Friday, March 25, 2016

Alberta Health review of Rural Physician Action Plan concerning to Town and MD councils

Josh Davis and Toni Lucas

Town of Pincher Creek and MD of Pincher Creek councils have each agreed to support the Alberta Rural Physician Action Plan (RPAP) which was established in 1991.  RPAP helps introduce, train, and retain medical students in rural practice. Alberta Health will be conducting a review of RPAP's programs and services and it is currently expected that recommendations on the fate of RPAP to be provided to the Deputy Minister by 31 March 2016. RPAP's current grant funding ends on 31 March 2016. Alberta Health has indicated that in the interim they will provide 6 months funding to cover it until September 30, 2016. A letter for a request for support was discussed at MD Council on Tuesday March 8, and Dr. Gavin Parker presented at Town Council on Monday, March 14 for similar support. Both councils agreed to support the initiative.

MD council deliberations

On Tuesday March 8, Pincher Creek's MD Council decided to show support for the Alberta Rural Physician Action Plan (RPAP) in response to a letter sent to council by RPAP. In a letter to Council from Executive Director David Kay, RPAP I Health Workforce for Alberta, dated February 16, 2016, Kay stated:

"RPAP is making a valuable contribution to the attraction and retention of physicians in rural Alberta. RPAP has a clear vision and mission which are underpinned by a number of objectives and goals. The initiatives within each goal align with both the direction of the goal and with each other."

"Physicians, residents and medical students all reported that RPAP was a positive driver within the rural Alberta health care environment. All three user groups stated that RPAP initiatives provided them with insights into rural practice and rural community living that might otherwise be unknown to them. Medical students felt that they were exposed to the advantages of rural practice through RPAP initiatives, and that the initiatives informed their career choices. Furthermore, medical students and residents reported that RPAP initiatives influence their decision to pursue rural practice. The seven-year retention rate of rural physicians has increased, year on year, as has the number (headcount) of physicians practicing in rural Alberta."

"RPAP initiatives are currently seen as the vanguard of Canadian rural physician recruitment and retention practices, and are aligned with most best practices."

"If you value the programs and services provided by RPAP, and wish to have them continue in your community, please immediately contact your MLA and the Minister of Health Hon. Sarah Hoffman to provide your input to the review. Otherwise the support you have come to expect from RPAP might not be there."

Reeve Brian Hammond was strongly in support of RPAP. "I think the initiatives of the RPAP group are significant enough, and have been significant enough in the South region that support needs to continue." Hammond stated that this group is responsible for encouraging medical professionals to practice in rural areas. "I go to meetings once a month in Lethbridge, and I hear over and over and over again the difficulties that small town Alberta is having encouraging and attracting medical staff. This group is single-handedly been able to provide those kind of people, to those communities."

MD Councillor Terry Yagos moved that the letter from Health Workforce for Alberta, dated February 16, 2016, regarding the Alberta Health Review of Alberta Rural Physician Action Plan be received; and that a letter supporting the Alberta Rural Physician Action Plan be forwarded to Alberta Health. The motion was carried.

Town council deliberations

At the regular meeting of Town Council of Monday, March 14, Dr. Gavin Parker said RPAP has an $11 million dollar budget. He expressed concern over taking a program which has been running well and removing it, possibly because of universities who would like to be more in control of the funding. Parker is a large supporter of the RPAP, having participated in the program himself serving residencies in Milk River, Rocky Mountain House, and Raymond. He said accommodation and travel are supported through the program, making it more feasible for resident doctors to practice. Other forms of support include scholarships for those who agree to practice in rural areas, Alberta high school outreach, resident and medical students, practicing physicians, and support for rural Alberta communities.

Councillor Doug Thrnton asked where the direction for this 'de-funding' is coming from, to know who else a letter of support should go to. "That is a really good question,"said Parker. "I think primarily, it's coming from the universities, wanting to have more control over that budget themselves. I think operationally, it's challenging for them because the rural residents do get a lot of extra support."

"We have been really lucky in Pincher Creek about recruiting a really good core," he said as a board member and for staffing and residents. "We have more learner weeks in Pincher Creek than any other rural setting in the province. We have four residents at any given time, and 2 medical students, plus other students, as well." He said all of this is funded through RPAP. He said five out of the ten local doctors currently practicing in Pincher Creek have gone through the RPAP program.

When a recent donation to the university was brought up, Parker explained there was a recent donation to the University of Calgary for $100 million dollars, "That $100 million came with the caveat that it would have to be matched by the donors, and the province will have to match it." He said he is happy the province is capable of finding matching funds for the sum of $10 million dollars per year for 10 years considerably shoring up funding for the university. Parker understands this funding will primary be used in research which he is in favor of. His concern however is what is going to go into rural health care.  He expressed concern over the lack of rural focus if the RPAP program is halted or stalled. This program helps to interest and support students in rural care where there is already a need for medical practitioners across Canada.

Mayor Don Anderberg said,"The results speak for themselves, I believe," and commented to get a program of this magnitude running well has taken years, and a lot of effort. "It shouldn't be about the cash, and this is all about the cash, I believe."

Town Council direct that a letter of support be drafted, to go to the following parties:
  • Premier of Alberta Rachel Notley
  • Deputy Premier of Alberta Minister of Health Sarah Hoffman
  • Opposition Leaders:  Conservative Party - Ric McIver, Liberal Party - MLA Dr. David Swann, and Wildrose Party - Brian Jean
  • Local MLA Pat Stier
  • MLA for Lethbridge-West Shannon Phillips
  • MLA for Lethbridge-East Maria Fitzpatrick

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