We’re Deeply Concerned For Our Patients, Minister Tyler Shandro

CAL111114-gyb-7.JPGKudos to emergency physician Dr. Adam Oster and colleagues who penned this letter to Health Minister Tyler Shandro, outlining the joint concerns of Calgary emergency doctors regarding his sudden, alarming cuts to health services in Alberta:



February 27, 2020

Minister Tyler Shandro,

It is with deep and urgent concern that we write as a united group of Calgary Emergency Physicians regarding the sudden and unilateral changes to health care in Alberta.

These changes will have significant negative short and long term effects for Albertans.

These changes will not result in cost savings but will greatly increase costs by shifting care from lower cost primary care to expensive hospital-based care.

These changes will impact the ability of family doctors to deliver comprehensive primary care, leaving patients with complex medical conditions or mental health illnesses to suffer the most.

Increasing numbers of our most vulnerable patients will be forced to seek care in Emergency Departments, resulting in care more fragmented and more expensive. A patient with diabetes and difficult-to-control sugars can currently be managed by their Family Physician. They can remain in their community, continuing to work and supporting their family. Patients with Mental Health issues will also disproportionately suffer from these changes.

There is an abundance of evidence that building a strong medical home and promoting community-based complex care management reduces overall health care costs and acute care utilization. This is research done in Alberta.

The primary goal is the sustainability of our health care system. This is a goal that AHS Physicians fully share and are highly engaged themselves to achieve.

As Alberta Physicians at the front line of care delivery we are concerned with the haste and lack of consultation regarding the changes. An example of this haste is revoking the Good Faith agreement. This will immediately affect our most vulnerable patients; those living with addictions, homelessness and mental health illness. These are Albertan patients who may not be able to produce sufficient personal information to a hospital or a primary care site. It is inconceivable to suggest that these patients be charged for care.

Prematurely ending the Master Agreement with Alberta Physicians following a brief mediation period fundamentally disrespects the negotiating process and the affected individuals. Our contract was a bilateral, legally negotiated agreement by which we were jointly bound. There is an onus upon concerned parties to negotiate contracts responsibly. The cancellation raises doubt about the durability of any future
contracts we may enter into.

Health care expenses, as you know, are immensely complex and arise from many demographic and capital variables. To focus on physician compensation and to de-emphasize cost increases due to population growth, equipment needs, facility costs, medical innovation and care complexity, creates the perception that “un-sustainability” is a function of physician compensation costs alone.

The focus on personnel costs shifts attention away from other opportunities for cost savings. Real cost efficiencies to our system involve the strategic input of the very care providers who have been working tirelessly for years on these exact issues. Not involving front line providers in system change will also reverse many of the substantive improvements that have been made in health care safety, quality, access to primary care, the patient experience and in resource stewardship.

Alberta Physicians, as well as the teams they work within, are local and national innovators, often partnering with government, in designing, implementing and sustaining countless novel processes in cost-effective and streamlined care

Minister Shandro, it is not too late to pause, to hold the changes and reconsider. We share your goals and the goals of government — ensuring that our system is sustainable, while providing the best possible care to all patients across the province.

We need to continue to innovate care delivery and to ensure that safety, quality and the patient experience are the driving principles of any changes made. These
principles can be aligned with changes to compensation models to achieve fiscal sustainability.

Physicians want and need to be allies in this discussion. We are fully committed to system-wide improvements but need to be strategic and respected partners in the process.

We look forward to working with you.

Calgary Zone Emergency Physicians:

