2014–15 Reports to the Annual General MeetingPatients First® Patients First® is a registered trademark of the Alberta Medical Association.

Dr. Anshula Ambasta – Calgary

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

ii

For more albertapatients.ca takeaway sheets and posters, email media@albertadoctors.org

albertapatients.ca

Refer a patient Today

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

1

For more albertapatients.ca takeaway sheets and posters, email media@albertadoctors.org

Dr. Richard G.R. Johnston – President

Dr. Natalie Logie – Calgary

Dr. Alika Lafontaine – Grande Prairie

TAble oF ConTenTs Agenda .................................................................................................................................................... 2Mission & Vision .................................................................................................................................... 3In Memoriam .......................................................................................................................................... 4Minutes .................................................................................................................................................... 5Report from the board of Directors to the Annual General Meeting ........................................................................................................ 8executive Director’s Report ............................................................................................................ 20Proposed non-substantive Amendments to the Constitution and bylaws of the Alberta Medical Association ....................................................................... 21nominating Committee .................................................................................................................... 22Financial statements ......................................................................................................................... 24summary statement of Financial Position ................................................................................... 25summary statement of operations and net Assets ............................................................... 26summary statement of Cash Flows ............................................................................................. 27

notes to summarized Financial statements ............................................................................... 28

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

2 AGenDA

o Canada

Call to order

In Memoriam Michael A. Gormley

President’s Valedictory Dr. Richard G. R. Johnston

Minutes, 2014 Annual General Meeting

nominating Committee Report Dr. Allan S. Garbutt

Report from Representative Forum Dr. Carl W. Nohr

• ReportfromtheBoardofDirectors

executive Director’s Report

Constitution and bylaws Report Dr. Edward W. Papp

Committee on Financial Audit Report/Financial statements Dr. T. Britt Simmons

other business

Adjournment

AMA Spring Representative Forum, 2015

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

3MIssIon & VIsIon Alberta’s physicians and the Alberta Medical Association (AMA) are committed to Patients First®.

Mission: Leadership and Support

The AMA stands as an advocate for its physician members, providing leadership and support for their role in the provision of quality health care.

Vision: Patients First®

Alberta’s physicians are committed to a health care system that facilitates wellness and delivers patient-and family-centered care:

• The provincial health care system is built around patients and families and defined by quality: » Acceptability » Accessibility » Appropriateness » effectiveness » efficiency » safety

• Patients and families enjoy optimal health through access to: » Healthy lifestyle choices. » Healthy environments and opportunities. » Health service access based primarily on need, not ability to pay.

• The health care system has the resources to deliver patient- and family-centered care, with best evidence used to allocate resources to what is most effective and efficient in meeting health care needs.

• The relationship between physician and patient remains a cornerstone of the health care system, founded on mutual respect, dignity, compassion and trust. Care is delivered with, not to, the patient, including: » Patient choice of physician. » Physicians as agents of patients acting always in the patient’s best interests. » Clinical and professional autonomy of physicians.

• Providers and patients are partners with funders and managers, sharing the goal of a patient- and family-centered health care system with defined roles and responsibilities and clearly specified accountability.

Samantha P. Lam (Medical student) – Edmonton

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

4 In MeMoRIAM Members deceased since the last annual meeting are:

ADAMACHe, Ana Calgary

AlDRIDGe, len Calgary

AllAn ARMsTRonG, Margaret Hinton

bAbIUK, Myron J. edmonton

bAInboRoUGH, Arthur R. lethbridge

bARTon, Pamela Calgary

bAsseTT, Terence H. Toronto on

bloCK, erwin W. Grande Prairie

bobeY, William edmonton

boYAR, stanley W. Priddis

CAFFARo, Antonietta D. edmonton

CARPenTeR, William b. Calgary

ClARK, stewart C. Calgary

CoUGHlAn, Michael X.M. edmonton

DIDUCH lAWRenCe T. edmonton

DZAVIK, Vladimir edmonton

FRAnK, Cyril b. Calgary

GoRe-HICKMAn, Francis G. lethbridge

GoRMAn, brian J. Calgary

HATCH, lorne R. edmonton

IDICUlA, Thekkethil K. edmonton

InGlIs, edward K. High level

IRWIn, Paul Hawkesville on

JUDGe, David l. edmonton

JUlson, Kenneth I. Calgary

KAVAnAGH, Aidan J. Calgary

KleIn, Allan edmonton

lAKeY, William H. edmonton

lARson, burns J. Cardston

leFsRUD, John b. edmonton

leWKe, Hans s. Milk River

lIn, Andrew n. edmonton

MARbURG, lutz north Vancouver bC

MAson, John T. edmonton

MCCoY, ernest e. Victoria bC

MCKeRnAn, Corinne G. Calgary

MCMIllAn, James F. edmonton

MICHAlYsHYn, bohdan edmonton

o’Connell, elena M. Cochrane

PAsCoe, Joseph H. edmonton

sAMUels, sheri l. edmonton

sAsMAl PUlIn b. edmonton

sCAles, Joseph J. edmonton

sIVA GAnesA nATHAn, Arumugam edmonton

sKRePneK, stan V. Palestine TX

sosnoWsKI, Terry D. spruce Grove

sTAnneRs, James Fort Vermilion

sTIllWell, John b. lethbridge

sToRCeR, Joseph Grande Prairie

ToDosIJCZUK, Demitrius edmonton

VU, Trung edmonton

WHARTon, David J. Calgary

WooDHeAD, brian H. edmonton

YAlTHo, C. Mathew edmonton

YAo, Jose P. Fort McMurray

YAseen, salma Calgary

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

5MInUTes 109th Annual General Meeting of the Alberta Medical Association (CMA Alberta Division) September 20, 2014

1. The 109th Annual General Meeting (AGM) of the Alberta Medical Association (CMA Alberta Division) was held on september 20, 2014 in the Imperial 4/6/8 Rooms, Hyatt Regency Hotel, 700 Centre street se, Calgary, Alberta.

2. o Canada was sung.

3. Call to Order Dr. Carl W. nohr presided as speaker and declared the 109th Annual General Meeting in session and duly constituted.

4. Resolutions Committee The Resolutions Committee appointed for the Representative Forum (RF) served as the Resolutions Committee for the AGM. Appointees were Dr. Darryl D. labuick, Deputy speaker, as chair, and RF Planning Group members Dr. Dianne e. brox, Dr. susan J. Hutchison and Dr. Fredrykka D. Rinaldi.

