A group of rural doctors says 44 Alberta communities will be directly affected by recent government changes to the way physicians can bill for services.

The Rural Sustainability Group was created to draw attention to what it calls an impending health-care crisis in Alberta's rural communities.

It says it has surveyed more than 300 physicians across the province.

"The responses we have received are quite alarming," said Dr. Samantha Myhr, who practises in Pincher Creek.

"Forty-four communities will be impacted by July from our initial data — that's physicians who have been forced to make changes or look ahead to make changes after the pandemic in order to protect their ability to see patients or look after their patients at all."

The total includes three communities — Sundre, Stettler and Lac La Biche — that have already been informed some of their doctors will be withdrawing emergency and obstetric services in hospitals.

Alberta Health has said in recent weeks that the province would work with the health region to replace any doctors who leave, but the ministry's response changed Monday.

"We're preparing to announce changes to support rural physicians very soon," Steve Buick, press secretary for Health Minister Tyler Shandro, said in an emailed statement.

"Rural communities face long-standing challenges in recruiting and retaining physicians."

The survey showed doctors in 41 additional rural communities would be informing their patients in the coming week that they will be making changes to some services by the end of July.

"Most clinics are letting their patients know through clinic websites or through local paper interviews," said Dr. Ed Aasman, who practises in Rocky Mountain House. "We've got a local Facebook page where we'll be putting those changes on."

Aasman, who's also president of the Alberta Medical Association's rural medicine section, said most doctors have decided they will give up their hospital work.

As an example, Myhr said her clinic is located down the hall from the hospital.

"As of March 31st, doing the same work in the clinic ... and in the hospital, it's now valued less on the hospital side," she said. "Whenever I am in the hospital, I am still paying overhead in my clinic and I am also not available to my clinic patients.

"That, I think, is the crux for most rural physicians that are trying to do everything."

The provincial government walked away from bargaining with doctors in February and pushed through a number of changes three weeks ago to how they can bill for services.

That has led to a lawsuit by the Alberta Medical Association, which argues doctors' charter rights were violated by not having access to third-party arbitration.

Doctors have said for weeks that the billing changes would force hundreds of clinics across the province, particularly in rural areas, to reduce staff or close their doors.

On April 10, a Bragg Creek doctor informed patients she would be closing her practice in July due to the billing changes introduced by the government.

"I am very worried about the future of health-care in this province," Dr. Annelies Noordman wrote in a letter, adding that she has been unable to find a doctor to take over her practice.

Dr. Vicci Fourie, who works in Westlock, said the decision by many rural doctors to give up their hospital privileges isn't something physicians take lightly.

"This is not something that just happened and we decided overnight to do this," he said. "We had lots of conversations with our rural MLAs. We had conversations with our mayors."

Fourie said he had a 2-1/2-hour conversation with his United Conservative MLA, but got the sense he would just walk the party line.

The rural doctors group said it would like the government to reverse the changes — at least until the COVID-19 pandemic is over.

It said it would also like to see the province return to the bargaining table with the Alberta Medical Association to consider the "unique needs" of rural physicians.