Dr. Ayesha Khory

Dr. Andrew Robinson

Dr. Jennifer Puddy

Dr. Margriet Greidanus

Dr. Michael Betzner

Dr. Scott Farquharson

Dr. Mandeep Sran

Dr. Michael Szava-Kovats

Dr. Dan Joo

Dr. Natasha Goumeniouk

Dr. Jasmin Fauteux

Dr. Patricia Lee

Dr. Chris Bond

Dr. Harry Koonar

Dr. Kelsey Macleod

Dr. Salima Alladina

Dr. Carey Johnson

Dr. Mark Bromley

Dr. Vanessa Potock

Dr. Anjali Pandya

Dr. Matt Frey

Dr. Cara McCulloch

Dr. Andrew Fagan

Dr. Jeff Bradley

Dr. Zoe Polsky

Dr. Kevin Haley

Dr. Dave Dyck

Dr. Marylou O’Byrne

Dr. Jesse Kao

Dr. Scott Seadon

Dr. Ian Rigby

Dr. Kelsey Ragan

Dr. Stuart Rose

Dr. Michele Bjornson

Dr. Carey Johnson

Dr. Eddy Lang

Dr. Patrick Mihalicz

Dr. Christine Kennedy

Dr. Derrick Smith

Dr. Jeff Grant

Dr. Peggy Thomson

Dr. Eileen Kabaroff

Dr. Shirmee Doshi

Dr. Don Bethune

Dr. Miles Hunter

Dr. Ryan Wilkie

Dr. Brad Granberg

Dr. Stefan Da Silva

Dr. Bruce Macleod

Dr. Michael Wolf

Dr. Paul Tourigny

Dr. Christine East

Dr. Charles Wong

Dr. Joe Vipond

Dr. Melanie Sohn

Dr. Brenda Nakashima

Dr. Robert Abernethy

Dr. Katie Anker

Dr. Andrew McRae

Dr. Aseem Bishnoi

Dr. Chris Lipp

Dr. Danny Peterson

Dr. Jen Graham

Dr. Lester Mercuur

Dr. Anoop Manocha

Dr. Anita Lai

Dr. Gord McNeil

Dr. Stephen Freedman

Dr. JenniferThull-Freedman

Dr. Karl Phillips

Dr. Kerri Landry

Dr. Jenn D’Mello

Dr. Rhonda Ness

Dr. Michael Pierse

Dr. Ed Les

Dr. Melanie Willimann

Dr. Michelle McTimoney

Dr. Adam Cheng

Dr. Bela Sztukowski

Dr. Sarah Mcpherson

Dr. Cheri Nijssen-Jordan

Dr. Gavin Burgess

Dr. Marc Francis

Dr. Ashlea Wilmott

Dr. Naminder Sandhu

Dr. TJ Kodeeswaran

Dr. Tom Rich

Dr. Amanda Schreiner

Dr. Catherine Patocka

Dr. Nicholas Packer

Dr. Kevin Johnson

Dr. Adam Oster

Dr. Hussein Unwala

Dr. Shawn Dowling

Dr. Heather Patterson

Dr. Kip Rogers

Dr. Arthur Tse

Dr. Antonia Stang

Dr. Joe McLellan

Dr. Arun Abbi

Dr. James Huffman

Dr. Ewa Courvoisier

Dr. Kathryn Crowder

Dr. Andrew Battison

Dr. Dave Choi

Dr. James Andruchow

Dr. Andy Anton

Dr. Jamie Fox

**Sign the petition BACK TO THE TABLE!


5 Replies to “We’re Deeply Concerned For Our Patients, Minister Tyler Shandro”

  1. In the last 3 years I have had to initiate the personal directive for my ageing father and make all his medical decisions for him. Up until that time I felt that our medical system was well structured until I needed to get fully involved with the constant care of my father. My father has multiple complex health issues along with dementia. NEVER was I able to take my father to see any physician and it take under 30 minutes. The amount of support services and different specialists that needed to be involved in order produce a care plan for him was overwhelming at times, all which had to be initiated by his primary health care physician. The wait times to receive these referrals and evaluations at times seemed horrendous to endure. I had to find multiple levels of care for my dad as his health deteriorated and he was no longer able to live in his own home. As his condition deteriorated, he was hospitalised and the wait time to get into long term care resulted with him being in the hospital for 4 months before a long-term facility was able to accept him.

    With the new changes this will only make the situation more desperate for patients and their families, as we now have a huge ageing population that our system is unable to keep up with at this time. By limiting the financial structure of the primary care physician and removing his ability to be able to spend extra time with these patients will only impact everyone in a very detrimental way. The primary care physician will not be able to afford to spend time with their patients and refer complex patients off to the emergency departments or urgent care which will only overburden the case load of these sites and physicians. The hospitals will become overcrowded with no physicians able to take over care of these patients.

    The truth needs to come out about the effect that these changes will truly make on everyone. I feel the government has made decisions based on incomplete information as to how these changes will impact our entire health care system but most of all patient care. Our health care system is structured around the primary care physician. We need to honour all medical professionals for their dedication and commitment to provide care to each and everyone of us.

    1. Thank you, Lori-lyn, for taking time to write that powerful comment. So sorry to hear of your struggles with your Dad. THANK YOU for speaking up.

  2. I know that losing my family Dr. means I’m losing the life we are just getting on track. It took me 8 months to find him only for Shandro to make it impossible for him to keep his practise open. With a new rare diagnosis and waiting for specialist, treatments and monthly care we work well together.
    I was down to the last of my meds the day I found him after my long term family Dr. fell too sick to work ever again. I was on my own with only a Dr. in Boston who for no reason helped me with researching my disease with her valuable time and case study she shared with me. I know more than the Dr.s do I was trying to find. They look at my puzzled and I would leave them copies of my research because I was misdiagnosed with this part of my disease for 34 years.
    I just got my foot in the door. My family Dr. helped line up my referrals got me back on my meds and we ran every test we thought the specialist would need to speed up the process. We are still waiting to hear almost a year later while I lay in bed every single day in pain and sleepless.

    I can’t go to a walk in clinic or emerg to get my meds. You are a drug seeker the minute you do that. I will become deathly ill without them. If my Dr. could write me a years worth of meds I may be able to sleep a night while I try and find a new Dr.
    So how do a find a new Dr. In this climate?? I can tell you no one wants to take on a chronically ill patient for the last 36 years.
    Shandro sees me as a number and not a person or a patient.
    I wonder how I can go to mom who had open surgery last week or my dad who is in a home with Alzheimer’s. She is 82 and has been looking after me for the last 2 years. She drove me to all my appts. I give her and my family full credit for surviving through my never ending health crisis’s for 36 years.

    I’m looking for help, hope, compassion and a family Dr. like the one I’m about to lose.
    I’ve researched this night and day learning complex modifiers, coding, the govt. budget etc. I’ve run out of people and organizations to write to.
    I’ve said all I can to Shandro but it falls on deaf ears or they are never read. How do I as one chronically ill person who’s surgeries are more life threatening every time I’m opened up live here.

    How can a Country, province and city I love come to this new level of low in health care that’s going to implode and cost more money than they think they will save?

    I still have a lot of years I want to live. Who can help me get one more chance at that dream? It’s been a dream for 36 years….


  3. The money that sustained public services in Alberta came from mainly O&G industry. Now that all industry has officially been driven out of this province no more money. Get used to it folks, Alberta is closed and broke.

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