The Departments of Psychiatry at the Universities of Alberta and Calgary, Alberta Health and Alberta Health Services (AHS) continue to make steady progress toward hammering out the details of a proposed Academic Medicine and Health Services Program (AMHSP) for Alberta's practicing psychiatrists.
That's the word from Dr. Alberto Choy, who is participating in the multi-party talks as Associate Chair, Academic Affairs, at the University of Alberta's Department of Psychiatry.
"The health ministry and AHS know there needs to be an incentive to shift over to an AMHSP from the traditional fee-for-service payment model. Right now we're in the midst of working out the details of what that package might look like," says Choy, who also serves as Director, Division of Forensic Psychiatry.
Pursuant to the terms of the 2016 Amending Agreement - which reset the relationship between the province's 10,000 physicians and Alberta's NDP government, as part of an effort to slow the growth of health care costs - representatives from Alberta Health, Alberta Health Services, the Alberta Medical Association (AMA) and the province's universities have been discussing how to design AMHSPs for psychiatry professionals for the past year.
The Amending Agreement gives the AMA a seat at both the provincial strategy and operations committees for the AMHSP talks.
The objective with AMHSPs - traditionally referred to as Academic Alternative Relationship Plans (AARPs) - is to ensure that physicians who teach, conduct research, or assume leadership and administrative roles at Alberta's faculties of medicine are not unduly financially penalized for taking on such activities.
"AARPs - or AMHSPs - have been around for many years in other specialties, but this time around, what the government has done is to unify the principles for the whole province, so there aren't individual AARPs. They know there needs to be an incentive to come over to an AMHSP," says Choy.
Although the principle components of the AMHSP have been established for the whole province, negotiations are currently underway to determine the base rate for psychiatrists interested in the AMHSP payment option. Alberta Health is in the process of finalizing its initial assessment for the range of remuneration and is expected to engage all parties in negotiations by the end of the calendar year, with the aim of meeting an April 1 start date.
"Under the old model, moving to an academic position meant you would likely be taking a major pay cut," says Choy. "But with the new AMHSP the government realizes that is probably not going to fly, so they want to make it less of a disincentive to move over to academia by making the pay rates competitive."
Specific details aren't yet available, but the department is doing all it can to ensure a strong remuneration number, and Alberta Health has stated that no physician should suffer any salary loss.
For many professionals, lifestyle issues are also a growing factor. Although most new psychiatry graduates, especially those with young families, opt to enter the fee-for-service system, at least until they are financially well established, attitudes may slowly be changing.
"I think more new grads don't see themselves working 70 or 80 hours a week anymore. Lifestyle issues are becoming a lot more important," says Choy. "Physicians also don't want to be unduly financially penalized if they see education, research, innovation or leadership as part of their professional identity."
Despite the challenges, Choy says both sides are motivated to come to some kind of accommodation.
"From the government perspective, they want increased budget stability, and from a university perspective, AMHSPs could bring in a whole new group of people who are currently restricted to seeing patients, but who also want to do some teaching, take on leadership roles or do research."
(Note: Physicians who have questions on AMHSPs or the current negotiations are advised to contact either Scott Phillips (scott.phillips@ualberta.ca) or Dr. Alberto Choy (Alberto.Choy@albertahealthservices.ca).