Physician resource planning

In the early and mid-2000’s, Alberta had fewer physicians per population than the national average and efforts were made to recruit and retain more physicians. These efforts, including financial incentives and amendments to legislation, resulted in an increase in Alberta medical graduates and increases in the number of physicians coming to Alberta from other countries and the rest of Canada.

In recent years, growth in the number of physicians has dramatically outpaced Alberta’s population growth and Alberta now has more physicians per population than the national average. Yet at the same time, the percentage of physicians practising in rural and remote areas in Alberta has decreased.

Despite growth in Alberta’s overall physician supply, physician access continues to be an issue in many rural and remote areas as well as in some urban areas. These trends also impact the affordability and sustainability of the health system.

The 2016 amending agreement between Alberta Health and the Alberta Medical Association (AMA) outlined a joint commitment to establish a physician resource planning committee and develop a needs-based physician resource plan. Physician resource planning is an important part of addressing these issues and meeting Alberta Health’s vision of ensuring that Albertans receive the right health care services, at the right time, in the right place, provided by the right health care providers and teams with the right information.

Updated: May 14, 2018

Regulatory amendments

The Alberta Government has approved regulatory amendments to the Alberta Health Care Insurance Regulation and the Claims for Benefits Regulation to set the direction for the implementation of physician resource planning in Alberta.

The regulations:

  • provide the Minister of Health with the authority to establish a Physician Resource Planning Advisory Committee (PRPAC) to advise on the supply and distribution of physicians in Alberta;
  • enable the Minister to establish the number of additional physicians required each year; and
  • formally require all physicians to have a practitioner identification number to bill the Alberta Health Care Insurance Plan for providing insured medical services (this was previously required, but only as a matter of policy).

The regulations do not include provisions that would restrict the number of practitioner identification numbers issued to new physicians. Instead, PRPAC member organizations will be responsible for implementing changes collectively, and within their individual authority, to achieve the number of additional physicians established by the Minister and other physician resource planning objectives. These objectives will include identifying where physicians are most needed in Alberta. .

Ministerial Order

The Minister of Health established the PRPAC by Ministerial Order on Aug. 14, 2017. The committee is collaboratively developing a needs-based physician resource and implementation plan. The plan will identify the optimal supply, mix and distribution of additional physicians needed annually in Alberta to ensure all Albertans receive appropriate health care.

In March 2018, the Minister of Health received PRPAC’s final recommendation on the number of additional physicians required for 2018–19.

In setting the number of additional physicians, the Minister considered the advice of the PRPAC, existing health resources, Albertans’ health needs, and the affordability and sustainability of paying benefits for insured services by additional physicians.

The committee considered current available evidence, physician supply forecasts and health system demand in making its recommendation. It also recognizes that a population health needs model requires a longer time to be completed.

The PRPAC is developing an implementation plan that contains recommended actions for member organizations to implement in 2018–19. Particular emphasis will be placed on improving physician distribution to rural and remote communities, underserviced urban areas and indigenous communities.

The committee will also continue providinge advice and recommendations to the Minister of Health on matters relating to physician resource planning.

What you should know

What the physician resource plan will achieve

The goal of physician resource planning is for Albertans to get the care they need by ensuring physicians are practising in communities where they are most needed. In November 2016, the government of Alberta and the Alberta Medical Association (AMA) publicly committed to developing a needs-based physician resource plan that will identify the supply, distribution and cost of physician resources that Albertans need.

The PRPAC will use the best possible information to identify Alberta’s physician resource needs and recommend strategies to achieve better distribution of physicians to serve Albertans.

Strategies to reach the agreed upon number of additional physicians

Organizations involved in PRPAC will be responsible for implementing changes collectively, and within their individual authority, to achieve the number of additional physicians established by the Minister of Health and other physician resource planning objectives. Alberta Health will continue to work with stakeholders to use current mechanisms, existing legislative mechanisms, and policy initiatives to influence the supply and distribution of physicians.