5. Rules of Conduct The speaker noted that business meetings of the association are conducted in accordance with Procedures for Meetings and Organizations (3rd edition) by Kerr & King.

6. In Memoriam Thirty-eight members passed away since the last AGM. The names of the deceased members were projected onto the meeting room screens while those in attendance stood to observe one minute’s silence in their memory.

THeoDoRe H. AARon eDMonTonleRoY M. AnHolT eDMonTonZIAUl b. AnsARI WeTAsKIWInIAn s. bRoWn CAlGARYlADIMeR A. DUsHensKI eDMonTonJoHn R. HUCKell VAlleYVIeWRoss KeTCHeson CAlGARYCAMIlle D. KoHUT CAlGARYs. JoAnne lAVenDeR MIllARVIlleMARlene R. lIDKeA sT. AlbeRTPeTeR K. lInDsAY lAC lA bICHeFReD lobAY sMoKY lAKeJoHn s. loW CAlGARYJessICA e. lYons CAlGARY

WIllIAM J. MClUHAn ReD DeeRJAMes o. MeTCAlFe eDMonTonJoHn C. MoRGAn CAlGARYJoHn G. MUlCAIR WInnIPeG MbelDon l.C. MUTTITT eDMonTonWAllACe e. MYDlAnD CAlGARYAlVInA e. neTT eDMonTonAllAn J.b. nICHolson KeloWnA bCnelson W. nIX FAllIsGeoRGe J. noWInsKI CAlGARYJoHn G. o’KellY sT. AlbeRTIlIJA PoPoVIC CAlGARYJUlIAn RAPHAel leTHbRIDGe bARRY ReWCAsTle seCHelT bCWeRneR b. sCHUlZe oTTAWA onRAM R. sInGH CAlGARYoTTo V. sPIKA CAlGARYDARRYl s. sTeWART eDMonTonJoHn G. sUGARs CAnMoReDReW sUTHeRlAnD eDMonTonRobeRT J. sWAlloW eDMonTonJosePH H. TAKAHAsHI PICTURe bUTTeWIllIAM T. WAlKeR CAlGARYKeeT P. WonG FoRT MCMURRAY

7. President’s Valedictory The outgoing president, Dr. Allan s. Garbutt, reflected on his term as president and on its challenges and accomplishments. He thanked the directorate for its support during his term.

8. Minutes Meeting of September 28, 2013 by formal motion, minutes of the AGM of september 28, 2013 were accepted for information.

9. Reports from the Nominating Committee 2015 CMA General Council Dr. R. Michael Giuffre, Chair, nominating Committee, presented the report and the list of nominees. MoTIon: Moved by Dr. R. Michael Giuffre, seconded by Dr. Daniel R. Ryan: THAT the following nominating Committee nominees for representatives to CMA General Council 2015 be approved (AMA President attends by virtue of position):

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

6 • President-elect, AMA

• Immediate Past President, AMA

• speaker or Deputy speaker

• nine representatives named by the board

• Ten representatives named by the nominating Committee

• Two physician appointees of the college, at least one of whom must be an elected member of the Council

• one dean or designate from his office

• one student representative

• one PARA representative

• Alberta representative on CMA Resolutions Committee

“CARRIED”

Nominating Committee Members Elected by the Annual General Meeting by due process the following were elected as members of the nominating Committee for 2014-15:

• Dr. Graham M.D. Campbell

• Dr. Arlie J. Fawcett

• Dr. Michal s. Kalisiak

• Dr. A. Robert Turner

10. Election of Speaker and Deputy Speaker Speaker Dr. Giuffre reported that no additional nominations had been received for the position of speaker. by due process Dr. Darryl D. labuick was acclaimed AMA speaker for 2014-15.

Deputy Speaker The meeting was informed that there were two nominees for the deputy speaker election:

• Dr. susan J. Hutchison

• Dr. Fredrykka D. Rinaldi

each candidate presented a two-minute platform to the meeting.

by due process Dr. Fredykka D. Rinaldi was elected as AMA Deputy speaker for 2014-15.

11. Report from the Representative Forum President-elect Dr. Richard G. R. Johnston highlighted the issues addressed in the written report circulated to members.

MoTIon: Moved by Dr. Richard G.R. Johnston, seconded by Dr. R. Michael Giuffre: THAT the report from the RF be accepted.

“CARRIED”

President-Elect Dr. Carl W. nohr was introduced as president-elect 2014-15; he expressed his appreciation for being elected as president-elect.

12. Report from the Committee on Constitution and Bylaws Dr. edward W. Papp, Chair, Committee on Constitution and bylaws, presented the report from the committee. MoTIon: Moved by Dr. edward W. Papp, seconded by Dr. Daniel R. Ryan: THAT proposed non-substantive amendments to the Constitution and bylaws outlined in the 2013-14 Annual Reports be authorized and approved.

“CARRIED”

MoTIon: Moved by Dr. edward W. Papp, seconded by Dr. ernst P. schuster:THAT the existing bylaws of the association be rescinded in their entirety and the bylaws as amended by resolution passed at this Annual General Meeting held on september 20, 2014, be adopted.

“CARRIED”

13. Report from the Committee on Financial Audit MoTIon: Moved by Dr. T. britt simmons, seconded by Dr. Christine P. Molnar: THAT the Auditor’s Report and the audited financial statements for the Alberta Medical Association for the year ended september 30, 2013, be received for information.

“CARRIED”

MoTIon: Moved by Dr. T. britt simmons, seconded by Dr. Dianne e. brox:

THAT the firm of PricewaterhouseCoopers be reappointed as auditors for the Alberta Medical Association for the 2014-15 fiscal year.

“CARRIED”

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

714. Installation of Officers Dr. Richard G. R. Johnston was installed as AMA president for 2014-15 by CMA Past President Dr. louis H. Francescutti at the CMA President’s luncheon.

15. Acknowledgments MoTIon: Moved by Dr. Richard G. R. Johnston, seconded by Dr. R. Michael Giuffre: THAT the profession express its sincere appreciation to Dr. Allan s. Garbutt, his wife bev and their family for their service, sacrifice, and dedication to the profession over the past year.

“CARRIED”

MoTIon: Moved by Dr. Richard G. R. Johnston, seconded by Dr. R. Michael Giuffre:

THAT the Annual General Meeting express its sincere appreciation to the senior Management Team and staff for their dedication to the pursuit of the goals of the association.

