We are the AMA - Alberta Medical Association

2012-13 Reports to theAnnual General MeetingDr. Allan S. Garbutt,Crowsnest Passwww.albertadoctors.orgWe are the AMA

Table of ContentsAgenda 2Mission & Vision 3In Memoriam 4Minutes 5Report from the Board of Directors tothe Annual General Meeting 9Executive Director’s Report 26Proposed Non-substantive Amendmentsto the Constitution and Bylaws of theAlberta Medical Association 27NominatingCommittee 28Dr. John T. Huang, CalgaryFinancial Statements 30L to R: Dawn Wyver(Administrative Assistant) andErika Serek (Project Coordinator,Practice Management Program),Southern Alberta OfficeDr. Susan J. Hutchison, Edmonton

AgendaAMA Representative Forum 2012O CanadaCall to OrderIn MemoriamMichael A. GormleyPresident’s ValedictoryDr. R. Michael GiuffreMinutes, 2012 AnnualGeneral MeetingNominating Committee ReportDr. Linda M. SlocombeReport from RFDr. Allan S. Garbutt- Report from the Boardof DirectorsExecutive Director’s ReportConstitution and Bylaws ReportDr. Edward W. PappCommittee on Financial AuditReport/Financial StatementsDr. T. Britt SimmonsCanadian Medical FoundationPresentation by Lee Gould,President and CEOOther BusinessAdjournment2

Mission & VisionAlberta’s physicians and the Alberta Medical Association (AMA) are committed to Patients First ® .Mission: Leadership and SupportThe Alberta Medical Association stands as anadvocate for its physician members, providingleadership and support for their role in theprovision of quality health care.Vision: Patients First ®Alberta’s physicians are committed to a healthcare system that facilitates wellness and deliverspatient- and family-centered care:• The provincial health care system isbuilt around patients and familiesand defined by quality: acceptability;accessibility; appropriateness; effectiveness;efficiency; safety.• Patients and families enjoy optimal healththrough access to:• Healthy lifestyle choices.• Healthy environments and communities.• Health service access based primarily onneed, not ability to pay.• The health care system has the resourcesto deliver patient- and family-centeredcare, with best evidence used to allocateresources to what is most effective andefficient in meeting health care needs.• The relationship between physician andpatient remains a cornerstone of the healthcare system, founded on mutual respect,dignity, compassion and trust. Care isdelivered with, not to, the patient, including:• Patient choice of a physician.• Physicians as agents of patients actingalways in the patient’s best interests.Dr. Neil D.J. Cooper,Calgary• Clinical and professional autonomyof physicians.• Providers and patients are partners withfunders and managers, sharing thegoal of a patient- and family-centeredhealth care system with defined rolesand responsibilities and clearly specifiedappropriate accountability.Scan to learn more aboutPatients First ® , or visit:www.albertadoctors.org/advocating/patients-firstwww.albertadoctors.org/advocating/patients-first3

In MemoriamMembers deceased since the last annual meeting are:ALLEN, Peter B.EdmontonLAWSON, Alan K.EdmontonANAND, Harminder S.EdmontonLEWIS, David J.Salt Spring Island BCANSELMO, John E.EdmontonLEWIS, Ronald D.M.CalgaryBEAMISH, William E.EdmontonLIPPOLT, Gordon B.Lac La BicheBEARDSWORTH, John H.InnisfailMCCRACKEN, Peter N.EdmontonBENNETT, IanLethbridgeMCEWEN, HowardCalgaryBEREZOWSKY, Walter H.EdmontonMCLEAN, Spencer R.CalgaryBLEVISS, MorleyEdmontonMCPHAIL, Bryan E.EdmontonBONHAM, Gerald H.Delta BCMERCER, Dennis F.High RiverBOWERS, Leslie S.Victoria BCMORRISH, Hugh F.CalgaryCALDER, Kimberley C.CalgaryMORTIMER, ShaneLethbridgeCOLTER, Donald R.EdmontonNATTRESS, John R.LloydminsterCOOKSON, Francis B.Qualicum Beach BCO’NEIL, Agnes J.CochraneDELIYANNIDES, CharlieCalgaryPIDDE, William J.EdmontonDIAMOND, Edgar G.CalgaryPOMAHAC, AnthonyLethbridgeFARVOLDEN, Cynthia G.CalgaryRAY, Mihirendra N.EdmontonFORWARD, James D.G.Oyama BCROSSALL, Richard E.EdmontonGANATRA, Bipin H.CalgarySECTER, Barbara A.EdmontonGRINSTEIN, MaxwellCalgarySHUTT, H. KenEdmontonHINTON-DRY, J. MargaretOttawa ONSMULSKI, JohnEdmontonJOHNSTON, Lloyd W.LethbridgeSTERNS, Laurence P.EdmontonJOWSEY, John W.CalgarySUIDAN, Ramzi M.Medicine HatKOCH, Eduard A.EdmontonVISSER, PieterWainwrightKOWALEWSKI, KonstantyEdmonton4

