The province's restructuring of doctor pay and other changes to the health-care system have now officially gone ahead, despite pleas from many doctors for the new framework to be postponed until after the COVID-19 pandemic.

Alberta ended its long-standing master agreement with physicians in February, and out of the 11 changes proposed by the government, nine went ahead on Wednesday. The province suspended changes to how family doctors are paid for in-person visits and delayed implementation of changes to stipends.

But the new funding framework will change how doctors — especially those in rural areas — are paid for their work.

Doctors angry, demoralized

Calgary and Area Medical Staff Society president Scott Beach said he's taken a 30 to 40 per cent hit to his pay.

Compounded with the hit to morale, he said the changes could see some clinics close up and doctors leave the province.

"Front-line providers, at this point, didn't require this radical shift in the approach of the bureaucracy while working tirelessly to provide the care they are [providing]," he said.

Family doctor Brendan Vaughan said the concerns front of mind for him are how patient care will be affected.

He pointed to the new rule that does not allow doctors to bill for visits if someone doesn't have an Alberta health-care card, which likely won't affect his office significantly but could be a big change for clinics that support vulnerable populations.

"I've never seen physicians more angry, more demoralized, more feeling betrayed by their government," he said.

"It has certainly turned Alberta into the least desirable province to practice family medicine in Canada."

More than 800 doctors sent an open letter to the government on Monday that asked it to delay the changes so that physicians can focus on the COVID-19 crisis, and the Alberta Medical Association has said it's preparing legal action.

The health minister's office pointed to a recent statement from Tyler Shandro, in which he said the government will provide whatever resources are needed to protect Albertans during the pandemic and that the government expects spending on physician services and health care overall to increase significantly this year and that he continues to work with doctors.

Total physician compensation remains flat at $5.4 billion in the government's 2020-21 budget.