“CARRIED”

MoTIon: Moved by Dr. Richard G. R. Johnston, seconded by Dr. R. Michael Giuffre: THAT the association express its sincere appreciation to Dr. Carl W. nohr and Dr. Darryl D. labuick for their conduct of this meeting.

“CARRIED”

MoTIon: Moved by Dr. Darryl D. labuick, seconded by Dr. R. Michael Giuffre: THAT the association express its sincere appreciation to Dr. Carl W. nohr for his service to the AMA as speaker (2012-14).

“CARRIED”

16. Adjournment There being no other business, the speaker adjourned the formal business session of the 109th Annual General Meeting at 11:00 a.m. Following the annual meeting, delegates participated in the Margaret Hutton lecture series (Alberta Medical Foundation History of Medicine presentations).

17. Alberta Medical Foundation – Margaret F. Hutton Lecture Series Dr. Frank W. stahnisch, Director, Alberta Medical Foundation, introduced the presentations on the following topics:

• Red, Blue and Yellow: The symbolic use of color in anatomical illustration – scott Assen

• Schizophrenia: A historical perspective of the ‘missing illness’ – sarah erem

• The pioneers of Canadian plastic surgery: Risdon, Gordon & Farmer – Malika ladha

Dr. Emmanuel A. Gye – Airdrie

Dr. Susan J. Hutchison – Edmonton

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

8 RePoRT FRoM THe boARD oF DIReCToRsTo the Annual General Meeting October 1, 2014 – September 30, 2015

Staying Focused on the Vision

1. For the Alberta Medical Association (AMA), 2014-15 was another year of implementing our seven-year agreement with government. Progress was made, but was affected by a tumultuous political year and a complete change of government. The AMA continued to look toward our vision of Patients First® in a patient- and family-centered health care system. We faced new opportunities to show the profession’s leadership. This report outlines the many activities aimed at turning mission and vision into action.

Considering a Strategic Agreement

2. In May, members were informed of efforts between the AMA, Alberta Health (AH) and Alberta Health services (AHs) to collaborate on several initiatives aimed at improving the health care system. These efforts took place under the auspices of the 2011-18 AMA Agreement, exploring ways to augment and modify the main agreement in a way agreeable to all parties.

3. A Memorandum of Understanding was agreed to, ensuring that the parties’ interests were protected. The key principles were that: We will not make any changes to the AMA Agreement without the express approval of the parties; This would be subject to an AMA member ratification vote.

• Discussions will be undertaken without prejudice to each party’s rights and interests as provided for in the AMA Agreement.

• We will not make any changes to the AMA Agreement without the express approval of the parties; This would be subject to an AMA member ratification vote.

• There will be bilateral representation from AMA and AH, with AHs attending in an advisory capacity.

• A rapid timetable is envisioned.

4. These discussions for a new strategic agreement address topics that impact the AMA business Plan but were still underway at time of writing. They are therefore being reported here, separately, as a precursor to the remainder of the board report to the annual general meeting (AGM).

5. AMA President Dr. Richard G.R. Johnston first wrote about these discussions in a May 15, 2015 President’s Letter. He identified four factors to help physicians and our partners succeed in meeting the challenges of the health care system;

• We must set clear and measurable objectives for what we want to do.

• We must be open to innovation and to allocating resources toward what matters most for patients.

• Physicians and other health care professionals have to be engaged as full participants in system change.

• Patients need to be included in planning and making this journey.

6. Through the summer of 2015, the three parties focused on their overall relationship and ways to improve their joint stewardship and management of health resources. several opportunities for improvement were identified, ranging from a bargaining framework covering all payments from AH and AHs, to ways to allocate existing dollars within the system that will improve quality of care for patients. strategies discussed included:

• Advancing the meaningful use of electronic medical records (eMRs).

• Promoting appropriateness in the use of health resources though activities like Choosing Wisely and the local development of clinical pathways.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

9• opportunities for aligning physician compensation with system objectives, such as a voluntary alternative relationship plan (ARP) for primary care.

7. The board of Directors provided oversight throughout these discussions and will continue to do so. none of the proposals that were developed were intended to replace current major activities in the health care system or under the AMA Agreement. Rather, they were to support and build on the foundation of what has come before – but also to seek opportunities for concrete progress and change arising from present-day circumstances.

8. These strategic agreement discussions will likely continue into the 2015-16 business year. When concluded, the results will require a ratification vote by physicians.

9. The themes that the AMA has taken to the table arose naturally from our vision and mission – which were operationalized during the year in the form of the AMA business Plan. The section that follows addresses the business Plan and explains the developments that were aligned in many ways to the ongoing strategic agreement discussions.

2014-15 Business Plan and Budget

10. The AMA’s business Plan establishes the long-term goals for the organization and the plans for moving toward these goals during a particular year. It describes the ends for the association as established by the board of Directors, ensures that management’s plans are aligned with the goals and ends established by the board and Representative Forum (RF). It is also the basis for assessing the annual performance of the Ceo (and used by the Ceo in discussing performance with senior staff).

11. The Key Result Areas (KRAs) under the mission and business plan were:

• Financial Health

• Well being

• system Partnership and leadership

12. each of the KRAs (described below) was built upon a number of long-term goals (five-to-10 year horizon), supported by short-term

objectives for 2014-15 by which we marked progress toward the goals.

13. The 2014-15 business Plan is available on the AMA website. (Visit www.albertadoctors.org. enter “business plan” in the top-right search box.) A year-end report card on the business plan will be presented to the 2015 AGM and also available on the website.

14. For this report to the AGM, commentary on relevant activities appears under the appropriate business plan/KRA headings. each KRA has its own goals which appear accordingly.

Business Plan 2014-15 Key Result Area 1: Financial Health

15. Under the Financial Health KRA, the AMA assisted and supported members in maintaining their financial health. This included negotiating with payers to ensure fair compensation, the provision of practice management services and offering financial products. Members in training were supported through a number of scholarships and bursaries.

Goal 1: Physicians are fairly compensated for their skills and training

16. Under this KRA, the AMA has been seeking formal recognition in legislation as the representative of physicians in negotiations with government (and AHs). legislated recognition occurs in other provinces. Under the 2011-18 AMA Agreement, some ongoing provisions survive the term of the agreement. This gives the association some evergreen capabilities to speak for physicians. nonetheless, in the interests of maintaining continuity between agreements and best serving the interests of members on matters that extend beyond the agreement, we continued to seek legislated recognition.

