public in Alberta hasn’t a clue either of the difference, because nobody really does as part of their everyday general knowledge. Shandro is a lawyer and most definitely does know the difference — that’s why his letter is directed to the CPSA, the regulator of standards. I read it and various web pages of the CPSA and the AMA before commenting here, particularly the “Closing or Leaving a Medical Practice” page of the CPSA.

    Personally, I cannot see what Shandro is asking of the CPSA is wrong in terms of patient care, Notley’s words notwithstanding, in the purest sense of professional care, with one exception. However, the exception I see as a possible legal sticking point is the direction by Shandro to the CPSA to “Prohibit an entire group of physicians from withdrawing at the same time. This could be identfied as a “job action” rather than a closure of a medical practice.”

    I should have thought that the existing regulations effectively covers standards of leaving adequately anyway, and that does leave doctors in a bind as it stands. They have to cover their practice/patients before moving on, so a bunch of them leaving all at once is not really possible in a practical sense. But it is not the CPSA’s business whether doctors effectively create a union, merely to monitor and regulate the following of existing standards by which individual members of the profession must govern their professional behaviour. So the CPSA are not responsible to regulate for what Shandro says ‘could be identified as “job action”‘. Tough luck, there, Mr Shandro.

    The UCP could write a whole new Act for regulating doctors professional standards, dissolve the CPSA and run things themselves. That would be a virtual guarantee that new existing Canadian doctors would not come to Alberta, and if passed the existing docs could individually decline to be recognized as such and resign their licence to practice, and leave free as a bird. They could do that now and de-register themselves, for that matter. If they are no longer doctors, they no longer have professional obligations. If fee salaries became so low they couldn’t run their offices and make a living and thus become desperate, they might have to do so, and take their chances at being re-recognized as docs in another jurisdiction, which might include having to sit exams. Who knows? But it would get them out from under the UCP jackboot, for that is what it is. Then the idiot UCP would be up a creek without a paddle blowing bubbles of wonder like pet fish. The Royal Canadian College of Physicians and Surgeons would be under no obligation to recognize some regulatory outfit run directly by a provincial government, particularly if, for example, it started importing foreign doctors for immediate replacement of resigned previously-licensed docs, and pols with no professional clue saying their new hires’ qualifications were quite OK by them.

    I’d say it was time for kenney to start paying up. He does not hold the ultimate hand. A tinpot regressive would-be dictator has no business running a provincial government like a fiefdom in the first place, but the UCP faithful need a hard lesson in the realities of life as well. They’re living in a dreamworld.

    Reply
  2. jerrymacgp

    July 16th, 2020

    The College of Physicians & Surgeons only has jurisdiction over physicians practicing in Alberta. What’s to stop Dr So-and-so from giving up their practice permit in Alberta, closing their clinic on a Friday afternoon after 5:00 p.m., & relocating to the Okanagan or the Island over the weekend? Once they’re no longer practicing in this province, there is no recourse.

    Ridiculous strategy.

    Reply
  3. Bob Raynard

    July 16th, 2020

    It seems like quite a while ago we read the stories about doctors announcing their intention to leave Sundre, Stettler etc. They voluntarily gave the UCP the prolonged notice Mr. Shandro is now demanding. Tyler’s response at the time was they would just hire replacement doctors; I guess that process isn’t going so well.

    I am sure all the other rural communities working diligently to recruit doctors to their communities will really appreciate everything the government is doing to help them.

    Reply
  4. Athabascan

    July 16th, 2020

    Behold, UCP facsism on full display.

    If you’re a doctor you can’t move out of province and resume your practice somewhere else?

    Are they kidding? In what world would this be OK? The UCP has no concept of democracy. That’s fascism!

    Hey, Alberta did you vote for this?

    Reply
  5. Abs

    July 16th, 2020

    Today on the UCP hit list, I dedicate this song to Tyler Shandro and his master, Dr. J.K. Evil. It’s called “Sunshine” by Jonathan Edwards, from the Vietnam War, just as true today.

    “Sunshine go away today, I don’t feel much like dancing.
    Some man’s come he’s trying to run my life, don’t know what he’s asking.
    When he tells me I better get in line, can’t hear what he’s saying.
    When I grow up, I’m gonna make him mine, these ain’t dues I been paying.
    How much does it cost?
    I’ll buy it!
    The time is all we’ve lost.
    I’ll try it!
    He can’t even run his own life,
    I’ll be damned if he’ll run mine–sunshine….”