27. The Board of Directors has consideredmany candidates and made two selectionsfor physician representatives to the PCC:one from family medicine and one fromsecondary/tertiary care. We will be wellserved by these outstanding individuals,both past presidents of the AMA and wellversed in matters of physician paymentand incentives. Dr. Linda M. Slocombe isa family physician within a primary carenetwork specializing in obstetrics andDr. Gerry N. Kiefer is a pediatric orthopedicsurgeon. The third AMA seat will be filledby AMA Assistant Executive Director,Health Economics, Jim Huston.28. As for the chair position, the parties haveagreed upon a search company to developa shortlist. Conroy Ross, a well-respectedbusiness advisory and executive searchfirm with offices in Calgary, Edmonton andRegina, has been awarded the task. The fall2013 Representative Forum will receive anupdate on these and other activities for earlyimplementation of the AMA Agreement.Electronic medical records29. The AMA Agreement contains a ProvincialElectronic Medical Record (EMR) StrategyConsultation Agreement. It explains that,in 2010 before the end of the previousagreement, the parties agreed to an EMRacceleration plan for which AH committedfunding through March 31, 2014. As such,physician support for the implementationof EMRs, currently provided through thePhysician Office System Program (POSP),will end on March 31, 2014.30. The Provincial Electronic Medical RecordsStrategy Consultation Agreement commitsthe parties to develop a provincial EMRstrategy that will define the futureapproach to EMR use in Alberta. While nota signatory to this Consultation Agreement,AHS will play a role in the strategydevelopment, participating in a workinggroup for the EMR strategy that willdevelop a report by February 15, 2014. Thereport will be presented to the provincialHealth Information Executive Committee,for recommendation to the minister ofhealth prior to March 31, 2014.31. Since 2001, POSP has supported physiciansto implement EMRs in their offices. Asof March 31, 2014, EMR support andtransition services as per the originalprogram will end.• VCUR 2008 funding support and serviceswill continue for eligible enrollees upto the maximum funding amount of$35,000 or to March 31, 2019.• VCUR 2006 funding support ends March31, 2014; invoice deadlines apply.32. AH and the AMA have reached anagreement that provides for continued butlimited new VCUR 2008 EMR deploymentsin fiscal year 2013-14. The arrangementextends the province’s commitment tosupport VCUR 2008 EMR use up to March31, 2019, which allows eligible physiciansaccess to their $35,000 maximum funding.More information including deadlines andtimelines can be found at www.posp.ca.Innovation in the delivery of primary care33. Throughout negotiations, the Primary CareAlliance (Section of General Practice, Sectionof Rural Medicine, and PCN Physician Leads14

Executive) led the AMA’s activities aroundprimary care under the Primary Care ActionPlan within the 2012-13 business plan.Specific activities included:• PCN 2.0: In January 2013 the PCABoard was asked by the minister ofhealth to develop a blueprint andaction plan for the evolution of primarycare networks (PCNs) in Alberta. Adraft charter was developed to look atstructure, governance, funding and thebasket of services being provided withrecommendations for enhancementsfor all areas. In May, the ministerrequested the PCN 2.0 SteeringCommittee present a paper, EvolvingPrimary Care Networks in Alberta. Thepaper provided a brief history of thevision and principles of what enhancedPCNs could look like as well asidentifying ways to achieve that vision.This work will continue, incorporatedunder the Primary Medical Care/PCNsConsultation Agreement under theseven-year AMA Agreement.• The PCA Board has continued toexplore various key concepts containedin the Primary Care Action Plan.These include accreditation of primarycare clinics and facilities and formalattachment of patients.34. The AMA’s plans for primary care thisyear required research into Albertans’perspectives regarding primary care andthe role of physicians. To undertake this,two primary care summits were held withpatients and physicians.35. The first, in Edmonton February 2,was well-attended with 28 patients,40 physicians, physician leaders from AHSStrategic Clinical Networks (SCNs) andother observers. Media also attended partof the day. The morning session includedan interactive discussion on the needsof primary care with the patients andphysicians. The second session in CalgaryJune 1 further explored concepts such asformal attachment and the relationshipbetween physicians and patients. Inaddition to serving as valuable informationfor the AMA board, results of both eventswill be the foundation of further researchincluding public opinion polling.Innovation in the delivery ofspecialist careScan to view the reportsfrom the PC summits, orvisit: www.albertadoctors.org/about/primary-care/pcn-summits36. Work with and support for secondary andtertiary care proceeds in a number of areas:• Strategic clinical networks: Meetingswere held with SCN medical leads todiscuss how the AMA could assist withspecialty care delivery strategies. Furtherdiscussions will lead into implementationof AMA Agreement activities includingthe System-Wide Efficiencies andSavings Consultation Agreement. TheRF will receive an update.15