17. The AMA is typically involved with any number of negotiations in addition to those at the provincial level with AH. An important example in 2014-15 was the Workers’ Compensation board (WCb). Following several years of negotiations, we were successful in reaching a new agreement that was ratified by physicians February 27, 2015.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

10 18. The new five-year WCb agreement represents successful work by the two negotiating teams to identify common interests at the table. It aligns payment with incentives toward the kind of care that physicians want to deliver. It effectively establishes the relationship between WCb and AMA and fairly recognizes the special nature of WCb work.

19. one example of a mutual interest was improving the timing and efficiency of the exchange of information that is important and unique to these patients/workers. The agreement applies incentives in areas that can reduce turnaround times for WCb patients to receive care and return to work when they are healthy once again.

20. both parties contributed to meeting these mutual interests. For example, some of the improvements will come from the way physicians manage information flow with WCb; updating physician office systems may be required to maximize ability to reach new targets for turnaround time. For WCb’s part, a faster turnaround time for injury reports allows WCb to facilitate an early return to work.

21. In other areas the AMA continued to support numerous discussions with AHs for non-fee-for-service negotiations, including clinical assistants and laboratory physicians. negotiations for clinical assistants continue and may be affected by the strategic agreement discussion. A laboratory physician agreement was ratified in May and signed off in August for a contract running April 1, 2014 to March 31, 2018.

22. Considering other needs of physicians (outside of fee-for-service), the AMA also worked with AHs and AH on a voluntary alternative payment model for primary care as part of the evolution toward the Patient’s Medical Home. A model was developed for consideration by the stakeholders.

23. Another objective under the KRA Financial Health was expanding support for AMA engagement with physicians under academic ARPs. The AMA remained in contact with leaders of academic medicine at both medical schools. All parties have been waiting for provincial direction regarding a new academic

medicine framework. The AMA looks forward to being able to provide more robust support when proposals for the academic framework are in place.

Goal 2: Physicians’ practice management decisions are based on sound management advice and best practice

24. This activity supported physicians in numerous ways:

• billing support and advice was delivered to members daily. In June the AMA launched its new online application Fee navigator to provide extensive self-serve assistance for working with our complex schedule of Medical benefits (soMb) and rules. Fee navigator was enthusiastically received by physicians. It received national attention through a positive article in the Canadian Medical Association Journal.

• The AMA’s Practice Management Program (PMP) provided advice to members for the life-cycle of physician practices. The program initiated a full review of its services to ascertain how best it can address the changing needs of physicians and ensure the services are delivered in an optimal manner.

• PMP began to prepare a preferred provider network of real estate brokers that physicians can access, knowing that these brokers will agree to meet established service standards.

Goal 3: Reliable and best-in-class financial products are available to all members

25. Financial Health also included delivering the best quality financial products and services to members. Following a 2013-14 review, the AMA monitored the effectiveness of a renewed formal relationship with TD Insurance Meloche Monnex (TDIMM) to provide insurance services to AMA members and their families. Improvements to the TDIMM claim process were implemented. The number of claim-related member complainants decreased substantially in 2014-15.

26. To increase education and awareness, members received regular communication through MD Scope and Alberta Doctors’ Digest about how to be informed consumers of insurance products.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

1127. Additional insurance transactional tools were moved from paper to online, including online reports for the Health benefits Trust Fund and calculators for term and other insurance needs.

28. A spring 2015 satisfaction survey of AMA members gave strong ratings for service and professionalism to ADIUM insurance, the AMA’s wholly owned insurance agency. Among responding physicians, 89% agree both that insurance rates are competitive and that ADIUM staff provide satisfactory service.

Business Plan 2014-15 Key Result Area 2: Well Being

29. The second Key Result Area for 2014-15 was Well being. This called for the AMA to support members in maintaining a healthy work-life balance, including being a leader in the development of a comprehensive physician health program. It also promoted physician contributions to the broader health of communities.

Goal 1: Physicians are supported in maintaining their own health and that of their families

30. Work continued with the College of Physicians & surgeons of Alberta (CPsA) regarding its relationship with the Physician and Family support Program (PFsP). PFsP developed a set of questions and answers that address how the program protects confidentiality and interacts with the CPsA Physician Health Monitoring Program. These were shared with the college and published in Alberta Doctors’ Digest and on the AMA website (www.albertadoctors.org/services/physicians/pfsp/i-need-help-now).

31. PFsP refreshed its promotional activities and increased outreach in some areas where fall 2014 surveying showed there may be some gaps in awareness about the program. We will be repeating the benchmark survey this fall and working to ensure that physicians know what PFsP can do and how to access its services.

Goal 2: The AMA brings physicians, patients and family together toward healthy communities and celebrates physician and community contributions

32. KRA 2 Well being also called on the AMA to promote and support physicians so that they can contribute to the broader community. our chief vehicle for this was the Many Hands™ initiative that celebrates the volunteer and philanthropic efforts of Alberta doctors locally, nationally and abroad. We shared these accomplishments and dozens of inspiring stories on our website https://www.albertadoctors.org/advocating/many-hands.

33. As our own flagship Many Hands™ project, the AMA chose the AMA Youth Run Club. Aimed to get kids active and physicians engaged, the club was offered free to schools and students. support was provided through our partner ever Active schools to help each school tailor the program. local physicians, resident physicians and medical students were involved by running with clubs or giving talks about the importance of activity, nutrition, sun safety or a variety of related topics. by June 2015, 305 schools and more than 17,000 children were involved across the province.

34. The board has directed that sponsorships should be sought to ensure the sustainability of AMA Youth Run Club. In this first year, the Running Room joined as a major sponsor. Physiotherapy Alberta was also a contributor.

35. As another part of promoting healthy communities, the emerging leaders in Health Promotion (elIHP) Grant Program continued in 2014-15. led by the AMA’s Health Issues Council, it is a partnership with the medical students’ associations at both universities and the Professional Association of Resident Physicians of Alberta (PARA). The goals of the program are to:

• Promote the physician’s role as an advocate for healthy populations.

• Provide students and resident physicians with experience in health promotion as an integral part of medical practice.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

12 • Facilitate growth of leadership and advocacy skills in a mentored environment by requiring a senior physician mentor for every project.

36. This year, the elIHP supported nine initiatives, for example: CPR at sporting events; self-discovery and healing through creative arts; rural adolescent sexual health workshops; health promotion in American sign language and refugee health.

