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Canada's wealthiest province has traditionally set the benchmark for physician fee increases across the nation as most jurisdictions believe they must match Alberta or risk having their physicians poached or persuaded to pack their bags for Wild Rose Country.
![Figure](https://www.cmaj.ca/content/cmaj/176/8/1073.2/F1.medium.gif)
The proposed $580-million deal for Alberta physicians should help mitigate some of the boom-related stressors. Photo by: Canapress
From that perspective, the Mar. 13 trilateral fiscal agreement between the Alberta Medical Association (AMA), the provincial government and the province's 9 health regions augers well for other negotiators as it proposes a 4.5% pay increase in both the current and coming fiscal year.
However, the unique deal may also set a new template for redressing threats to the viability of community practice through a multi-pronged solution that includes retention bonuses and targeted monies for overhead costs.
AMA President Dr. Gerry Kiefer says this “made-in-Alberta approach” should help the province retain its 7100 physicians and attract the estimated 1500 additional doctors needed to handle a population boom of 11% over the past 5 years.
“I'm hopeful it will make practice in Alberta attractive,” says Kiefer. It should also help redress financial pressures faced by family and community practitioners, he adds.
Alberta physicians are now voting on the agreement through a mail-in ballot. Results are expected in early May.
At the core of the proposed $580-million deal lies the 4.5% hike in the fee schedule, which will increase Alberta's overall outlay to $1.7 billion this year and $2 billion in 2008.
The agreement also sets aside $103.5 million over 2 years for initiatives to help cover skyrocketing overhead costs, including rent and salaries, associated with the province's oil and gas boom, as well as keep Alberta physicians at home by paying them an annual 2.8% retention benefit. The amount of the latter depends on how long a physician has practised in the province and the amount they bill. Doctors billing over $80 000 annually are eligible for a 100% retention payment. The majority of the province's physicians are expected to receive either $8000 (for 16–25 years of practice) or $10 000 (for 26 or more years).
The agreement also provides $56.5 million for a new clinical stabilization fund targeted at under-serviced communities, like Fort McMurray. Some $17 million of that fund will be set aside to help offset higher overhead costs associated with practice across the province.
The agreement also reserves roughly $175 million over 2 years for continuing operations in Alberta's 19 existing primary care networks, and the creation of new ones. About one-half of family physicians are projected to be linked to such networks by 2008.
Some $70 million over 2 years will be used to extend the Physician Office System Program, which covers up to 70% of costs associated with a physician's move to electronic patient records. About 70% of Alberta MDs have enrolled.
The AMA's 116-member representative forum unanimously recommended the agreement be ratified by physicians and medical residents but Kiefer isn't forecasting the outcome. “There's lots of unrest, especially amongst family physicians and northern Alberta physicians about whether this deal would have enough in it to maintain viable practices.”