• Academic medicine and the ProvincialAcademic Alternative RelationshipPlan (PAARP): The AMA has interfacedregularly with the universities throughour Advisory Committee on AcademicMedicine and has hosted the deansand associate deans at a board strategicsession dinner. The development ofthe PAARP has been a focus of facultyactivity for many months. While theAMA has been involved provinciallyin the development of the PAARPframework, we are also looking at waysto support individual physicians moredirectly as they contemplate involvementwith the PAARP. This could includeproviding analysis and advice to academicphysicians on particular elements of thePAARP that may be of specific interest orconcern to individual members. Progresson the PAARP implementation has beenslowed as a result of funding discussionsbetween government and the facultieson the conditional grant funding portionof the academic alternative relationshipplans (AARPs). The AMA’s new mandatearising from the AMA Agreement maypresent new opportunities to assistmembers in these arrangements.Family care clinics37. Staff continue to assist the physicians whoare under contract with the three familycare clinic (FCC) pilot projects in Slave Lake,Northeast Edmonton and East Calgary.Work includes guidance around enhancingthe legal agreements while ensuring thephysicians are well informed on their rightsand responsibilities under their contracts.38. The AMA initiated a process to solicitinterest from physician clinics and PCNsthat may want to pursue joining an FCC.The 40-plus physician groups across theprovince who submitted expressions ofinterest in pursuing an FCC were invitedto the February 2 Primary Care SummitSeries meeting where FCCs were discussed.Depending on direction of Alberta Healthpertaining to FCCs, the intention ifrequested is to appoint AMA resources toserve as consultant to clinics still interestedin moving forward.39. The AMA responded formally to AH’sFamily Care Clinic Application Kit Wave 1.President Dr. R. Michael Giuffre and Sectionof General Practice President Dr. Ann R.Vaidya co-signed a letter that was sent mid-February, noting some positive inclusionsin the document but also highlightingnumerous significant issues with thedocument and approach. The letter to theminister was shared with AMA members.40. In June government announced that 24new FCCs would be established acrossthe province. The AMA began supportingmembers on the myriad of business andpractice decisions associated with thosewho may wish to become involved in theseventures (either as new ventures or evolvingfrom an existing PCN). Plans for FCCs willform another element of discussion underthe Primary Medical Care/Primary CareNetworks Consultation Agreement.41. In tandem with supporting FCCs, theAMA continued discussions with bothAH and AHS on the evolution of primary16

care and primary care networks. Physicianrepresentation was provided to thegovernment as part of their developmentof a primary care strategy. This strategywill guide the further expansion of FCCsand the role of PCNs and their continuedevolution. Concepts such as attachment,accreditation and access improvements arekey to strategy and continued evolutionof primary care. Physicians have played aleadership role within these areas and willcontinue to work with the trilateral partnersin further developing models to implementin the coming year.42. Discussions on a provincial FCC paymentrate for physicians have begun.Preferential Access Inquiry43. This year, the AMA sought and was grantedfull intervener status in the public inquiry intopreferential access to health services. TheAMA attended on behalf of the professionand as a demonstration of support for asystem in which access to care is basedon medical need. The Canadian MedicalAssociation (CMA) agreed to providefinancial support for the AMA’s participation.Hearings were held in December, Januaryand February and continued through April.The AMA filed a formal submission withCommissioner John Vertes.44. For the AMA, the underpinning ofthe inquiry was the ability to provideappropriate and timely access for patients,based on their needs. Canada’s health caresystem and Medicare are predicated on thisphilosophy. There are three components todelivering access based on need. These are:• The patient-physician relationship.• The advocacy role and function.• Clinical autonomy.45. The fundamental question for this inquirywas whether improper preferential accesshas been occurring in a systemic way, i.e., asa result of “threat, influence or favor.” TheAMA submission stated that if the system isrunning with adequate resources, then it isfairly simple to grant access to health servicesbased on the relative needs of patientswho pass through our care. If, however,the system is inadequately resourced, thenwait times grow, some services may becomescarce and bottlenecks build. This climatemay make it more difficult to decide aboutone patient over another and who gets carefirst, even without the hypothetical presenceof threat, influence or favor.46. The AMA submitted that the queue ofconcern for the inquiry should begin atthe point where the patient begins toaccess services through AHS facilitiesand programs, e.g., surgery in a hospital,pathology or imaging in a diagnosticclinic, or other screening clinic such asa colonoscopy clinic. We note that thisphilosophy matches the approach ofCanadian wait list registries, including theAlberta Provincial Waitlist Registry.47. We stated in our submission that anyprocesses the patient passes through to getto such access points within the queue shouldthemselves be outside the scope of the inquiry.We wished to resist needless interventionwith the practice of “professional courtesy”for physician family members and friends.17

Certainly many of these services are publiclyfunded, but we argued that physicians shouldremain free to exercise traditional practices, tosee patients in their private practices at theirdiscretion and, if necessary, provide patientswith access to AHS services.48. The point was made several times during theinquiry (and not only by the AMA) that anysolutions to prevent improper preferentialaccess within the queue should not becounterproductive in terms of slowing timeto service or paralyzing clinical autonomy.Certainly this would be the effect ofregulatory measures to control pre-queuemovement of the patient within the doctorpatientrelationship. That is the great pointthat supports the exclusion of this part of thecontinuum from the purview of the inquiryas the AMA has argued.49. What kind of preferential access is“improper?” The AMA believes that allaccess to publicly funded AHS servicesis fundamentally “preferential,” if onlybecause of the fact that someone has to getto a service in a facility first! For example,processes to access specialist services thatare within the queue vary widely. Familyphysicians may have stronger workingrelationships with some consultants thanothers. In some facilities, streamlinedreferral-consultation processes mightimprove efficiency such that patients passingthrough them enter the queue more quickly.These things have always been and theycannot ever be wholly eliminated.50. In the AMA’s eyes, the concept of harm isthe lynchpin. Physicians regularly extendprofessional courtesy to other physicians byseeing those physicians’ family members orfriends out of office hours without bumpingany patients in the existing schedule.51. We do not believe this is harmful,because these things do not underminethe fundamental integrity of access andmovement within the queue based onmedical need. The Canada Health Act doesnot guarantee “equal” or even “equitable”access to health care services, but insteadrequires physicians to “facilitate reasonableaccess.” Once the patient arrives in thequeue as defined, movement forward isbased on medical need. Any movementwithin the queue based on any otherfactors would be improper.52. The commissioner released his report onAugust 21 with his conclusions and 12recommendations. He concluded thatthere was no evidence of widespreadimproper practices although some instancesof improper preferential access wereuncovered. The commissioner found noevidence that “anyone had been medicallyharmed as a result.”53. With respect to issues raised by theAMA, the commissioner did not find thatprofessional courtesy was in and of itselfimproper when limited to services provided“by one physician to another physician orto other professional colleagues such asnurses.” He expressed concern, however,about any extension of such courtesiesbeyond that level and said the AMA,with the regulatory bodies and publicrepresentatives, should “closely examinethe practice and ethical implications18

