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ChemPetE

Alberta poised to unilaterally expire the physicians master agreement and make billing number changes

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There are still worse places to work than Alberta in Canada. I think the provinces are being smart by squeezing us instead of providing incentives. Cheaper in the short run for their budgets and it's not like we can all leave for the US or other countries. 

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3 hours ago, zxcccxz said:

All this is going to do is make physicians want to work anywhere but Alberta and make it even more difficult to serve the underserved areas they claim to be helping through this bill.

Considering Alberta is one of the better remunerated and easier to work in provinces, very unlikely. 

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Ridiculous... As an upcoming Albertan medical graduate, the only reason CMGs are picking to work in Alberta is because 1) living close to family ties, or 2) the Alberta Advantage ($). Given that the UCP is proposing to force Albertan CMGs into rural spots, and are inevitably going to slash physician compensation either by negotiating with the AMA or forcibly through legislation, what's keeping future Albertan CMGs here? To encourage rural physicians, they need to incentivize, not force. Nobody likes being told what to do.

Welcome to the brain drain and to even larger doctor shortages.

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5 hours ago, JohnGrisham said:

Considering Alberta is one of the better remunerated and easier to work in provinces, very unlikely. 

The issue is gonna be hard to fill positions in rural areas. Those are mostly going to be family docs. People already don't want to work in those places and family docs are in demand all over the country. If you tell a newly minted family doc they can only work in AB if they move to some rural location they have no interest in ever living in, the doc will just look for work in another province where they can live in a location that is more appealing to them. It's not like they are surgeons and there are very limited jobs in the country (those people don't need work location limitations to force them into crappy jobs. Needing to eat and pay debt does that job nicely).

My thoughts are this will probably hurt family medicine in hard to fill locations. But politically it will be meat for the conservative base, which is what the politicians likely intended it to be anyway. And most people supporting it will be too ignorant (involuntary or voluntary) to realize the very policy they are cheering is hurting them. 

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7 hours ago, Compton said:

Now the question is..will other provinces adopt this (especially Conservative provinces)?

That's the only way this will really work on a scale big enough to be effective for family medicine, which is what the public really cares about in rural areas, is if most provinces dictated where you could work in that province. 

If that happens:

1. I expect a major court challenge would be mounted.

2. New grad doctors had better start loving the idea of a long career in rural Newfoundland, Northern Ontario or middle of nowhere Saskatchewan, because that's the type of jobs they will be forced into.

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5 hours ago, NLengr said:

That's the only way this will really work on a scale big enough to be effective for family medicine, which is what the public really cares about in rural areas, is if most provinces dictated where you could work in that province. 

If that happens:

1. I expect a major court challenge would be mounted.

2. New grad doctors had better start loving the idea of a long career in rural Newfoundland, Northern Ontario or middle of nowhere Saskatchewan, because that's the type of jobs they will be forced into.

I think providing rural incentives hasn't had the greatest success in the past and it will be increasingly unaffordable for the government given continually rising healthcare costs. Installing the structure to force doctors to work might be the road forward for provinces looking to address rural demand for physicians (a.k.a get rural votes). I'm curious what the supreme court would say in such a situation. I'm not sure if our right to work anywhere will outweigh societal need for physicians in rural areas if shortages get really bad. I think in previous rulings it has been established that it is a privilege to be a regulated professional (doctor, lawyer, accountant, etc) rather than a right. Not sure how all the arguments will lay out as I'm not up to date on all the case law but I think it would be complex on both sides. Regardless, I think the environment will continue to move in an antagonist direction for physicians across Canada.

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9 hours ago, blah1234 said:

I think providing rural incentives hasn't had the greatest success in the past and it will be increasingly unaffordable for the government given continually rising healthcare costs. Installing the structure to force doctors to work might be the road forward for provinces looking to address rural demand for physicians (a.k.a get rural votes). I'm curious what the supreme court would say in such a situation. I'm not sure if our right to work anywhere will outweigh societal need for physicians in rural areas if shortages get really bad. I think in previous rulings it has been established that it is a privilege to be a regulated professional (doctor, lawyer, accountant, etc) rather than a right. Not sure how all the arguments will lay out as I'm not up to date on all the case law but I think it would be complex on both sides. Regardless, I think the environment will continue to move in an antagonist direction for physicians across Canada.

I agree that incentives don't work well either. It's a difficult to solve problem.

The problem is living in a rural area really sucks (at least for most people) and the incentives offered aren't enough to overcome that. I work rural and get a "bonus" for it. It isn't near enough to make me stay. If a non rural job came up, I'd leave smoking tire tracks in the parking lot I would leave so fast.

Now if they started paying 5 million a year for people to work rurally it would be different.......

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10 hours ago, NLengr said:

I agree that incentives don't work well either. It's a difficult to solve problem.

The problem is living in a rural area really sucks (at least for most people) and the incentives offered aren't enough to overcome that. I work rural and get a "bonus" for it. It isn't near enough to make me stay. If a non rural job came up, I'd leave smoking tire tracks in the parking lot I would leave so fast.

Now if they started paying 5 million a year for people to work rurally it would be different.......

I agree that the incentives are not enough for many physicians to compensate the downsides of living in a rural area. Lack of good schools for children, lack of family/friends, lack of dating opportunities if single, etc. Paradoxically, I think from the outside the incentives look generous on public budgets and in the news so I don't think there's much push to further increase pay. For better or for worse our profession is heavily tied to public perception and need so I think the only way forward is down.

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This assumes that urban trained residents are being adequately prepared to work in a rural environment. I don’t think that is the case, and would be very resentful to a government that forced me to work in an environment I am neither comfortable in or trained in. I would be interested to know what the regulatory bodies had to say about the government forcing physicians to work outside of their education and “scope”...

While we’re at it we might as well bring back the rotating internship year and general license, then the government could tell us what specialty we’re allowed to be each year.

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On 10/29/2019 at 3:22 AM, NLengr said:

That's the only way this will really work on a scale big enough to be effective for family medicine, which is what the public really cares about in rural areas, is if most provinces dictated where you could work in that province. 

If that happens:

1. I expect a major court challenge would be mounted.

2. New grad doctors had better start loving the idea of a long career in rural Newfoundland, Northern Ontario or middle of nowhere Saskatchewan, because that's the type of jobs they will be forced into.

That really sucks! In Quebec, the PREM system has existed for awhile. It's the major reason why I left my home province, as I want to do inner city health with marginalized population who is underserved as well!

I wonder if the government recruits IMGs to work in rural and remote communities; they should ACTUALLY PAY ATTENTION of where those IMGS end up working. I know a few who work in GTA; or who get exempted because they work in academic hospitals; or who just not abiding by the contract and no PENALTIES  are imposed. 

What's the point of having IMGs and making them looking attractive to the general public if the government is not making sure that they are serving the rural population??

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55 minutes ago, LittleDaisy said:

 

What's the point of having IMGs and making them looking attractive to the general public if the government is not making sure that they are serving the rural population??

So the public votes for you because they think you are helping the situation. You get reelected and get your sweet pension. That is the point. 

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