If existing mechanisms aren’t successful, the Minister may consider using other legislative mechanisms and policy initiatives to achieve physician resource planning goals.

Committee information and timeline

Committee membership

PRPAC members are health system stakeholders working together to provide the Minister of Health with recommendations for physician resource planning in Alberta.

Members of the Physician Resource Planning Advisory Committee are:

  • Alberta Health – Associate Deputy Minister (Chair), and Assistant Deputy Minister (Vice-Chair)
  • Alberta Health Services – President and Chief Executive Officer, and the senior executive responsible for health workforce planning.
  • Alberta Medical Association – Executive Director, and one member of the AMA
  • College of Physicians and Surgeons of Alberta – Registrar
  • University of Alberta Faculty of Medicine and Dentistry – Dean
  • University of Calgary Cumming School of Medicine – Dean
  • Alberta Rural Health Professions Action Plan – Executive Director
  • Professional Association of Resident Physicians of Alberta – President and Chief Executive Officer
  • Alberta Advanced Education – Assistant Deputy Minister responsible for post-secondary programs and accountability.
  • Medical Students’ Association (University of Alberta) – President
  • Medical Students’ Association (University of Calgary) – President

Timeline

  • July 5, 2017 – Regulatory amendments came into force.
  • August 2017 – PRPAC established by Ministerial Order. The committee began the work of developing the number of additional physicians needed in Alberta for the 2018–19 fiscal year.
  • January 2018 – PRPAC will provide the Minister of Health and the Deputy Minister of Health with its recommendation for the number of additional physicians needed in 2018–19 and a recommended implementation plan for meeting physician resource planning goals.
  • April 1, 2018 – The Health Minister, by order, will set out the number of additional physicians needed to provide insured services in 2018–19.
  • April 2018 to March 31, 2019 –Committee stakeholders will take action within the authority of their organizations to implement physician resource planning to achieve the target number of additional physicians set out in the Ministerial Order for 2018–19.

PRPAC meeting highlights

March 19, 2018

  • The PRPAC reviewed a draft implementation plan containing recommended actions for member organizations to implement in 2018–19. The recommendations are intended to influence physician resources in each of the three pillars that have driven this work: supply, distribution, and mix.
  • The committee has placed a particular emphasis on best practices to improve physician distribution to rural and remote communities, underserviced urban areas, and indigenous communities. Its focus is ensuring physician resources are available to meet the health needs of Albertans.
  • The committee will present the finalized implementation plan to the Minister of Health in the coming months.

Jan. 31, 2018

  • The PRPAC reviewed its analyses and agreed on a recommended range of additional physicians required for 2018–19. The committee is finalizing its written recommendation, which will be presented to the Minister of Health.
  • The committee is refining a list of actions that member organizations can take to improve the supply, distribution, and mix of physicians in Alberta and achieve the recommended number of additional physicians in 2018–19. Particular emphasis was placed on best practices to improve physician distribution to rural and remote communities, underserviced urban areas, and indigenous communities.
  • The committee recognizes that the short term actions are an important first step, but the committee is also moving towards a needs-based plan to best serve Albertans.

Nov. 29, 2017

  • The PRPAC agreed on the initial estimated range of new physicians required for 2018-19. The initial estimate takes into account physician supply forecasts, current available evidence and health system demand.
  • The committee will continue its analyses on Alberta’s physician workforce and health needs in order to update its initial estimate in preparation for the final recommendation to the Minister of Health prior to Jan. 31, 2018.
  • The committee discussed many potential options, as identified by the operational working group, for achieving its physician resource planning goals. The operational working group will continue to explore several priority options for implementation.
  • The committee continues to emphasize the need to align its work with other health system initiatives and priorities.

Nov. 1, 2017

  • The technical working group presented its methodological approach to planning Alberta’s physician workforce. The committee discussed the number of additional physicians needed in Alberta and requested further analyses before drafting the initial estimate in preparation for the recommendation to the Minister prior to Jan. 31, 2018.
  • The committee had an initial discussion on potential options that are available for influencing the supply and distribution of physicians in the province. In the coming months, it will discuss both short and long-term recommendations for achieving its supply and distribution goals.