of professional courtesy with a viewto defining its scope and applicationand providing guidelines to health careprofessionals.” While we see practicaldifficulties to this recommendation (as doesthe registrar of the College of Physicians &Surgeons of Alberta), the AMA is willing toparticipate in such a process.54. Other key commentary from the inquiry reportsupported the concept that the best way toeliminate improper preferential access is toeliminate the queue itself. The AMA welcomesthe recommendation that AHS “continue itscurrent efforts to improve access to healthcare overall and to reduce associated waittimes. It should also consider implementinga comprehensive wait time measurementsystem.” We are also pleased that thecommissioner recommended expansion ofwhistleblower protection to include physicianswho are not employees of AHS.Zone Medical Staff Associations55. In accordance with prior RF direction, theAMA implemented measures to support astrong and integrated partnership betweenthe AMA and the zone medical staffassociations (ZMSAs). This has includedproviding channels of communication,Scan to learn moreabout ZMSAs, or visitwww.albertadoctors.org/about/leaders/zmsasrepresentation and advocacy back and tothe AMA through Zonal Advisory Forums(ZAFs). Calgary and Edmonton ZMSAs arefully functioning and hosting ZAF meetingstwice yearly. Central ZMSA hosted its firstannual general meeting February 13 and ishosting ZAF meetings twice a year. SouthZMSA elected a new president and isorganizing itself as a society with a first ZAFplanned for October. We continue to assistthe North ZMSA in efforts to organize; theyare at work on constitution and bylaws butno ZAF has yet been scheduled.56. In August, ZMSA presidents became thefirst point of contact from the PhysicianAdvocacy Assistance Line (PAAL). Thisservice was originally hosted by AHS, but atthe urging of the ZMSAs, AHS has agreedto transfer intake for calls coming to PAALto a third-party provider Confidence Line.ZMSA presidents will be alerted by theConfidence Line when a physician in thezone calls for help and the ZMSA presidentwill manage responding to the call.Other issuesPharmacist prescribing and scopes of practice57. AMA members continue to expressconcerns about pharmacist prescribingand increasing scopes of practice by otherhealth professions. Meetings were heldthis fall with the Alberta PharmacistsAssociation (RxA) to discuss issues ofconcern for both sides.58. Subsequently, a meeting was held with theAMA, CPSA, RxA and Alberta College ofPharmacists to discuss working together19

to improve communication and processesaround pharmacist prescribing. The intentwas to use the first meeting to buildconsensus for moving forward, but thatobjective has not yet been reached.59. The Board of Directors discussed how toaddress pharmacist prescribing and scopeof practice issues in general at the 2013board retreat in May. Resolutions relatingto scope of practice were tabled by Albertadelegates and passed at the CanadianMedical Association General Councilmeeting August 19-21 in Calgary.60. The College and Association of RegisteredNurses of Alberta has a proposal to expandthe scope of practice to allow registerednurses with extra training to prescribeSchedule One drugs, limited to theirdemonstrated expertise within a certaingeographic location. This expanded scopewould allow them to diagnose within thatscope of practice.61. We are still awaiting government’s decisionon a major proposal from optometryregarding an expansion to scope of practicefor that profession. The AMA made apresentation in late 2012 to the HealthProfessions Advisory Board to expressserious concerns about the safety andefficacy of the optometry proposals.Physician and Family Support Program andHealth Law Institute62. The AMA and the Physician and FamilySupport Program (PFSP) staff have beeninvolved in lengthy discussions with theCollege of Physicians & Surgeons ofAlberta (CPSA) on how to operationalizerecommendations arising from a June 2012report from the Health Law Institute (HLI).The HLI was retained by the parties to helpexplore and resolve difference of opinionwith respect to standards of practice aroundduty to report impairment. Members mayrecall that CPSA had proposed changing thestandards to require reporting of suspectedvs. demonstrated impairment for oneself ora colleague. While some issues have beenresolved, some outstanding issues remainaround logistics for a proposed review panel.We appreciate the ongoing dialogue.Other negotiations63. Groups of physicians and individuals cameto the AMA again this year seeking supportin various negotiations and contracts. Theassociation supported ongoing and newdiscussions for: cancer care physicians;laboratory physicians, physicians billingWorkers’ Compensation Board (WCB);Alberta Orthopedic Society and others.AMA staff also continue to assist withrequests from individual physicians toreview their individual service contracts.64. New agreements between the AlbertaSociety of Laboratory Physicians and AHS,and cancer care physicians and AHS, werecompleted, ratified and are now in place.AdvocacyHealth issues65. Health Issues Council (HIC) continuesto discuss and advance a variety ofhealth advocacy issues. Additionally, HICimplemented the second year of the Emerging20