37. The AMA was very pleased to welcome the Canadian Medical Association as a co-sponsor of the elIHP. We thank the CMA for their generous support of this important leadership and advocacy initiative.

Business Plan 2014-15 Key Result Area 3: System Partnership and Leadership

38. For KRA 3, the AMA supported members in their role as leaders within the health care system, including developing innovations in care delivery through primary care networks (PCns), strategic Clinical networks (sCns) and other initiatives. The AMA had a key role with AH under the AMA Agreement in developing and maintaining the physician payment strategy for the province, programs aimed at quality improvement, activities related to information management and technology and supporting the development of physician leadership skills.

Goal 1: Work with AH, AHs and other partners to lead and influence positive change in delivery of health services

39. Priority activities began with the system-Wide efficiencies and savings (sWes) Consultation Agreement. building on the previous year’s work, the parties identified a prioritized list of proposals that are within the common sphere of AMA, AH and AHs. It was agreed that initiatives to be pursued must:

• Make Albertans healthier.

• Improve patient satisfaction with health care.

• Make best use of health care dollars.

40. Choosing Wisely Alberta was a major area for our efforts. The Alberta-based projects chosen built on the foundation of the Choosing Wisely Canada initiative, seeking to reduce the ordering

of tests, procedures and treatments that are of limited or no value and are potentially harmful.

41. Two projects launched this year around ordering of Vitamin D testing in healthy patients and diagnostic imaging for low back pain, the latter in partnership with the Alberta society of Radiologists. Work is ongoing for Choosing Wisely Alberta in partnership with sCns on priority topics including headaches, head trauma and blood transfusion. Funding for this was provided through Partnership for Research and Innovation in the Health system grants from Alberta Innovates – Health solutions.

42. The AMA’s Vision for Primary and Chronic Care (2010) and PCN Evolution Vision and Framework (2013) were the basis for leading innovation and change in primary care delivery. This included additional policy development and practical activity planning and implementation around:

• Paneling of patients as a fundamental of the Patient’s Medical Home including work by the PCn Program Management office and PMP to perform Medical Home Assessment surveys with every PCn. These assessments were designed to identify where gaps may exist and where PCns can support their member clinics.

• strengthening the patient-physician relationship.

• Developing the blueprint for the voluntary alternative primary care physician compensation model as referenced earlier in this report.

• Developing and implementing accountability measures within PCns.

43. In a President’s Letter, Dr. Richard G.R. Johnston wrote about the importance of establishing a stronger attachment between each Albertan and a primary care physician. He also pointed out that patients and government have responsibilities too. “The best evidence available

– and there is a lot of it – is that strengthening these attachments pays off in terms of overall system quality and efficiency. For this to happen, Albertans will need to commit to that relationship and accept a focusing of their major entry point into the system. I understand and

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

13accept that strengthening the patient-physician relationship is a two-way street: additional resources at the primary care level will be necessary.”

44. With the PCn Physician leads executive, the AMA has been advocating to the notley government with respect to the redirection of $75 million in accumulated PCn surpluses, as well as a new requirement for PCns to submit balanced budgets by July 1, 2015 (vs. budgets which include spending to bring down accumulated surpluses). These provisions were part of the provincial budget tabled by the Prentice government. They were a matter of extreme concern for PCns who were either using or planning to use these funds to increase access and services for patients or to maximize PCn evolution-type activities (such as implementing panel management). Without the funds, PCn evolution could be hampered and PCns could be at risk of reducing programs and laying off front line staff.

45. newly established Minister of Health and seniors sarah Hoffman indicated her support for a stable planning environment for PCns. she stated that, while a review of the funds and PCn operations would continue, the requirement for balanced budgets would be deferred. The minister has, however, noted that she cannot make any firm funding commitments before the first nDP provincial budget in october. she has, though, been very positive in her statements about the value of PCns. Additionally, she has promised to share the results of the current PCn reviews with the PCn Physician leads executive and the AMA before any changes in policy or process.

46. Finally under Goal 1 to lead innovation and change, the AMA continued to work to meet commitments made as a result of the 2013 Continuity of Patient Care study from the Health Quality Council of Alberta. The AMA was identified in a number of recommendations in that report. These led to further work with the CPsA, AH and AHs. The AMA convened a working group, the function of which subsequently moved to the jurisdiction of the provincial Health Quality network. A letter was

sent to government seeking prioritization for a provider registry, the patient’s Personal Health Portal and an e-referral project.

Goal 2: Align key incentives and supports for physicians with delivery of care and toward overall system objectives of timely access for patients to quality care

47. Under the AMA Agreement, the Physician Compensation Committee (PCC) is a joint committee of AH and the AMA. It includes an appointed, independent chair and three representatives of each party, with one vote in total for each party. The AMA’s three representatives were guided by the board of Directors, which in turn is informed by the AMA Compensation Committee (AMACC) among others.

48. The PCC was established under the agreement to provide a specific and focused “authority and responsibility over all elements of physician compensation, plans and programs.”

49. The PCC made progress in a number of areas this year, before being required to cease activities in the run-up to the provincial election. Meetings began again in July with the new government in place. Activities that occurred and/or are still underway included:

• Continuing to implement an individual review of 20 codes in the soMb, developing a methodology with feedback from the RF, the board, the AMACC and the PCC itself. At time of writing, the PCC planned to make an initial decision on the methodology in mid-August and then communicate with the impacted sections to discuss any concerns, effect on services, implementation timeframe and effect on relativity. An implementation timeline was not to be established until those discussions had been held.

• Improving information and overall knowledge base for decision-making with the specific objective of updating the business Costs Model that is used for allocation.

• Completing the April 1, 2015 allocation. The board provided direction for a macro-distribution:

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

14 i. $54.9 million, including $11.8 million to fund electronic eMRs, was applied for overhead costs.

ii. Targeted items received $10.3 million:

• 03.05JR Telephone calls (must be physician interaction) directly to patients to discuss patient management/diagnostic test results paid at $15.12 (maximum seven per week).

• 03.05JQ Family conference with relative(s) by telephone in connection with management of a patient with a psychiatric disorder paid at $50.66 (billable where distance/mobility issues prevent face-to-face meetings).

• 03.05JP Family conference via telephone relating to acute care facility in-patient or registered emergency or out-patient, or auxiliary hospital, nursing home patient, AACC or UCC patient to be paid at $40.11 for family conferences where patient is unable to communicate with physician and family is unable to attend an in-person conference.