Oct. 11, 2017

  • Alberta Health Services (AHS) presented its physician vacancies report to inform the committee about AHS’ existing principles and process for establishing vacancies and recruitment priorities. Discussions took place on understanding how AHS vacancy information feeds in to the committee’s deliverable of recommending a target number of additional physicians for 2018–19.
  • A community-based physician presentation identified a gap regarding community-based family physicians and specialists in metro Edmonton and Calgary. The committee agreed that to achieve success, decisions must align with population health outcomes to ensure Albertans receive the health care they require.
  • It was agreed the exercise of determining the number of additional physicians needed in Alberta would serve as a compass to measure against benchmarks and provide insight on how best to improve distribution.
  • The committee met with the Provincial Primary Care Network Governance Committee to foster collaboration and create synergies between the two groups on physician resource planning.

Sept. 25, 2017

  • The second committee meeting was held on Sept. 25, 2017. Guest speaker Professor Des Gorman, Associate Dean of the Faculty of Medical and Health Sciences at the University of Auckland, Executive Chairman of Health Workforce New Zealand, and world renowned expert in health workforce planning, spoke to the committee about health workforce planning in a constantly evolving health system.
  • The committee reviewed and discussed the work of the technical working group to gain understanding of the methodologies and modelling capabilities to develop a recommendation of the number of additional physicians required in Alberta in 2018–19.

Aug. 28, 2017

  • The Minister of Health established the Physician Resource Planning Advisory Committee (PRPAC) by Ministerial Order on Aug. 14, 2018.
  • On Aug. 28, 2017, the PRPAC held its inaugural meeting and confirmed its terms of reference, as contained in the Ministerial Order.
  • The committee identified its key activities, reviewed background analyses on the current state of physician resources in Alberta and other jurisdictions, and discussed a strategic framework for conducting short, medium, and long-term physician resource recommendations.
  • The committee agreed on an approach and methodology to developing the number of additional physicians for 2018-19, categorizing physicians under three broad categories: specialists and family physicians affiliated with Alberta Health Services, community-based family physicians, and community-based specialists.
  • The next meeting was scheduled for Sept. 25, 2017.

Why physician resource planning is necessary

  • Alberta is experiencing unsustainable increases in the number of physicians in our province.
    • Between 2000 and 2016, the number of physicians per 100,000 populations in Alberta grew by 45.3%, compared to 21.3% growth in comparator provinces.
    • On average, Calgary and Edmonton have 28% more family medicine physicians per 100,000 populations than the rest of the province.
  • Alberta is maintaining the highest per capita spending on physician services in Canada.
    • Alberta will pay $5.2 billion this year for physician compensation and development programs.
    • This is nearly a quarter of Alberta Health’s budget at 24.3%, with the Ministry making up 39% of the entire government’s budget.
  • Despite the growing number of physicians, Albertans are still not getting access to the physician care they need. This is especially true for rural and remote areas, but certain urban populations are underserviced as well.
    • In 2012, 8% of physicians practised in rural areas; in 2016 this percentage had declined to 7.3%.
    • Of the 994 net new family medicine physicians in Alberta between 2012 and 2016, only 60, or 6%, were practising in rural areas.
  • Through the AMA Amending Agreement, both the Alberta government and physicians have committed to physician resource planning.

Other physician planning work

As a member of the PRPAC, Alberta Health Services is a valued partner in Alberta’s Physician Resource Planning initiative. Alberta Health Services’ physician workforce and recruitment planning informed the PRPAC’s recommendation to the Minister on the number of additional physicians needed in 2018–19.

Alberta Health Services' recruitment and workforce planning and forecasting will continue to be aligned with the work of the PRPAC to support future recommendations based on population health needs of Albertans.