67. We have continued to support Studentsfor Cell Phone Free Driving for educationalsessions in high schools.Scan to learn more aboutthe Emerging Leadersgrant program, or visit:www.albertadoctors.org/emerging-leadersLeaders In Health Promotion initiative. Thisprogram provides grants to medical studentsand residents for health advocacy initiatives.The goals are to: promote development ofthe physician’s role as advocate for healthypopulations; provide experience in healthpromotion as integral to medical practice; andfacilitate growth of leadership and advocacyskills in a mentored environment. For 2012‐13,seven projectsreceived funding.66. In a brand newinitiative, the AMApartnered withEver Active Schoolsto pilot an “AMAYouth Run Club” on a small scale this spring.This project is based on one operated verysuccessfully by Doctors Nova Scotia. The pilotwas extremely successful and will lead to moreinvolvement for the AMA in the coming year.Scan to learn moreabout the AMA YouthRun Club, or visit: www.albertadoctors.org/advocating/ama-youthrun-clubRefugee health68. Recent changes to the federal government’sprovision of health care coverage to refugeesin Canada have led to the current situationwhere approximately two-thirds of refugeeshave no health care coverage except whentheir medical condition poses a risk to publichealth or safety (e.g., tuberculosis). The AMAhas written to the federal minister responsibleasking him to reverse the decision. We havealso asked Alberta’s minister of health toextend coverage to these disadvantagedpeople. Information has been provided tophysicians via MD Scope newsletter on billingpractices for those refugee claimants who arecovered by Medavie Blue Cross.69. Media reports say a charter challenge byCanadian Doctors for Refugee Care andthe Canadian Association of RefugeeLawyers will be brought before the FederalCourt. The lawsuit will argue that the cutsto refugee care violate the fundamentalhuman rights of refugees.Indoor tanning70. The AMA is also assisting a coalition,“Indoor Tanning is Out,” which is lobbyingthe provincial government to introducelegislation to ban usage of artificial tanningfacilities to those under 18 years. Threeother provinces have already introducedsimilar legislation. The federal minister ofhealth has also released draft regulations,replacing labeling laws for tanning beds21

to one that reads: Tanning equipment cancause cancer. Not recommended for use bythose under 18 years of age.Day of Service proposal71. In her valedictory address in September2012, Past President Dr. Linda M. Slocombeproposed that the AMA establish a “day ofservice” or some initiative through whichphysicians could collectively give back to thecommunity. The Board of Directors exploredthe suggestion and a number of options.72. The outcome was the establishment of theMany Hands initiative (www.albertadoctors.org/advocating/many-hands). Through ManyHands the AMA compiles and celebratesthe amazing volunteer contributions ofAlberta physicians at home and abroad.Information is also being included for doctorswho would like to volunteer but are seekinggood opportunities. Many Hands has beenwell received by honorees and members alikeand will be expanded further.Canadian Medical Association73. The 2013 General Council (GC) washeld August 18-21 at the Calgary TELUSConvention Centre. The GC was lasthosted in Alberta in 2005. The 2013 AMAdelegation was:• AMA President.• President-Elect.• Immediate Past President.• Speaker or Deputy Speaker.• Nine representatives named by the board.• Nine representatives named by theNominating Committee.• Two physician appointees of thecollege, at least one of whom must bean elected member of the Council.• One dean or designate from his/her office.• One student representative.• One PARA representative.74. On August 21, Dr. Louis H. Francescutti,an Edmonton-based emergency medicinephysician, was installed as the 2013-14President of the CMA. He became Alberta’snominee after an election for which therewere six candidates.75. Dr. Ernst P. Schuster, who served as speakerand deputy speaker of the RepresentativeForum for 14 years, sat on the GCResolutions Committee.76. Two outstanding Alberta physicians werehonored with CMA Special Awards. TheDr. William Marsden Award in Medical Ethicswas presented to Calgary’s Dr. Ian Mitchell(along with Toronto-based physician Dr. DavidMcKnight). Dr. Mitchell was recognized as aleader who enhances ethical and professionalbehavior in physicians and displays excellencein his own ethics research and teachinginitiatives. He is known as a meta-teacherwho serves bioethics and the profession withinsight, innovation and fearlessness.77. Board member Dr. Kathryn Andrusky ofEdmonton was recognized with the CMAAward for Young Leaders in the early careerphysician category. Now a clinical lecturerand preceptor for the Department of FamilyMedicine at the University of Alberta, shehas been politically active in medical issuessince her undergraduate years, and is a pastpresident of the Professional Association ofResident Pnysicians of Alberta.22

78. The AMA also nominated two additionalwinners. The CMA Award for Excellencein Health Promotion went to the Boysand Girls Club of Canada. Canadianhumanitarian Mr. Nigel Fisher receivedthe CMA’s Medal of Honour for personalcontributions to the advancement ofmedical research and education.Member communication79. The AMA launched a new website in May2012, featuring state of the art designand built around extensive research withmembers and staff. While it was ratherearly to measure success at the time of the2012 annual general meeting, a year laterwe can say that utilization statistics speakto a high level of satisfaction.80. The number of people visiting the site hasincreased 66% for the full year period(measuring from launch date in May). Theamount of time visitors spend on the site witheach visit has increased by 47%. That’s anaverage visit of almost four minutes.81. The mobile friendly design appears to behaving an effect: the number of visits byphone or tablet went from 8,000 to 36,000per year.82. The AMA has ventured into the realm ofsocial media, engaging in Twitter (media,opinion leaders, industry observers),Facebook (members and public), Linked Inand YouTube. We will continue to monitorthe effectiveness of these tools, usage ofwhich by website visitors took a massivejump in November 2012 during the periodof the imposition.83. Members received a record 42 President’sLetters in 2012-13. Thousands ofmembers chose to reply and exchangeemail directly with the president abouttheir thoughts and concerns. This directinput was as valued as it was appreciatedby the president.84. Three membership opinion tracker surveyswere conducted this year. The schedulefourth-quarter tracker was cancelledonce the new agreement was reachedto provide an opportunity to review thesurvey’s structure. Most questions haveremained unchanged since 2003. Weexpect to launch a new tracker in the newbusiness year.85. Overall, the surveys continue to showthat members overwhelmingly (96%range) support the AMA’s role as theirrepresentative in negotiations. Membersalso indicate they feel well-informed aboutthe health care system (85% range) andthe association’s activities (88% range).86. Special surveys were also conductedregarding the AMA website and studentsponsorship initiatives. We conductedtwo additional member surveys vis a visnegotiations and potential actions tosupport the profession.87. MD Scope electronic newsletter wasrevamped. Typically, about 45% ofmembers open and read articles in thenewsletter, up from 29% 18 months ago.88. Alberta Doctors’ Digest magazinewas also redesigned and is now beingproduced in full color. Increased printing23

