The Alberta government is taking a new approach to get physicians where they are needed most in the province.
Too many communities – especially rural communities – continue to face physician shortages, despite Alberta having one of the highest numbers of physicians per capita.
We have taken steps in the past to address this challenge, such as sustained funding in spaces for medical students and significant investment in rural attraction and retention programs. But these haven’t worked well, and rural Albertans still don’t have enough physicians to meet their health needs.
Bill 21, the Ensuring Fiscal Sustainability Act, 2019 adjusts billing systems to start matching new physician supply with demand starting April 1, 2022.
New physicians will only be able to bill the government for delivering insured services if they practice in locations with an identified need. This will include rural and remote areas, as well as underserved urban areas.
This does not mean new physicians will only be able to work in rural communities. New physicians will be matched where health services are needed – including urban areas.
The changes will not apply to existing physicians.
These changes will be phased in over 2 years to allow for consultations with the medical community, including the Alberta Medical Association, to develop regulations on the new system and how it is implemented.
We will continue to work with communities and experts to identify physician needs in geographic areas throughout Alberta by looking at factors such as population, physician utilization and disease prevalence data.
The goal is to ensure all Albertans have equitable access to physicians no matter where they live.
Research confirms that Alberta doesn’t have a doctor shortage. In fact, we’re in much better shape than other provinces. Over the past 15 years, the number of physicians in Alberta has grown at more than twice the rate of other provinces.
According to the Canadian Institute of Health Information, the number of physicians per capita in Alberta went up by 50% between 2001 and 2018. By comparison, the number of physicians per capita in Ontario, Quebec and British Columbia grew by 25% over the same time.
In 2018, Alberta had 10,806 physicians, or 249 physicians per 100,000 population, compared to 5,154 physicians, or 167 per 100,000 population in 2001. Nationally, the number of physicians per 100,000 population grew from 188 to 241 in the same period.
Despite growth in the number of physicians in Alberta, physician service shortages continue in rural and remote areas of the province as well as in some underserved urban areas. There is significant variation in the number of primary care physicians per 100,000 population across Alberta and misalignment with population health needs.
Between 2014 and 2018, the number of doctors in urban Alberta rose by approximately 14%, but the number of doctors in rural Alberta has only risen by 6%.
In 2018, the total number of physicians practicing in rural Alberta was 732, down 3.6% from 2017, accounting for 6.8% of all physicians in Alberta.
Alberta has two medical schools offering high quality medical education and training. Alberta Health’s 2019-20 budget offers approximately $167 million for (postgraduate) resident physicians’ medical education and compensation for providing health services.
There are currently 1,657 ministry-funded medical resident physicians in Alberta; 820 at the University of Alberta and 837 at the University of Calgary.
In 2018-19, there were 195 first-year, government-funded resident physicians at the University of Alberta and 197 at the University of Calgary. Approximately 75% of resident physicians remain in Alberta to practice after completing their postgraduate education.
Rural physician recruitment and retention initiatives
Improving access to care in rural communities and other underserved areas is a priority for government. Alberta Health’s 2019-20 budget provides approximately $80 million to address the distribution of physicians through financial incentives, attraction and retention initiatives and rural medical education programs, including:
- Rural Remote Northern Program (RRNP) – provides direct financial incentives to physicians who live and practice in underserviced communities.
- Rural Health Professions Action Plan (RhPAP) – works with communities to enhance the attraction and retention of health professionals for rural practice.
- Rural Medical Education programs – support medical students and residents’ experience with rural health care, with the goal of increasing interest in, and ultimately choosing a rural medicine career path.
- Physician Locum Service Program – ensures that communities with four or fewer physicians have access to continuous medical coverage if a physician is unable to provide services due to short-term absences.
- Rural On-Call Program – provides remuneration to physicians providing emergency on-call services at eligible facilities in rural areas.