• bMI modifier rule changes to expand eligible locations and including the physician office for a new bMIPRo modifier replacing the previous bMIsRG.

iii. $13.3 million was applied for a fixed amount per physician (sectional allocation equivalent) of $1,853.

• Reviewing allocation processes and options for future years.

• Considering research and development of new fees and new methods of payment.

50. In order to lead innovation and change, physicians need to be supported by an integrated health information system, including enhanced information exchange and data analytics. There was a great deal of activity by the AMA in a number of venues that will continue into the 2015-16 business year. With significant infrastructure costs involved, government and AHs discussions around the best way to pursue information, decisions can take time. The AMA continued to advocate for leveraging the investments that have already

been made to begin encouraging the kind of information exchange that is needed at the system and practice level.

51. The priorities that the board identified were:

• Making solutions available for physicians to securely exchange health information to support improved access and quality of care.

• Allowing physicians to use data analytics to appropriately collect, consolidate, access, use and contribute health information to improve care delivery.

• ensuring that physicians in co-custodial situations are supported with an information sharing framework (IsF) and individual assistance to meet their professional obligations.

52. We have also been providing input into development of a key provincial initiative for secondary use of health data and have supported a major effort in edmonton Zone to extend the AMA/AHs IsF to all physician users of the AHs shared eMR eClInICIAn. Discussions continued regarding further extension of the IsF to Calgary physician users of the shared eMR sCM Ambulatory.

Goal 3: Physicians and the AMA, in partnership with patients, play a leadership role in advocating and promoting a system characterized by Patients First®

53. In June the AMA launched a new patient engagement website platform so that the association can engage in two way conversations with the public. When announcing the launch, the president wrote: “The website (albertapatients.ca) is an online forum for Albertans to come together and participate in conversations about health care.” once they have joined, people have the opportunity to:

• Participate in surveys about different aspects of health care.

• Take quick polls and see instant results.

• Join discussion forums about topics that interest them.

• Receive invitations for special surveys or discussions that relate to the interests expressed in their profiles, etc.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

15• Receive newsletters about what’s been happening on the website, including survey results, news from the AMA or other items such as what is happening in other jurisdictions and recent health care-related studies.

54. office-based physicians received a poster and supply of patient take-away sheets to leave in reception areas or examination rooms. Physicians were also asked to encourage patients to visit the website.

55. To further engage the public, this year the AMA promoted the inclusion of at least one non-clinical member on each PCn board and the establishment of PCn Advisory Councils. PMP developed two guidebooks to assist PCns in the process of acquiring these representatives and further engaging with their communities.

56. Physicians can become better leaders of a patient- and family-centered health care system when they receive training for their leadership skills. Under the business plan, the AMA:

• Worked with AHs and the CPsA to assemble an inventory of advocacy and leadership resources and made them available on the AMA website. (www.albertadoctors.org/advocating/physician-advocacy)

• scheduled an in-house Physician Management Institute course for AMA members (september 25, 2015 in edmonton).

• Piloted two well-received leadership courses, one in each of edmonton and Calgary.

Healthy AMA

57. Achieving the above goals and objectives under the KRAs requires a healthy, vibrant and sustainable AMA. For the 2014-15 year, the association focused on core organizational capabilities:

• Governance: The Governance oversight Group worked to strengthen communication and collaboration capabilities between members, the RF and board.

• Workforce: six edmonton office sites were consolidated to two locations and a longer-term space strategy (five years or more) is being developed. There was also a transition

to the amended employee pension plan with equitable risk sharing.

• Relationships: This included the non-partisan government relations work already discussed in this report as well as strengthening relationships with other provider organizations.

• Financial: The association has developed prudent financial controls that give management reasonable assurance that the assets are safeguarded and reliable financial records are maintained. These controls, which are reviewed by the Committee on Financial Audit, include written policies and procedures, technology controls and an organizational structure that segregates duties. We focused on maintaining sustainable operations and fully funded reserves as well as effective stewardship of the AMA Agreement grant program funding.

• Knowledge: This year the AMA implemented the first phase of a unified telecommunications strategy across all our offices to streamline the member experience and improve our ability to engage with members, particularly around key initiatives.

Other activities and issues

58. outside of those things directly linked to the AMA business plan and described so far, the AMA was involved in many other activities that were consistent with our mission.

Continuing and chronic care

59. A september 2014 report from the province’s Auditor General highlighted the lack of support in the community for Albertans with chronic conditions.

60. In an october President’s Letter, Dr. Johnston noted that inadequate community support for the chronically ill results in patients ending up in hospitals too often and for too long. He further said that to get the most out of our acute care resources, we must invest more in the community with a medical home for every Albertan. To do this will require things that have been commented on throughout this AGM report:

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

16 • stepping up the implementation of PCns and PCn evolution to the medical home.

• Finding ways to use payments for physicians and other providers as incentives to support the best care right across the system.

• Improving and enhancing our information systems so that they can measure and record the patient’s entire journey, avoiding gaps along the way.

61. The Prentice government accepted the recommendations of the Auditor General’s report and pledged to act upon them. The new nDP government had not yet spoken about the issue at time of writing.

seniors’ care

62. The Alberta College of Family Physicians has formed the Alberta seniors’ Care Coalition (AsCC) of which the AMA became an early member. The coalition now involves AH, AHs (including the AHs seniors’ strategic Clinical network), Covenant Health, the College and Association of Registered nurses, Alberta Pharmacists’ Association and College of licensed Practical nurses of Alberta.

63. In April, AsCC hosted a conference, themed “Working Together for seniors’ Care,” as a multi-disciplinary professional development event. The goal was to provide relevant, practice-based learning sessions with a focus on seniors’ health, innovative models of service delivery, dementia, palliative and end of life care.

64. As part of our contribution to the coalition and conference, the AMA conducted public opinion research on Albertans’ attitudes toward aging, being a senior and caregiving. This material was the focus of a joint AMA-Canadian Medical Association session at the AsCC conference. While CMA President Dr. Chris simpson presented on national findings gathered by the CMA, Alberta-specific survey data was presented by our partner ThinkHQ Public Affairs President Marc Henry.

Council of Zonal leaders and Zone Medical staff Associations

65. The presidents of the five zone medical staff associations (ZMsAs) meet twice a year as the

Council of Zonal leaders. The June 1 meeting marked the end of Dr. Darryl labuick’s term as chair. He served in this role for four years, following three years chairing the councils earlier incarnation, the Council of Presidents. The council honored Dr. labuick’s contributions and welcomed his successor, Dr. Michael Giuffre.