costs are being offset by the availabilityof additional full color advertising space.Podcast versions of Digest feature articlesare available on the AMA website.Flood supportFollowing the devastating fires in Slave Laketwo years ago, a disaster recovery plan wasestablished for affected physicians there. Weworked with Alberta Health (AH) and AlbertaHealth Services (AHS) for some interim incomesupport during practice disruption. The AMAalso waived its annual membership dues.We have taken similar steps for membersmost affected by the flooding this summer.Specifically, we are using the boundaries of theprovincial state of emergency zone establishedby the government around the High Rivercommunity. Physicians in that disaster zone:• Will be guaranteed 80% of their grossbillings (based on fees billed last year), forthe first 120 days after the flood and thismay be extended further. I thank PremierRedford and Minister Horne for their fastresponse to this obvious need.• AMA membership dues for 2013-14 will bewaived for these members.In the first few days of the flood, the AMAalso helped to connect physicians who wereout of home with temporary accommodations.Over 100 physicians offered up their homes inthe first 48 hours – a heartwarming display ofcollegiality that was so very much appreciated.TD Insurance Meloche Monnex89. Our AMA membership has a high enrolmentrate for TD Insurance Meloche Monnex(TDIMM) products. In fact, 5,800 memberscarry TDIMM products, which representsover half of our entire membership. TDIMMis endorsed by the AMA. This arrangement isscheduled for a review because we are at themid-point in our 10-year exclusive contract.This planned review is underway and wasdiscussed at the board. We have establishedan advisory group to conduct our portionof the review. Member feedback will besought, and all recent experiences – positiveand negative – will be shared and discussedin detail, including with respect to the floodrecovery from the recent flooding in southernAlberta. We have heard directly from over80 AMA members specifically on this issue.The AMA will be thorough in our deliberationsand you will be further informed.Leadership and AHS90. The AMA is working with the CPSAand AHS to explore development ofleadership and advocacy training forAlberta physicians. The steering committeealso includes a ZMSA representative,Dr. Fredrykka Rinaldi. We have hireda consultant to define the advocacyprocess and produce navigational tools forphysicians who are advocating for theirpatients. In addition, the consultant willhold focus groups with physicians in eachof the zones to ascertain what leadershipskills physicians would like to see in sucha program and how they wish to havethe instruction delivered. The consultant’sreport is due for presentation in October.91. In further leadership development activities,the AMA is also assisting the CMA onits leadership development program.The CMA has contracted the services of24

Rothman College from the University ofToronto to explore options for a national,CMA‐sponsored leadership developmentprogram for physicians. They are holdingfocus groups in various regions of thecountry to determine the needs of physiciansin each region. The AMA participated inthe focus group held recently in Vancouver.As a result of those efforts, the CMA willbe launching their first national leadershipdevelopment course in 2014. The AMA willbe sending five participants to that course,which will be held annually.Board of Directors and ExecutiveCommittee92. Members of the 2012-13 Board of Directors:2012-13 Board members:• Dr. R. Michael Giuffre – President• Dr. Allan S. Garbutt – President-Elect• Dr. Linda M. Slocombe – ImmediatePast President• Dr. Pauline Alakija• Dr. Kathryn L. Andrusky• Dr. Sarah L. Bates• Dr. Paul E. Boucher• Dr. Padraic E. Carr• Dr. Alison M. Clarke• Dr. Neil D.J. Cooper• Dr. E. Sandra Corbett• Dr. Christine P. Molnar• Dr. Paul Parks• PARA observer: Dr. Joanna S. Lazier (July1, 2012 – June 30, 2013); Dr. Sylvia G.McCulloch (July 1, 2013 – June 30, 2014)• MSA observer: Braden Teitge (May 31,2012 – June 30, 2013); Stefan B. Link(July 1, 2013 – June 30, 2014)93. In 2012-13, the Board of Directors met:• September 22 (post-RF meeting)• October 9 (teleconference)• October 16 (teleconference)• October 26• November 19 (teleconference)• November 29 (teleconference)• December 13-14• February 8• March 7 (teleconference)• March 19 (teleconference)• March 22 (teleconference)• March 25 (teleconference)• March 30 (special board meeting)• April 5 (teleconference)• April 9 (teleconference)• April11-12• April 24 (special board meeting)• May 4 (post-special RF board meeting)• May 23-25 (meeting and retreat)• July 18-19• September 2594. Members of the Executive Committee:• Dr. R. Michael Giuffre – President• Dr. Allan S. Garbutt – President-Elect• Dr. Linda M. Slocombe – ImmediatePast President• Dr. Sarah L. Bates• Dr. Padraic E. Carr95. The Executive Committee met:• October 5• November 16• January 18• March 22• May 3• June 28• September 325

