These are only a few of the elements in our environment that the AMA is trying to address. We are guided by our vision statement of a high-performing health care system. Physicians are willing to be responsible fiscal partners, but it’s clear that we won’t succeed by focusing on cost as the first priority.
Instead, we should think about something more important: value. Value from the health care system matters because it’s something that patients – and taxpayers – deserve. It’s also something that organized medicine can also recognize and appreciate.
When both patients and the medical profession value and aspire to the same things, we can make good things happen. When organized medicine can work effectively with their governments – and the AMA has done so for decades – we can find province-wide solutions that provide what Albertans need by harnessing the leadership and stewardship of physicians.
Value for patients, value for the system, value for physicians, value for governments ... all come together under one concept: sustainability. And when you hear the AMA talking about contributing to a sustainable system, you can know that it’s one that is fiscally prudent but also provides quality care for patients, delivered by a healthy medical profession.
We are very fortunate in Alberta to have a strong foundation for bringing these ideas to reality. For example, we have primary care networks caring for about 80% of Albertans with team-based care and under the model of the medical home. There are 42 PCNs, which would normally make decision making rather difficult. We have, though, established a PCN governance framework so all those PCNs caring for their local patients have a way to make provincial decisions together and provide input to government.
We have what I believe is the highest percentage of physicians in Canada using electronic medical records.
Through the AMA, we have the largest program in Canada to support physicians in transforming their practices to create a medical home for every Albertan. Very recently we have begun looking at how to turn that medical home outward and connect it with a medical neighborhood. These program supports will be able to guide the profession through changing practices toward the goal of a fully integrated system including primary and acute care.
All these innovations have come from agreements between the AMA and the provincial government, and we look forward to continuing partnerships to pull greater value from the system.
The early benefits have been encouraging! Research in Alberta and other places have shown, for example, that patients with a medical home have:
- Fewer ER visits and hospitalizations
- Improved access
- Improved results in preventative care
- Improved overall quality
- Improved patient satisfaction
That sounds like a good beginning to me! And here are some of the things that we are working on with our partners for the next phase toward the medical neighborhood:
- Sharing information from community electronic medical records so that information can follow the patient.
- Ensuring that every Albertan has a family physician to call their own.
- Taking advantage of technology for electronic visits and virtual care.
- New payment models in primary, acute and academic settings that compensate physicians in ways that make sense for the patient populations that they serve.
Let me conclude by returning to something that I mentioned earlier today – and that is the power of stewardship and leadership.
Stewardship is a professional responsibility and core competency of physicians. Beyond that, it is also embedded in the social contract between society and physicians. Society provides our profession with benefits such as autonomy, trust and self-regulation. In turn, we provide compassion, availability, accountability and altruistic service.
Continuing our contract with our patients and society will cause physicians to step up in new ways and make decisions that are based on maximizing value in the system. We will learn to make more decisions together. We will be leaders in seeking to keep expenditures at a sustainable level. We will think of payment not as the goal, but as a means to the ends and a high-value system. We may have to look hard at ourselves: how we practice, where we practice, and with whom.
A past AMA president said it this way a few years ago:
“Every time you see a patient, think of it is an opportunity to reshape the health care system. We can do this by positively shifting the social contract equation to improve the relationship – not only with that patient, but also with society in general. Ultimately, this will create both provider happiness and system success. Management changes cannot do this. We can do it only through the individual choices each of us makes, every time we interact with a patient.”
I can’t think of any better challenge to leave with you. Thank you for listening, and if you have questions or comments, I would be glad to hear them.
Banner photo credit: Zach Polis