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At issue for him and many other physicians is that the province has decided to stop paying the overhead stipend for each fee for service paid to a physician performing a task in a hospital, rather than in their own private practices. While on the surface that appears logical, it in fact penalizes doctors who have both a private clinic and work in a hospital, like so many physicians do, not just in rural Alberta, but in cities, too.

Hackett says he pays approximately $150,000 overhead per year for his one-sixth portion of the medical clinic he works in. Those fixed costs don’t stop when he works in the emergency room, where the complexity of patient needs and risks are much higher. The fees he is paid for work in the emergency room have decreased by about 20 per cent because of the recent changes that came into effect on March 31.

In fact, Hackett worked from 8 p.m. to 8 a.m. on March 31 into April 1. At 12:01 a.m. on April Fool’s Day, the amount he could bill for each patient he saw went from $38.03 to $31.

Boeré wrote: “These changes are going to make it impossible to continue to run our clinic, a small business, as it will no longer be solvent. The choice then before me is grim. Do I give up my hospital work? Do I give up my clinic work? Do I relocate?”

She says she would choose to relocate “because I love what I do and if it is no longer possible to do that here then I will go elsewhere. I’m very saddened by this reality,” she said, adding that “full scope care” includes 60- to-80-hour work weeks “spent managing in-patients at the hospital, comprehensive care in the clinic, building my practice, seeing residents in long-term care, 24-hour call shifts in my emergency department, and sometimes I am lucky enough to bring a new life into this world or assist someone to leave it in comfort and with dignity. This is what I do. I love what I do.”