Proposed Non-substantive Amendmentsto the Constitution and Bylaws of the Alberta Medical AssociationProposed wording15.15 Add clarification with regards to votingrights of the Speaker and DeputySpeaker:NON-SUBSTANTIVE CHANGES15.15 The Speaker and the Deputy Speakershall not have the right to vote atmeetings of the Forum and shall not beincluded in the determination of whetherquorum exists for a meeting of theForum.17.3 Amend reference to Section 46.4. Shouldread 45.4, due to the deletion of a sectionlast year, which altered the numberingsequence. To read:17.3 Directors shall be elected by and fromamong the Members of the Forum tohold office for a term of three years, withannual elections for approximately onethirdof the Directors provided, however,subject to the provisions of Section 45.4that no Director serve more than twoconsecutive three-year terms.Present wordingNot applicable; addition to provide clarification17.3 Directors shall be elected by and fromamong the Members of the Forum tohold office for a term of three years, withannual elections for approximately onethirdof the Directors provided, however,subject to the provisions of Section 46.4that no Director serve more than twoconsecutive three-year terms.www.albertadoctors.org/about/governance27

Nominating CommitteeIn accordance with the Alberta MedicalAssociation Constitution and Bylaws, theNominating Committee nominates candidatesfor office to be elected by the annual generalmeeting, to be elected by the RepresentativeForum, and to be appointed by the Board ofDirectors of the association.The Nominating Committee submits thefollowing nominations for consideration duringthe annual general meeting:1. Representatives to CMA GeneralCouncil 2014NOTE: The president attends GeneralCouncil by virtue of the position and isnot included in the number of Albertarepresentatives (27). The NominatingCommittee recommends that the 2014CMA General Council representatives be:• President-Elect.• Immediate Past President.• Speaker or Deputy Speaker.• Nine representatives named by theboard.• Nine representatives named by theNominating Committee.• Two physician appointees of the CPSA,at least one of whom must be anelected member of the Council.• One dean or designate from his office.• One student representative.• One PARA representative.• Alberta representative on CMAResolutions Committee.2. Speaker and Deputy Speaker 2013-14a. Speaker: Dr. Carl W. Nohr, GeneralSurgery, Medicine Hatb. Deputy Speaker: Dr. Darryl D. LaBuick,General Practice, St. AlbertIn accordance with custom, brief profiles forthese candidates follow on page 29.3. Nominating Committee 2013-14The bylaws require that the annual generalmeeting elect four (4) members to theNominating Committee. The currentelected incumbents are:• Dr. Kathryn L. Andrusky, GeneralPractice, Edmonton.• Dr. Daniel J. Barer, EmergencyMedicine, Edmonton.• Dr. Peter C. Jamieson, GeneralPractice, Calgary.• Dr. Gerry D. Prince, General Practice,Medicine Hat.The Nominating Committee is scheduledto meet Friday, November 1. Anyone whois a member of the Nominating Committeecannot be the committee’s nominee for theBoard of Directors. This does not, however,preclude a member of the NominatingCommittee from being nominated fromthe floor.28www.albertadoctors.org/about/leaders/committees

Curriculum VitaeDr. Carl W. Nohr2012-presentRF SpeakerVice-President, South Zone Medical Staff Association2010-presentCPSA Councilor2009-presentMember, Provincial Physician Liaison ForumRF Planning Group (currently Chair)2009-12 Member, Council of Zonal Leaders2009-10 AMA Co-chair, AHS Medical Staff Bylaws Committee2008-10 Member, Nominating Committee, PFSP Advisory Committee2007-12 RF delegate2009, 2010, 2011, 2013 AMA representative to CMA General CouncilDr. Darryl D. LaBuick2012-presentRF Deputy SpeakerMember, RF Planning Group2011-presentChair, Council of Zonal Leaders2010-presentMember, Negotiating Committee2010-11 Member, General Practice Representation Working Group2001-11 RF delegate2008-11 CMA Board member2002-09 AMA Board member2008-09 Chair, Trilateral Agreement Committee – Co-ChairsChair, Nominating Committee2007-09 Member, Joint AMA/CPSA Executive2005-09 Member, Executive Committee2007-08 PresidentMember, Committee on Constitution and Bylaws, Nominating Committee, RF Planning Group2006-08 Member, Trilateral Agreement Committee – Co-ChairsChair, Pharmacists and Primary Care Networks Advisory Committee2006-07 President-ElectMember, Committee on Constitution and Bylaws, Government Affairs Committee, RF Planning Group2004-06 Member, RxA/AMA Working Group2003, 2005, 2006, 2007, 2008 AMA representative to CMA General Council29

