Problems with medical claims payments are having a significant impact on Saskatchewan’s physicians, Saskatchewan Medical Association (SMA) president Dr. Andre Grober said during his address to the SMA’s 2024 Fall Representative Assembly (RA).

“The SMA has been advocating strongly within the Ministry of Health for fixes to the new billing system,” he told RA delegates on Friday, Oct. 25. “We need to know that when we submit a claim, it will be processed. We need our claims paid promptly so that we can operate our clinics.”

While the backlog of claims has been reduced, Medical Services Branch must continue tackling the backlog until all claims are processed promptly and correctly, he said.

Dr. Grobler added that since ratification of the MCRC Agreement in February, SMA staff have worked extremely hard implementing its various aspects. The first payments under the Transitional Payment Model (TPM) were issued in August. More than two-thirds of eligible fee-for-service family physicians have registered for the TPM. The $10-million Innovation Fund launched in August.

“These and other provisions of the agreement are becoming part of a more sustainable practice environment for physicians,” Dr. Grobler said.

Dr. Grobler also highlighted a new format for the 2024 President and Vice-President’s Tour that saw Dr. Grobler, SMA vice-president Dr. Pamela Arnold, and SMA staff visit physicians in their clinics and work environments on the way to and from the evening tour destination. He thanked physicians for attending the various tour stops and sharing their ideas. He told delegates that the concerns expressed by physicians are shared directly in his conversations with the Minister of Health.

Physician of the Year, Leadership, and Service Award recipients

The SMA handed out five awards during an evening ceremony held Oct. 25 as part of the Fall RA. Dr. Nasim Alibhai (pictured), a Regina family physician, received the 2024 Physician of the Year Award. Click here for more on Dr. Alibhai.

The SMA also recognized outstanding achievement in leading Saskatchewan’s medical community by presenting three leadership awards. Click here for more on the 2024 SMA Leadership Award recipients. They are:

• Physician Leader of the Year: Dr. Marilyn Baetz
• Resident Leader of the Year: Dr. Adedamola Bello
• Student Leader of the Year: Brock Weston

The SMA also presented the 2024 SMA Service Award, which recognizes contributions to the SMA on committees, the board or in other activities that support the SMA and its mission. The recipient is Dr. Peter Butt (pictured). Click here for more on Dr. Butt and the Service Award.

Addressing Retention: The SIPPA Physicians’ Workplace Wellbeing Report

Dr. Gbenga Adebayo, SMA Physician Advocate, Workplace Wellbeing, and Blayn Nienaber, SMA Workplace Wellbeing Consultant, made a presentation to RA delegates. In June 2023, the Saskatchewan International Physician Practice Assessment (SIPPA) program invited the SMA Workplace Wellbeing Team (WWT) to engage with SIPPA physicians who were experiencing distress during their supervised practice phase.

The goal was to understand the challenges and provide individual and group support. The SIPPA program asked the SMA to provide regular wellbeing checks, which led the WWT to take immediate action in July 2023 through group wellbeing sessions. A wellbeing check-in now occurs monthly with each new SIPPA cohort. Highlights of the presentation included:

• Many international medical graduates (IMG) are committed to their work in rural communities, yet they often have contracts that seem exploitative rather than mutually beneficial. Return of Service (ROS) agreements and clinical service contracts should be transparent around placement locations, workload, and remuneration before signing.
• The lack of suitable housing is a significant barrier to successful integration into rural areas, making long-term retention significantly less likely. Some physicians feel isolated in their assigned community. Racism in the workplace toward IMGs also needs to be addressed through education, cultural sensitivity training, and workshops on cultural competency and anti-racism. Health care institutions and local communities must make a concerted effort to foster an inclusive environment.
• The experiences of internationally trained physicians in rural Saskatchewan reveals a narrative of resilience, dedication, and the urgent need for systemic change. Addressing challenges such as racial barriers, housing shortages, unfair contracts, excessive workloads, and a lack of community integration is essential to fostering an environment in which these physicians can thrive.

Wellbeing Index Tool Launch

A new partnership with the Mayo Clinic Well-being Health Index was announced at the Fall RA. The Well-Being Index is a 100 per cent anonymous, web-based tool used to evaluate multiple dimensions of distress in just a few questions. It is designed to measure burnout, provide valuable resources, and allow users to compare their scores to their peers as well as track progress over time to promote self-awareness.

Click here for a link to the Well-Being Index Tool.

Racism in Medicine: SMA and CPSS Physician Survey Findings

Dr. Nnamdi Ndubuka, SMA Physician Advocate, Equity, Diversity, and Inclusion; and Dr. Dapo Mabadeje, Chair, College of Physicians and Surgeons of Saskatchewan (CPSS) Diversity and Bias Committee, made a presentation highlighting the findings and recommendations from this joint survey, which was conducted last fall. Click here to see the survey report. Close to 500 physicians, residents, and medical students responded to the survey. Highlights of the presentation include:

• The aim of the joint survey was to determine if racism is an issue among physicians and medical learners in Saskatchewan. The survey findings will play a crucial role in driving positive change and promoting a health care system that values diversity and respects individual rights.
• The survey found that almost half of respondents reported experiencing racism in their careers or training in Saskatchewan, while three-quarters of those who experienced racism were visible minorities. Experiences of racism were reported to have occurred across interactions involving patients and their family members, physician colleagues, and leadership. It affected physicians regardless of their ethnicity, licensure, or tenure. A strong majority of respondents indicated that racism affected them emotionally.
• Recommended actions for the SMA and CPSS are: Educate physicians and the public about experiences with racism and build awareness throughout the health care system; develop policies, with clear communication and implementation plans; provide support and safe procedures for reporting cases of racism; demonstrate inclusive leadership; and advocate for physicians.

