Dr. Patrick J. (P.J.

) White

March 17, 2011

Dear Member:

 In this letter:
 Promoting a culture of openness and engagement
 AMA supports a public inquiry
 Expectations for the agreement in principle

The medical profession is being drawn into the maelstrom of Alberta politics as health care
dominates Question Period and media reportage.

The focus continues relentlessly on the issue of advocacy and the time-honored responsibility of
the medical profession to speak out for quality patient care. The Alberta Medical Association
(AMA) has a well-documented history in supporting this kind of advocacy, in fact we have
directly supported physicians involved in a number of the high-profile cases that have been
featured in media coverage.

Based on the public discourse – and related discussion at last weekend’s meeting of the 125-
delegate Representative Forum – there are concerns that, when speaking out, physicians may
not feel they will be heard or may fear negative consequences. Personally, I have no doubt that
the first instinct of physicians is always to stand up for patients, but the fact that these
perceptions are out there at all is a source for concern, while the assertions related to
intimidation are disturbing.

So, what do we do about it? How do we move forward? How do we move to a system that not
only permits criticism, but also openly encourages all providers to share their issues and
concerns in an effort to improve patient care?

One proposal being put forward is that government should call a full public inquiry regarding
the issue of intimidation. While I am not an expert in the various approaches that may be taken,
an open and full review is needed to clear the air and move forward. The AMA will support
and cooperate with such an approach if this occurs.

I hope that the climate of trust can be improved and I think there are things that can contribute
to improvement. The AMA, Alberta Health Services (AHS) and the College of Physicians &
The President’s Letter
March 17, 2011
Page 2

Surgeons of Alberta agreed in 2010 on a joint statement regarding a physician’s right and
obligation to speak out. This is now reflected in the AHS Code of Conduct and in the recently
approved Provincial Medical Staff Bylaws. Yesterday’s statement in an open letter from the
medical leaders at AHS points to an increased awareness of these issues and their fundamental
importance to physicians.

Our negotiations with government and AHS provide yet another opportunity.

In my March 14 President’s Letter, I described an agreement in principle (AIP) that may be the
foundation for negotiations of a new, three-year master agreement. We have until June 30 (or
later if the parties so decide) to turn a list of principles and elements into a new master plan that
answers the question: How can we make the system better for patients?

With this AIP, physicians have been asked to make a significant contribution in the form of a
budget frozen for 2011-12 and 2012-13 and with a cost-of-living increase in 2013-14.
Government would also maintain all programs and put in the funds required for all new
services. Finally, several strategic directions to improve access will be developed.

In accordance with advice of the Representative Forum and direction of the Board of Directors,
we are willing to explore this through negotiations for the next 90 days and will be looking for
the following:

1. Concrete and immediate plans to achieve the goals, targets and strategies that
government has set for itself with its five-year plan and recent announcements. These
should determine what can and will be done to improve patient care and how all levels
of care will be supported in this.

2. A comprehensive physician engagement strategy, especially in regard to dealing with

issues of quality and access improvement. This engagement must occur at the level of
individual physicians and organized medicine through the AMA.

No health care system can achieve excellence without putting Patients First® and then fully
supporting the providers who deliver care.

I know there are many challenges ahead. It’s my hope that we can make this work. Let’s refocus
ourselves on looking ahead to a system that we can truly say is better than the one we have had,
because patients are getting what they need.

I will continue to update you in the weeks ahead. As always, your emails are instructive and
valued. I would appreciate your comments on recent events and your impressions.

My email address is president@albertadoctors.org.

Yours truly,

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

President