Financial StatementsResponsibility for thefinancial statementsThe management of the Alberta MedicalAssociation (the Association) is responsiblefor the integrity and fair presentation of thefinancial statements.The Association has developed prudentfinancial controls that give managementreasonable assurance that the assets aresafeguarded and reliable financial records aremaintained. These controls, which are reviewedby the Committee on Financial Audit, includewritten policies and procedures, technologycontrols and an organizational structure thatsegregates duties.The Association’s independent auditors,PricewaterhouseCoopers LLP, CharteredAccountants, have been appointed to expressan opinion as to whether these financialstatements present fairly the Association’sfinancial position and operating results inaccordance with Canadian generally acceptedaccounting principles. Their report follows.The Board of Directors has reviewed andapproved these financial statements. To assistthe board in meeting its responsibility, it hasestablished the Committee on Financial Audit.The committee meets with management andthe independent auditor to review accountingprinciples and practices, financial controls andaudit results.Michael A. GormleyExecutive DirectorCameron N. PlittChief Financial OfficerAuditors’ report on summarizedfinancial statementsTo the Members of Alberta Medical Association(CMA Alberta Division)The accompanying summary financialstatements, which comprise the summarystatement of financial position as at September30, 2012, the summary statements ofoperations, summary statement of netassets for the year then ended, and relatednotes, are derived from the audited financialstatements of Alberta Medical Associationfor the year ended September 30, 2012. Weexpressed an unmodified audit opinion onthose financial statements in our report datedFebruary 8, 2013. Those financial statements,and the summary financial statements, donot reflect the effects of events that occurredsubsequent to the date of our report on thosefinancial statements.The summary financial statements do notcontain all the disclosures required by Canadiangenerally accepted accounting principles.Reading the summary financial statements,therefore, is not a substitute for readingthe audited financial statements of AlbertaMedical Association.Management’s responsibility for the summaryfinancial statementsManagement is responsible for the preparationof a summary of the audited financialstatements in accordance with CanadianAuditing Standard 810, “Engagements toReport on Summary Financial Statements.”30

Auditor’s responsibilityOur responsibility is to express an opinionon the summary financial statements basedon our procedures, which were conducted inaccordance with the criteria referred to above.OpinionIn our opinion, the summary financialstatements derived from the audited financialstatements of Alberta Medical Association forthe year ended September 30, 2012, are afair summary of those financial statements, inaccordance with Canadian Auditing Standard810, “Engagements to Report on SummaryFinancial Statements.”PricewaterhouseCoopers LLPChartered AccountantsEdmonton, CanadaNotes to SummarizedFinancial StatementsSeptember 30, 20121. Basis of presentationThis report represents selected financialinformation extracted from statements, auditedby PricewaterhouseCoopers LLP, CharteredAccountants. Complete financial statements areavailable upon request.2. Administered ProgramsIn addition to its principal activities, the AlbertaMedical Association (the AMA or Association)administers certain programs by agreementbetween the AMA, her Majesty the Queenin Right of Alberta, and the Regional HealthAuthorities (now operating as Alberta HealthServices) (the Parties). These programs aregoverned by the Master Committee ofthe Parties, with separate audited financialstatements being provided to the Partiesannually. As the AMA is the administratorof the programs, the assets, liabilities,revenues, and expenses of these programsare not included in these statements. Theadministration fees received by the AMA toadminister these programs have been includedand are segregated for greater clarity.A summary of the total net assets of theprograms administered by the Association forthe Parties as at and for the year ended March31, 2012, which is the most recent fiscal year ofthe programs, is as follows:Opening restricted programnet assets$21,437,598Revenue 165,351,861Expenses (166,488,853)Reserve adjustment (400,887)Closing restricted programnet assets19,899,7193. Reconciliation of carrier experienceIt is the intention of the Association thatinsurance products operate on a break-evenbasis over the long term. Over the short term,the Association participates in experiencesurpluses and losses out of reserves, calculatedas of December 31 of each fiscal year.An experience gain of $2.5 million (2011 - $4.5million) was recognized during the year.31

Condensed Statement of Financial PositionAs at September 30, 20122012 2011$ $AssetsCurrent assetsCash 17,664,154 11,726,732Accounts receivable and prepaid expenses 562,306 657,796Due from administered programs 2,867,266 2,618,269Due from AMA Health Benefits Trust Fund 45,547 50,50621,139,273 15,053,303Portfolio investments 17,371,325 16,337,019Property, plant and equipment 2,094,510 2,330,04340,605,108 33,720,365LiabilitiesCurrent liabilitiesAccounts payable and accrued liabilities 3,839,701 3,872,203Payable to Canadian Medical Association 1,225,472 793,616Due to Alberta Medical Foundation 2,871 525Deferred membership revenue 4,270,390 2,745,864Deferred membership revenue - levy 3,508,734 773,000Deferred revenue and program grants 76,024 81,50312,923,192 8,266,711Net Assets 27,681,916 25,453,65440,605,108 33,720,36532

Condensed Statement of Operations and Net AssetsFor the year ended September 30, 20122012 2011$ $RevenueMembers dues 12,545,966 12,126,553Fees and commissions 1,537,097 1,441,889Other 856,451 748,349Investment income 609,523 1,068,05815,549,037 15,384,849ExpendituresCorporate affairs 5,651,379 5,833,209Executive office 3,201,093 2,907,494Health policy and economics 2,673,122 2,020,045Committees 1,816,140 2,056,855Public affairs 1,767,244 1,742,480Professional affairs 960,169 884,123Southern Alberta Office 490,561 251,98916,559,708 15,696,195Realization of insurance experience (note 3) 2,549,072 4,469,790Net revenue for the year 1,538,401 4,158,444Net assets – Beginning of year 25,453,654 21,825,865Unrealized gain (loss) for the year on available for sale565,051 (152,727)financial assetsRealized loss (gain) impairment loss transferred to investment 124,810 (377,928)incomeNet assets – End of year 27,681,916 25,453,65433