    Reply
  6. tom

    July 16th, 2020

    Dave,

    The “government’s paid social media trolls” have become ubiquitous on AB social media of late–almost to pandemic proportions. I know every government relies on comms people, but these comms people are at the point of becoming the story themselves. It would be interesting to see a post on them.

    Reply
  7. Abs

    July 16th, 2020

    Perhaps it is time for the federal government to stop transfer payments to Alberta for health. Alberta is obviously not upholding its end of the bargain under the Canada Health Act. Public administration fail!

    Reply
  8. Athabascan

    July 16th, 2020

    Here’s a very short lesson on labour relations for Albertans and specifically Jason Copping, our Minister of Labour:

    Unions are democratic institutions. The UCP is a corrupt and fascist political party. Got it?

    Reply
  9. Keith McClary

    July 16th, 2020

    “I haven’t seen any polling that suggests how Albertans feel about this — but it can’t be good.”
    Who would spend money to commission such a poll?

    “Some of those who were staying put out of loyalty to their patients during a pandemic may now rush for the exits in the next 30 days to beat the new rules out of town.”
    Sort of the like the UCP well cleanup program:
    “As industry players compete for the government funding, oil and gas producers aren’t spending any of their own money to clean up wells. As a result, reclamation work has dried up completely, which is the opposite of what the stimulus program was meant to achieve.”
    https://www.cbc.ca/news/business/srp-alberta-oilpatch-wells-1.5641024

    “Mr. Kenney’s nascent provincial police”
    Kenney’s Keystone Kops?

    Reply
  10. Dave

    July 16th, 2020

    There does seem to be a whiff of desperation to Shandro’s latest move. Also, it is possible it will backfire prompting a large number of doctors to quit before the deadline. What is he going to do, drag them all back to Alberta after and force them to work?

    I suspect the desperation is due to realization at some point in time, there could be a big political blow back if hospitals in a number of rural areas either have to close or reduce operations considerably. Recent polls have shown the largest decline in UCP support in rural areas and I suspect growing concerns about keeping doctors in some of these communities is a part of that. While the UCP still has a comfortable margin of support in rural Alberta, I am sure it does not want this trend to continue and have to start worrying about an area where it was previously insurmountable.

    While Mr. Shandro’s aggressive and I would even call it obnoxious approach fits well with the general character of those in charge of the UCP government, it sure does not go over well with doctors who do not like being treated this way. I have to wonder if even those in charge of the UCP will realize he is making a bad situation much worse and the first step to fixing things is to replace Shandro. I imagine this could happen around the time doctors start to leave, perhaps around the time of Shandro’s deadline. Wouldn’t it be ironic if the date he set became the deadline for his own departure as well?

    Reply
  11. Carlos Beca

    July 16th, 2020

    Well it seems that we may have to enter the Legislature to save our democratic rights as Albertans.
    It looks like UCP/ISIS is finally showing its colours and they are not pretty

    To all their fans – I TOLD YOU SO

    Reply
    • collette oddleifson

      July 17th, 2020

      I am no activist and pandemic or not, I would like to be one of , say 60,000+ people to march in protest on one day across in Alberta if it would be useful.

      Reply
  12. Bruce Turton

    July 16th, 2020

    Sooooo. In Albertistan you are free as long as you agree with the UCP goons. Otherwise, they will find ways to censure, disparage, and deal what they believe is irreparable harm to you – from doctors, nurses, and anyone who makes claims that the ‘dear’ O&G and coal sectors are the ‘real’ engines of the future. What will happen in rural UCP constituencies when their health care is in jeopardy? Will urban residents start to feel the pinch? Why do we need to find out?

    Reply
  13. Ian St. John

    July 16th, 2020

    The UCP is governing like a autocratic dictatorship. Only their ideas matter and public input is not needed. Their only goal is to suppress the portion of the public that does not agree with them. But as with all autocracies, that portion will keep growing as freedom is suppressed by the ‘big stick’. Autocracies always break eventually.

