We are the AMA - Alberta Medical Association

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