Over the past few months, the AMA has been speaking with Albertans about the COVID-19 care deficit and what it means to them and their health. Many of those Albertans have indicated they have experienced delays in diagnosis and treatment, as well as concerning gaps in chronic disease management – situations that impact health now and may lead to poorer outcomes.

Throughout the pandemic, news reports have detailed instances of patients and their families struggling to access the care they need and the physical and emotional impact of those challenges. In recent months, those stories have grown more dire, with many patients discussing the serious consequences of those delays. Some Albertans have shared their experiences and how it has affected them through albertapatients.ca. The AMA has also shared how physicians are feeling in terms of dealing with the care deficit in our patient populations.

A study released late last year by the Canadian Medical Association (CMA) noted that “the COVID-19 pandemic has had an impact on the health of Canadians that is broader than the effects of contracting the virus itself.” This care deficit has been documented across Canada and around the world, and has been particularly difficult for marginalized populations, including the elderly. Now, more than two years into the pandemic, the care deficit has become increasingly urgent. It is vital that physicians determine how to get patients the care they need now, while preparing the health care system to deal with a backlog of care that threatens to overwhelm and deplete our already limited health resources. 

The care deficit: Dr. Vesta Michelle Warren, President, Alberta Medical Association

The importance of primary care

The AMA has been working closely with front-line physicians to understand the challenges and explore both work-arounds and solutions that will lead us out of the care deficit. Any movement forward will require working together to develop innovative solutions amid growing health human resource shortages, including physician supply challenges in primary care and specialties such as anesthesia. Access to family physicians is particularly crucial, as without comprehensive primary care the pressures on other parts of the system, including acute care, are intensified. Physicians know that without primary care, there is no system at all. In late December, AMA president Dr. Michelle Warren published an op-ed submission with Post Media, co-signed by the Sections of Family Medicine and Rural Medicine with the Specialty Care Alliance,  on the importance of community care in relation to Omicron. In the article she outlined the support needed to ensure sustainable and safe practices for community physicians.

The Joint Physician Advocacy Committee and Care Deficit Assessment Series 

Physicians in Alberta are uniquely positioned to lead the way with expertise and advocacy. The input members provided in the AMA’s August 2021 survey about how the care deficit is evident in practices across the province helped identify a range of issues that must be acknowledged and addressed. The Joint Physician Advocacy Committee (JPAC) has been helping prioritize those advocacy issues.

Formerly the Joint Task Force, the JPAC has been working in an expanded role since the fall, bringing specialists and primary care together to support and advise on AMA advocacy activities. Last month the JPAC launched the Care Deficit Assessment Series (CDAS) on patient care issues across the profession. Each issue in the series will explore the breadth and depth of the care deficit’s impact on Albertans and discuss possible solutions. So far, JPAC has created two issues papers – one on Pediatric Mental Health and one on Women’s Health, with several more planned over the coming months. Along with an executive summary, a detailed document and talking points, the AMA will also be amplifying the messaging from each issue paper on social media and other communication channels. This will help Albertans better understand what the care deficit means to our health care system and how physicians are working to protect patients. 

It is also important for patients to know that while physicians are here for them, they are working under incredible strain and pressure. The growing concerns regarding physician burnout cannot be overstated. In early April, the CMA released a survey that noted 53% of Canadian physicians are experiencing burnout and that 46% are considering cutting back their clinical workloads. This survey echoes what the AMA has heard from front-line Alberta physicians, who have been candid in discussing their exhaustion and despair. It is clear that the current situation is not only untenable but worsening. 

Although there are no simple solutions to these complex issues, it is important to ask questions and listen to what we are told about the care deficit and the unrelenting pressure on Alberta’s physicians. The Care Deficit Assessment Series is an important part of that process, as it will capture the challenges and realities facing patients and the health care system, as well as the suggestions from front-line physicians on strategies and processes that could help. 

Finding a way forward will not be easy. It will require a concentrated, collaborative effort from physicians, partners, stakeholders and the public to create innovative approaches and solutions. It will necessitate inviting input, advice and suggestions from members who perhaps have not shared their perspectives until now.

If you have ideas, observations or an interest in advocacy, please consider adding your voice to your colleagues who are working to help move us forward.

Banner image credit: Mulyadi on Unsplash