‘Alberta needs to remain competitive’: AMA on doctor recruitment efforts

B.C. is working to attract doctors and health-care professionals from the United States. AMA president Dr. Brian Wirzba on whether Alberta should follow suit.

Alberta Medical Association president Dr. Brian Wirzba joins Alberta Primetime host Michael Higgins to discuss doctor recruitment efforts in Alberta, particularly as B.C. touts the success of its campaign to recruit U.S. health workers.

This interview has been edited for clarity and length.

Michael Higgins: What do you make of B.C.’s approach to attracting health-care workers from south of the border, and how do you weigh their results?

Dr. Brian Wirzba: Health-care providers and health-care workers are in a very competitive marketplace. We’re always competing with other provinces and other jurisdictions. With some of the things happening south of the border a number of provinces, as you highlighted British Columbia most recently, have been targeting American health-care workers, physicians and other allied health workers. It’s great for British Columbia. We do know Alberta is also looking at recruiting high quality health-care workers that can help fill gaps. We’ve been successful in some areas, but there’s still some more recruitment areas that we need.

MH: To what degree do you see Alberta tailoring efforts to tap that American market?

BW: To date I haven’t seen any specific recruitment efforts for physicians into the United States. My understanding is there are recruitment efforts for some of the other allied health professionals. That said, we’re also seeing physicians we train in Alberta move to other jurisdictions because of that competitive marketplace. Alberta needs to remain competitive.

MH: How difficult might it be for an American physician to practice in Alberta?

Are there lessons we could learn from what they’re doing in B.C.?

BW: Absolutely. There’s always lessons, particularly for types of physicians practicing in areas that we might not have enough of, like anesthesia or some of our surgical specialties. The actual ability for an American trained position to move over to Canada - I don’t think it’s arduous. There certainly are requirements. To get accreditation through our college and licensure. Those aren’t insurmountable, and certainly aren’t significantly different than anywhere else in the country.

MH: How does Alberta compare as somewhere to come for doctors from America or elsewhere?

BW: It’s important to remember that physicians move based on a variety of different reasons. It’s the ability to practice the type of medicine that they want to practice. It’s the infrastructure that’s available, particularly when it comes to resources that require more than just a regular office. Surgeons have different requirements, and there’s different recruitment options available. Physicians move because of lifestyle, because of what a place can offer for their family. Often partner job opportunities are also important. That’s one of the reasons why we have seen a significant increase in new physicians in some of the urban centers. We’re still struggling in some of the smaller communities and regional centres.

Some of the lessons we can learn are how we actually support recruitment to those areas that are more challenging to recruit to but still offer a great opportunity for physicians to work. I also think locally, individual towns and cities have started to actually come up with innovative ways to recruit people, and I think we should be seeing more of that in the future.

MH: How do you expect Alberta’s move to allow some doctors to practice in both private and public systems to influence the draw of doctors to Alberta?

BW: That might attract some types of physicians, certain types of practices that might be more conducive to that dual practice model. It wouldn’t necessarily attract physicians who have no interest or the ability to actually practice in a private or dual model system. So it remains to be seen.

The details of exactly what that dual model will eventually look like have not been finalized, and while it might attract some physicians it will not solve all the problems. As an organization the AMA is very focused on ensuring we are recruiting physicians to participate in high value care, care where patients most need expertise. The payback for providing that level of care is significant. Some of the concerns we are seeing relate to physicians participating in sometimes lower value care.

Alberta has an ability to provide physicians an opportunity to practice where patients are getting services that they desire, but not necessarily ones that are leading to long-term better outcomes. So we really need to look at what types of healthcare workers are coming to Alberta, try to really make it attractive for those providing that high value care, and have a better understanding of where physicians are actually working and what they’re doing.

MH: Pre-budget last month, the government pledged an additional $1.4 billion for what it called “physician recruitment, training, compensation and development.”.

Have you gotten any more clarity since then on what exactly that announcement meant?

BW: After looking at those numbers, we do see what the government did was correct for previous under-investment in the physician services budget. It is not necessarily new money. It is new money in the budget, but that money is being spent already on the positions that are here. We have seen the government talk about the increased number of positions we have in the province. Again, the total number of physicians doesn’t really tell the story of where they’re working, but when physicians are working in the province and are being paid by the province that leads to increased utilization or increased budget requirements. We were happy to see the government has finally recognized that after several years of essentially under-budgeting despite what was actually being paid out. So just to be clear, it wasn’t new money. Although it’s a 22 per cent increase in the budgeting amount, the actual amount that would essentially be considered new above utilization is about 1.6 per cent.