66. The AMA and ZMsAs continue to work effectively together, including Zone Advisory Forums and the Council of Zonal leaders. Areas of collaboration have included the medical staff bylaws amendment process, in which the AMA successfully advocated for a “whistleblower” amendment, and joint advocacy on issues like workplace violence policy and the Annual Information Verification and Attestation process.

67. In fall 2014 the ZMsA presidents and AMA teamed up to launch an awareness campaign to promote voluntary influenza immunization among physicians.

68. AHs and government were willing this flu season to test education and awareness as a tool to encourage better results than had been seen in previous years. In the end, and although immunization rates took a large jump among members of the public, AHs statistics did not show a significant increase in immunization among physicians. Yet at the same time, data collected by the CPsA with its membership renewal process showed that 88% of physicians intended to be immunized.

69. In the meantime, with a year in which the vaccine was less effective than normal, many more Albertans were immunized while parts of the province were hit hard by influenza outbreaks. The policy ramifications remain unclear.

Government relations

70. The AMA continued its non-partisan approach to government relations this year. The Government Affairs Committee met informally with politicians from different parties. The AMA president met with party leaders and leadership candidates.

71. our message both before and after the election was that physicians want to be leaders and to assist with solving the challenges facing our health care system. We positioned the AMA

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

17Agreement as a good foundation that provides opportunity to make a difference.

72. The previous and current minister and the president were in contact in their relationship established by the agreement. AMA senior staff interacted daily with the civil service at Alberta Health.

Advocacy for public policy

73. This past year, the AMA advocated in areas of government public policy provincially and federally:

• At the provincial level, the AMA supported a ban on menthol in tobacco products. The former government had tabled flavored tobacco legislation with an exemption for menthol. The nDP government subsequently announced that menthol would be included in the list of prohibited flavorings when the legislation was reintroduced in the fall.

• At the federal level, the AMA continued to support restoration of full health benefits – lost in 2012 – for refugees, refugee claimants and certain other non-citizens under the Interim Federal Health Program. In november 2014 due to the Federal Court of Canada decision declaring these program cuts to be unconstitutional, the federal government introduced a partial, temporary health program. Many refugees, however, still remain without any coverage other than in emergency situations or if they pose a danger to public health. The AMA president participated in an event on June 15 as part of the Alberta activities for the national Day of Action on Refugee Health.

Canadian Medical Association

74. The 2015 CMA General Council (GC) was held August 23-26 in Halifax. The 2015 AMA delegation was:

• AMA President

• President-elect

• Immediate Past President

• speaker or Deputy speaker

• nine representatives named by the board

• 10 representatives named by the nominating Committee

• Two physician appointees of the college, at least one of whom must be an elected member of the council

• one dean or designate from his/her office

• one student representative

• one PARA representative

• Alberta representative on CMA Resolutions Committee

75. on August 26, Dr. Cindy Forbes, a family physician based in Fall River, nova scotia, was installed as the 2015-16 president of the CMA.

76. Dr. ernst P. (ernie) schuster, who served as a speaker and deputy speaker of the Representative Forum for 14 years, sat on the GC Resolutions Committee.

77. Five outstanding Albertans and one organization were honored with CMA special Awards.

78. The Frederic newton Gisborne starr Award represents the highest award that lies within the power of the Canadian Medical Association to bestow upon one of its members. Achievement is the prime requisite in determining the recipient of this award. Medalists may have achieved distinction by making such outstanding contributions to science, fine arts, non-medical literature, serving humanity, advancing humanitarian or cultural life or improving medical service in Canada as to serve as an inspiration and a challenge to the medical profession in Canada. Calgary-based internist Dr. norman Campbell’s commitment to prevention and control of hypertension has had a global public health impact on stroke and heart disease. over a 35-year career this world expert has been extraordinarily successful in changing public nutrition policy and in transferring scientific knowledge about hypertension into medical practice.

79. The CMA’s Medal of Honor is the highest award that CMA can bestow on an individual who is not a member of the medical profession. It is awarded to individuals who have demonstrated excellence in any of the following areas: personal contributions to the advancement of

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

18 medical research, medical education, health care organization and public health education; service to the people of Canada in raising the standards of health care delivery in Canada; or, service to the profession in the field of medical organization. Calgary’s Ms Camille Dow baker was the 2015 recipient in recognition of her outstanding contributions to health promotion through her efforts to ensure clean water and proper sanitation are available to everyone, no matter where they may live.

80. Dr. Paul byrne of edmonton received the Dr. William Marsden Award in Medical ethics, which salutes exemplary leadership, commitment and dedication to the cause of advancing and promoting excellence in the field of medical ethics in Canada in one of the following areas: demonstrated level of commitment to furthering the cause of medical ethics in Canada; demonstrated leadership in enhancing ethical and professional behavior among Canadian physicians; or demonstrated excellence in research and/or teaching initiatives in medical ethics. Dr. byrne has provided leadership as a tireless advocate for the place of medical ethics in academic, clinical and public settings.

81. Grande Prairie’s Dr. Alika lafontaine was recipient of the CMA Award for Young leaders in the early career physician category, recognizing exemplary dedication, commitment and leadership in one the following domains: political; clinical; education; research; or community service. Dr. lafontaine was recognized for his accomplishments in the political and community service realms, particularly his personal commitment to improving the lives and health of Canada’s aboriginal population.

82. The CMA John McCrae Memorial Medal is given to current or former clinical health services personnel of the Canadian Armed Forces for exemplary service demonstrating traits such as compassion, self-sacrifice, or innovation beyond the call of duty that have greatly benefited the health or welfare of fellow military personnel or civilian populations. lieutenant Colonel Dr. Robert stiegelmar was recognized for being

an invaluable resource for the Canadian Forces Health services branch as well as an admired and respected orthopedic specialist and national leader in amputation surgery. His contributions were deemed particularly helpful in treating military personnel and the complex health issues surrounding their care.

83. The Calgary based norlien Foundation (now known as the Palix Foundation), received the CMA Award for excellence in Health Promotion, which is intended to highlight specific efforts by an individual or organization outside of the health sector to promote the health and wellness of Canadians. In conferring this award, the CMA recognized that the foundation has worked tirelessly to make an impact on policy and practices that will improve health and wellness outcomes for children and families.

