Majority of Alberta doctors would leave province if it separates from Canada, survey finds

EDMONTON · A new survey from the Alberta Medical Association indicates a majority of the province's doctors would leave Alberta if it separates from Canada. Of the 1,649 physicians who responded to the AMA's Pulse survey, 55 per cent said they would move to another province or territory and discontinue practising in Alberta. The survey found 15 per cent of respondents would continue living and practising in an independent Alberta, while 18 per cent were uncertain about what they would do. Another eight per cent said they would retire or leave medical practice earlier than planned.

The survey results were published Tuesday in a letter from AMA president Dr. Heidi Fell. Tuesday also marked the first of five days of advance voting ahead of the official referendum day on Oct. 19. Premier Danielle Smith's United Conservative Party government has put 10 questions on the ballot. The 10th question asks whether the province should stay in Canada or hold a second, binding referendum on leaving the country.

"As Albertans prepare to vote, the AMA is focused on an important question," Fell said in the letter. "What could the referendum outcomes mean for patients, physicians and Alberta's health-care system?" The association said if Albertans choose to separate, not only would the medical workforce shrink, but health care would be left in limbo. Fell said it is unclear how an independent Alberta would fill the health-care funding gap created by losing federal money. "In addition to assuming federal health-care funding responsibilities, significant health-care concerns remain, including maintaining access to medicines, equipment and medical services," she said. The AMA also raised questions about the potential effects of the referendum's immigration questions on health care. The first nine ballot questions concern Canada's Constitution and immigration, including whether the government should impose limitations and fees for newcomers and temporary workers accessing health care.

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Fell said she wrote to the province's health ministers last week seeking clarity on several practical issues. She asked what doctors should do when someone needs medically necessary care but their eligibility cannot immediately be confirmed. She also asked how questions about eligibility should be resolved without delaying care. "Physicians often need to make clinical decisions before a patient's identity, residency status or coverage can be verified," Fell said.

"Our position is straightforward: uncertainty about coverage should not unnecessarily delay care, and physicians and their staff should not be placed in the position of determining or enforcing a patient's immigration or coverage status." Fell said the AMA is not telling Albertans how to vote. "At a time when access to care and health workforce capacity are important concerns for Albertans, we believe these perspectives are relevant to the wider public conversation," she said. She emphasized the need for a credible examination of these issues so Albertans can understand the full impact separation could have on health care, particularly if fewer physicians remain. "Our responsibility is to identify potential health-care implications, raise practical questions where greater clarity is needed, and advocate for an approach that protects patient access to medically necessary care," Fell said.

The office of Hospitals Minister Adriana LaGrange said it is reviewing the association's letter. "It would be inappropriate to speculate on the outcome of the referendum or any technical legislative, policy or program changes that may follow until Albertans have had their say," her office said in a statement Tuesday. Fell said the AMA hopes to hear from the government soon. "Ultimately, we believe questions about coverage should be addressed through a reliable and timely administrative process so physicians can remain focused on clinical decisions and patients can receive the care they need," she said.

With files from Edmonton Journal, CBC News and The Globe and Mail