Listen to this article
Estimated 6 minutes
The audio version of this article is generated by AI-based technology. Mispronunciations can occur. We are working with our partners to continually review and improve the results.
Edmonton could begin seeing surgical cancellations and other impacts to patient care in the next few weeks, a group of physicians warn in a letter to two of Alberta’s health ministers.
The letter, obtained by CBC News, was sent on Feb. 11 to Primary and Preventative Health Services Minister Adriana LaGrange and Hospital and Surgical Health Services Minister Matt Jones.
It was sent by surgical hospitalists in Alberta Health Services’ Edmonton Zone, a group of doctors that provide support and care for surgical patients.
The letter warns that the doctors believe the end of the funding model currently in place for hospitalists will cause “immediate, unavoidable surgical cancellations” at hospitals in the Edmonton Zone. Those cancellations would need to begin in mid-March “for patient safety reasons,” the doctors write.
“Patient care would fragment into ad hoc, site-specific arrangements, increasing reliance on already overburdened ER, surgical teams, internal medicine, and ICU (intensive-care unit) services.”
The authenticity of the letter was confirmed to CBC News by the three hospitalists who authored it on behalf of their group, but they declined further comment.
CBC News sent a list of questions to the press secretaries for LaGrange, Jones and Premier Danielle Smith.
In a statement, Maddison McKee, LaGrange’s spokesperson, said the province is engaging with the Alberta Medical Association “as we develop solutions to support a smooth transition” to the end of the hospitalists’ contracts on April 1.
“Alberta’s government remains committed to collaborating with physicians to maintain stable, continuous patient care as legacy stipend arrangements and related inequities are addressed,” she wrote.
The statement did not answer a question about whether the ministers believed cancellations were likely.
Dr. Paulose Paul, an orthopedic surgeon who has worked in the Edmonton Zone since 2002, said he and his colleagues are reliant on hospitalists to do their work.
“As physicians, our group is always committed to providing and delivering safe, effective care for patients that need orthopedic surgery,” said Paul, who was previously the zone lead for orthopedic surgery.
“It seems hard to imagine that that job is going to be easier when you remove such a significant portion of our day-to-day workforce.”
Stipends critical for hospitalists
Surgical hospitalists attend to patients who are in hospital for surgery. This support allows surgeons — who often work at multiple hospitals — to focus on surgical duties rather than post-procedure care or time-consuming tasks such as patient discharge.
In their letter, the hospitalists say they are predominantly family physicians, although their group has “always included internists, surgeons, emergency physicians and other specialists.”
Hospitalists have for more than a decade been compensated through a combination of a stipend and the ability to bill for services (known as fee-for-service).
In a 2017 brief during arbitration with AHS, the Alberta Medical Association wrote that stipends accounted for “an estimated 40-50 per cent of total earnings” for most Edmonton hospitalists.
A letter sent by a group of doctors to two Alberta cabinet ministers last month, which was shared with CBC News, warns of possible surgery cancellations if a deal isn’t in place by April 1 to compensate hospitalists. Natasha Riebe has the details.
But the provincial government has sought to move away from this funding model and towards “alternative relationship plans,” or ARPs.
“We are hearing from physicians who have received letters indicating that their stipend contracts will terminate by March 31, 2026,” AMA president Dr. Brian Wirzba wrote in a public letter to members in December.