    One other thing they have wrong is the idea that Alberta doctors have it so good because they are paid more than other provinces. The ‘market system’ of negotiation has led to a balance which has been disrupted. Alberta has more rural practices and the funding for doctors does not go entirely in their pockets. They have to run the practice with overhead that consumes MORE of the income than in other provinces because Alberta is more spread out than large populations in big cities like Toronto and Montreal. It may also be that Alberta has a better spread of doctors between big centers like Calgary or Edmonton and the smaller towns, cities and rural zones. Alberta is less focused on the big corporations which need the export, finance and communications infrastructure of big centers.

    Same as with higher grocery prices (fewer customers per store) and transit (fewer riders and longer routes). Alberta has to deal with it’s own situation, not make false narratives to punish the public (including doctors).

    Reply
  14. Just Me

    July 16th, 2020

    Considering the amount of meddling the UCP does with their beloved free market, one wonders if they believe in such things to begin with.

    I mean freedom of choice is fine, so long as it doesn’t interfere with your own bailiwick. Btw, Shandro’s bailiwick is burning down.

    So, Shandro looked to ancient lore for inspiration and discovered the tale of ‘King Canute and the tide’. In a fit of brilliance, Shandro decides to order bodies he has no influence over to do his bidding. Of course, Shandro wasn’t paying attention to the part where King Canute was trying to demonstrate to his flattering courtiers that his influence was limited. Oh, well. Shandro never struck me as a details kind of guy anyway.

    Time to make another pipeline announcement.

    Reply
  15. Bruce McCoy

    July 16th, 2020

    We have to remove these people due to massive incompetence and coverups at all levels of gov’t .How do you spend 1.6 billion dollars on a hospital to be built on a design build basis where there is no accountability of real quality control on the products being used as well as to ensure that these products are being tendered openly and not being supplied around certain companies who are in the fold, as we have heard of illegal graft from the construction on other projects.Is the construction industry absolutely corrupt note Canadian engineering companies such as SNC- Lavalin as one of the many .

    Reply
  16. Janet

    July 16th, 2020

    It’s hard enough to get doctors into northern Alberta. Why is the minister guaranteeing, the doctors we do have will leave our communities?

    Reply
  17. Adrian Sloan

    July 17th, 2020

    It seems peculiar that Mr. Shandro would make such a request–he should know all the laws and charter rights it violates–As Tyler Shandro is listed as a practising lawyer with the Law Society of Alberta. Is he now exempt from practice standards as a MLA?

    Reply
    • Keith McClary

      July 17th, 2020

      And how could they define “withdrawing at the same time” precisely enough to be enforceable? Is it OK if they quit on different days? Perhaps he means different months – but that would mean if eleven docs give notice then an unconnected twelfth doc is locked in for a year. The UCPers don’t seem to think things through.

      Reply
  18. Jim

    July 17th, 2020

    What exactly is Shandro and Kenney’s end game strategy other than making a complete mess of things? We know they want to privatize the healthcare system, Shandro for what appears to be personal gain and Kenney because of his rigid ideology. So they have now pissed off any potential employees for their private healthcare system, who exactly will work for them? To the casual observer it appears they have no idea what the hell they are doing.

    That said they sure know how to stick it to rural Alberta thanks for all those votes you really don’t need doctors do you? Oh yeah and all those oil and gas jobs we promised you yeah that’s not going to happen. To top it off here is some more debt I’m sure you won’t mind paying higher taxes for. Much easier to pick up and move a medical office then to pick up and move farmland I would think.

    Reply
    • Abs

      July 17th, 2020

      Of course they know the current stance will make it difficult for private (and foreign) medicorps to attract hourly wage-earning physicians to Alberta. This is when the double whammy of relaxing doctor standards comes into play. Once Tyler the Terrible takes over the CPSA and licensing, bam! Anything goes. If Tyler says you’re a doc, you’re a doc. If you went to some online college and got a doctoring certificate (and marriage commissioner licence in a BOGO deal), you’re a doc. (Guaranteed it won’t be that easy, but let the man live in his fantasy world.)

      This is the man who thought Dr. Heref Oru was a real doctor, whom he threatened. It must have been very confusing for him when many other people also became Dr. Heref Oru online, and completely overwhelming when Dr. Startled Squid appeared. I wouldn’t put it past him to have reported Dr. Startled Squid to the CPSA, too. Gosh, it’s gotta be embarassing to have a law degree from Ty’s alma mater these days. A box of lightbulbs is a lot brighter.

      Reply

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