Dr. Patrick J. (P.J.

) White

April 15, 2011

Dear Member:

In this letter:
 Time to clear the air
 AMA supports HQCA review into quality care

Albertans deserve a health care system that values and encourages physician advocacy, where
physicians feel secure speaking out and advocating for the best possible care for each and every
patient; a system free of intimidation and fear of retribution.

To move forward in creating such a system, a public inquiry should be held “into issues of
physician intimidation in Alberta’s health care system,” the Alberta Medical Association’s
(AMA’s) Board of Directors agreed at its meeting yesterday.

The decision reflects concerns within the medical profession that it is time to clear the air, and a
public inquiry – with the authority to compel evidence – is the best forum in which to
accomplish this.

The AMA has previously voiced its willingness to cooperate with a review into “quality of care
and safety of patients requiring emergency room care and cancer surgery” that is currently
underway by the Health Quality Council of Alberta (HQCA). The board acknowledged
HQCA’s expertise in dealing with issues of quality care.

But HQCA’s processes – so well suited for much of its work – are problematic in dealing with
issues related to intimidation of physicians; specifically, the non-public nature of HQCA’s
activities and its inability to compel evidence could inhibit its effectiveness.

This then raises questions as to whether a report on the “role and process of physician advocacy
in patient and health service quality” would have credibility with the medical profession; and
even this doubt is a problem.

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The President’s Letter
April 15, 2011
Page 2

Government established the review following problems raised by the AMA’s Section of
Emergency Medicine and in the Legislature by MLA Dr. Raj Sherman (Edmonton-
Meadowlark), who was kicked out of the PC caucus.

As reported in the April 4 President’s Letter, the AMA has explored its options in depth,
including a review by legal counsel. An analysis compared elements of a public inquiry with
those of the HQCA review.

The AMA’s expectations for the review are outlined in the March 28 President’s Letter, which
included a joint bulletin from the AMA and the Canadian Medical Protective Association.

The board’s decision reflects input from many AMA members that a public inquiry offers the
best opportunity to change the culture within Alberta’s health care system and to address
physician disengagement from AHS.

This input includes calls for a public inquiry from seven sections: Addiction Medicine,
Anesthesia, Dermatology and Dermatologic Surgery, Emergency Medicine, Internal Medicine,
Pediatrics and Rural Medicine.

If, however, the HQCA review remains the only formal venue where physician intimidation is
examined then the AMA will cooperate. We have offered suggestions to improve the
effectiveness of the review, e.g., remove barriers posed by non-disclosure clauses; release
physicians from any contractual obligations or provisions under agreements that could silence
or deter them from participating.

Our preference, though, is a public inquiry into issues of physician intimidation, augmented by
the HQCA review into quality care and patient safety issues. Together, the inquiry and the
review would help Alberta’s health care system to look ahead, move forward and put
Patients First®.

Yours truly,

Patrick J. (P.J.) White, MB, BCh, MRCPsych

President