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More than a hundred emergency room doctors have penned a letter to Alberta Health Minister Tyler Shandro, urging the province to press pause and reconsider proposed changes to healthcare.

Over the weekend, more than 120 E.R. physicians in the Calgary region alone signed the letter.

“I think it’s unprecedented to have this many doctors come together so quickly to speak with a unified voice about a single issue,” pediatric emergency room physician Dr. Edward Les said on Sunday.

Les, one of the doctors who helped draft the letter to the health minister, said Alberta physicians are deeply worried the proposed changes will have significant negative short and long-term effects on patients.

Last month, Shandro announced the province was ripping up its master agreement with Alberta doctors, and bringing in new rules.

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Starting April 1, physician compensation will remain at its current level of $5.4 billion a year. But the changes are expected to prevent $2 billion in added costs tied to physician services over this current fiscal year and the three after that.

There won’t be any changes to the current rates doctors charge for individual procedures and benefits such as parental leave will remain in place.

The key change, which has also been the focus of a fiery dispute between doctors and the government, will be to a billing designation known as “complex modifiers.”

Under Alberta’s current fee-for-service model, doctors can bill $41 as a base fee for each patient visit no matter how short or how long.

A decade ago, the Alberta government added in an extra fee — called a complex modifier — to recognize that some patients have multiple or complex issues and doctors should be compensated for overly long visits.

If a visit went more than 15 minutes, doctors were able to extend it 10 minutes and bill the province a complex modifier fee of $18, for a total of $59.

As of April 1, the fee will be halved from $18 to $9, for a new total fee of $50. Then on April 1, 2021, the $18 complex modifier will return. But physicians won’t be allowed to bill for it until the 25-minute mark.

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The doctors letter states that patients with complex medical issues will suffer the most, if those new rules are brought in.

“What that will mean is their care will be fragmented,” Les said. “What that will mean is more of those patients will turn up in E.R. departments where they’re likely to be seen by physicians who do not know them, and where their care will delivered in a much more expensive fashion.”

“This is not the time to make health care worse for Albertans.” Tweet This

The health minister was not available for an interview, but his office issued a statement on Saturday saying the province shares physician’s goals to improve care for Albertans, while ensuring the health system is sustainable.

“Despite repeated efforts, the [Alberta Medical Association] failed to put forward alternatives that would hold the line on physician compensation,” ministry spokesperson Tara Jago said in the written statement.

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Les said the suggestion that high wages for Alberta doctors are to blame is frustrating.

“This is not about doctors pay. This is not about gobbledygook terms like ‘complex modifiers,'” Les stated.

“We too are invested in making a healthcare system that’s more streamlined and efficient,” Les added. “We too understand that cuts and changes must be made.”

“They must be, in a way that involves input from front-line practitioners, from family doctors, from pediatricians, from E.R. doctors — from everyone in the medical care system. They cannot be made unilaterally.” Tweet This

A petition to get the province back to the table, which was started Saturday night, garnered over 1,500 signatures in under 12 hours.

— With files from Dean Bennett, The Canadian Press