Implementing the 2022-26 MCRC Agreement

Dr. Shane Sheppard, Chair, Economics Committee; Dr. Kirsty Sanderson, Co-Chair, Innovation Fund Oversight Committee, Dr. Ndubuka, and Dr. Grobler provided an update on the MCRC Agreement. They told delegates that membership voices were critical and guided the work of the SMA’s Negotiations Committee. Highlights included:

• Physicians asked for and received a new payment model for fee-for-service family physicians, team-based care, increased fees to address administrative burden and overhead, enhancements to benefit programs, pay and gender equity, rural and regional incentives, retention and recruitment measures, and virtual care as an insured service. Many of the provisions of the agreement have been implemented, and others are in the works.
• The TPM and Innovation Fund closely align with the Patient’s Medical Home (PMH) framework. The TPM compensates family physicians for volume of service and variety of work required for a patient panel, provides graduates with a reliable source of income, holds family physicians accountable as they build their PMH clinics, and provides the option to register or withdraw at any time. Seventy-five per cent of eligible family physicians have registered for the TPM.
• The intent of the Innovation Fund is to advance the development of family physician-led, team-based care clinics that support the unique needs of the community and practices, in collaboration with Health Networks.
• The Equity, Diversity, and Inclusion Continuing Medical Education (CME) Reimbursement Program will go live in January on the MySMA member portal. It will receive $1.5 million in annual funding for reimbursement of costs associated with EDI-related CME courses and reference materials for learning and awareness of EDI, and truth and reconciliation.

SHA Bylaws: The Path Forward

Dr. Grobler, Dr. Arnold, SMA Honorary Treasurer Dr. Carla Holinaty, and SMA past-president Dr. Annette Epp, made a presentation to delegates. A session on Sept. 6-7, 2024, that included senior leaders from the SMA, SHA, and Ministry of Health, was held to develop a foundation of trust and build relationships as discussions resume on SHA Practitioner Staff Bylaws.

Guiding principles are foundational to building trust and strong relationships. Work has started on them and will include focusing on collaboration, bringing forward issues that all sides can agree on, and meeting in person as often as possible. A renewed Bylaws and Rules Review Committee (BRRC) is in place and includes two SMA representatives who sat on the previous BRRC and two new SMA members as well as four new SHA physician members.

Further sessions are planned for December and March 2025. The goal is to deliver mutually acceptable revised Bylaws by May 2025.

Resolutions Update

Reché McKeague, K.C., SMA Legal Counsel, made a presentation to delegates on crafting resolutions. A resolution passed by a majority vote of delegates at a properly constituted RA is considered valid and in effect as if approved by a general meeting of all SMA members. The Resolutions Committee reviews and amends submitted resolutions to ensure that they follow the proper format and that the content is appropriate for consideration at the RA.

The Resolutions Committee requests that resolutions be submitted using the online form at least four weeks prior to each RA. This allows the Committee to work with the mover and seconder to ensure that the resolution is as clear as possible before being presented to the RA. It also allows the Resolutions Committee, who are all delegates, to participate in the RA on behalf of their constituencies.

Once the resolution has been presented to the RA, it is considered owned by the RA and no longer belongs to the mover and seconder. If the RA does not approve the resolution, no further action is taken. If the RA approves the resolution, SMA staff make a recommendation to the SMA Board of Directors on whether to advance it and how. The board considers the resolution’s alignment with the SMA’s strategic priorities, impact on the membership, and available SMA resources to follow through. After an update on the status of a resolution has been presented to the RA, delegates can bring that information back to their sections and Medical Staff Associations.

College of Physicians and Surgeons of Saskatchewan Report

Dr. Alan Beggs, CPSS president, told delegates that the Committee on Medical Licensure in Canada is developing a national approach to licensure and studying how changes will affect jurisdictions. The move to national standards is becoming more important as recruitment becomes more competitive. There are potential benefits, but also risks. While provincial ministries want to attract more physicians through alternative pathways to licensure, this must be done without compromising practice standards.

He added CPSS had 107 outstanding complaints as of September 2024. Expertise gained through handling complaints and an expansion of the legal department has created efficiencies in processing complaints. A dual-stream process for handling non-disciplinary and disciplinary complaints is working well.

College of Medicine Report

Dr. Sarah Forgie updated the RA on her activities after beginning her role as dean of the College of Medicine, University of Saskatchewan, on July 1, 2024. A priority has been to build on the strong connections that already exist between the college and its stakeholders, including the SMA. This has involved meeting physician leadership and students in their home communities and educational environments.

The college is in a period of growth, with 108 Year 1 students and more than 400 learners overall. Eighty-six per cent of Year 1 students are from Saskatchewan. The college’s admissions pathways, including for Indigenous students, aim to create classes that reflect Saskatchewan’s population and attract students who will remain in the province. Residency programs continue to expand to more departments. There are about 500 residents across the province, including 52 in family medicine. More residency graduates are staying in Saskatchewan than ever before.

Approximately 90 delegates attended the 2024 Fall RA in-person or virtually, as well as 45 guests. The SMA’s 2025 Spring RA will be held May 2-3 in Saskatoon.