Member communication and research

84. Members had received 16 President’s Letters as of date of writing.

85. Three member tracker surveys will have been conducted by the end of the year. These surveys showed how members feel about important issues and the role and performance of the AMA. overall, 82% of members agree that the AMA is an effective advocate for physician members (only 6% disagree).

86. To help members stay connected to what is happening, the AMA introduced a new service: news for Docs. This daily news service, for many years available only to RF delegates and other physician leaders, was made available this year to all members. over 1,500 physicians subscribed in the first two months to receive a curated, daily selection of political and medical affairs news from Alberta and across the country. To subscribe, visit: www.albertadoctors.org/media-publications/publications/news-for-docs

Board of Directors and Executive Committee

87. Members of the 2014-15 board of Directors:

• Dr. Richard G. R. Johnston – President

• Dr. Carl W. nohr – President-elect

• Dr. Allan s. Garbutt – Immediate Past President

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

19• Dr. Kathryn l. Andrusky

• Dr. sarah l. bates

• Dr. Paul e. boucher

• Dr. neil D.J. Cooper

• Dr. Robin G. Cox

• Dr. Kimberley P. Kelly (elected March 14, 2015)

• Dr. Christine P. Molnar

• Dr. Paul Parks

• Dr. Jasneet Parmar

• Dr. A. James Pope

• Dr. ernst P. schuster (resigned March 1, 2015)

• PARA observer: Dr. Anshula Ambasta (July 1, 2014 – June 30, 2015); Dr. Kimberly Williams (July 1, 2015 – June 30, 2016)

• MsA observer: Paras satija (July 1, 2014 – June 30, 2015); Hamza Riaz (July 1, 2015 – June 30, 2016)

88. The board regretfully accepted the resignation of Dr. ernie schuster as noted above. We were, though, pleased to know that he was moving to a new opportunity to work with the CPsA in the area of competence assessment and outreach to the profession. We have benefited from his service and wish him well.

89. In 2014-15, the board of Directors met:

• 2014o september 20 (post-RF board meeting)o october 24o December 11-12

• 2015o January 12 (teleconference)o February 6o April 16-17o May 26 (teleconference)o June 4-6 (meeting and retreat)o June 16 (teleconference)o June 23 (teleconference)o June 30 (teleconference)o July 16-17o August 26 (special meeting at GC)o september 16

90. Members of the executive Committee:

• Dr. Richard G. R. Johnston, President

• Dr. Carl W. nohr, President-elect

• Dr. Allan s. Garbutt, Immediate Past President

• Dr. Paul e. boucher, board Representative

• Dr. neil D. Cooper, board Representative

91. In 2014-15 the executive Committee met:

• 2014o october 3o november 21

• 2015o January 16o March 20o May 15o June 26o August 18

Dr. Sarah A. Hall – Calgary

Dr. John T. Huang – Calgary

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

20

Michael A. Gormley, Executive Director, Alberta Medical Association

eXeCUTIVe DIReCToR’s RePoRT 2014–15

The AMA’s mission of providing leadership and support for

physicians is expressed in three key result areas: Financial

Health; Well being; system Partnership and leadership. This

report to the annual general meeting summarizes the process

made in each of these areas toward the goals established by

the AMA board and Representative Forum (RF).

The area of Financial Health encompasses the traditional role of the medical association to represent the economic interests of physicians. We continue to do this in a number of settings, including discussion and negotiation with Alberta Health (AH), the Workers’ Compensation board and Alberta Health services. We also continue to look for new ways to assist physicians, including further development of a billing app and working closely with MD Financial Management in our alliance on financial services.

Well being includes services aimed to support physician health through the Physician and Family support Program: the AMA has been a leader in physician health for a number of years. Increasingly, the AMA is also looking to reach out to the broader community. The Youth Run Club and emerging leaders in Health Promotion Grant Program are outstanding examples of our activities in this regard.

system Partnership and leadership refers to the numerous innovations and projects aimed at improving timely access for patients to quality medical care. Much of this involves work with organizations such as AH on key innovations such as primary care network evolution, or the further development of a provincial clinical information system . I would highlight, however, the start this year of the Voice of the Patient project (albertapatients.ca), providing a place for patients to share their concerns and insights. The AMA vision places the patient partnership at the center of the health care system and we will continue to look for ways to engage Albertans.

To support these activities requires a strong and healthy organization. From the work of the RF Governance oversight Group to that of the Committee on Financial Audit, we have worked to follow best practices and ensure we have the resources and capabilities to meet the needs of members.

There are two foundations to our ongoing success.

The first is physicians, our members. I’ve written before that to the AMA, the members are everything: owner; customer; leader; and worker.

The other foundation is the AMA staff. They work hard on behalf of Alberta’s physicians and consistently go the extra mile in carrying out their responsibilities. I feel very proud to be included in their ranks.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

21PRoPoseD non-sUbsTAnTIVe AMenDMenTsTo the Constitution and Bylaws of the Alberta Medical Association

NON-SUBSTANTIVE CHANGES

Proposed wording Present wording

10.12 At any AGM or Special General Meeting of the Association, 27 Members shall constitute a quorum.

34.0 A special Resolution may be passed at a special general meeting where notice has been given at least 21 days in advance specifying the motion, and is approved by at least 75% of those Members present and entitled to vote.

10.12 At any AGM, general meeting or special meeting of the Association, 27 Members present shall constitute a quorum.

34.0 A special Resolution may be passed at a general meeting where notice has been given at least 21 days in advance specifying the motion, and is approved by at least 75% of those Members present and entitled to vote.

37.3 (ii) the procedure for all referenda shall follow the procedures, as a minimum, set out in Article 38, sections 38.1 through 38.20 – Election procedures, herein wherever practical. When interpreting the procedure for referenda pursuant to this section, the term “referenda” shall be substituted for the term.

37.3 (ii) the procedure for all referenda shall follow the procedures, as a minimum, set out in Article 39, sections 39.1 through 39.20 – Election procedures, herein wherever practical. When interpreting the procedure for referenda pursuant to this section, the term “referenda” shall be substituted for the term.

38.20 If any extension of time under Article 38.19 hereof results in the date for counting return ballots being delayed until after the date for assumption of office contemplated by these bylaws, then the retiring officers and Directors shall remain in office until the newly elected officers and Directors assume office on the date that the counting of the ballots is completed and the winners of the election are declared elected.

38.20 If any extension of time under Article 39.19 hereof results in the date for counting return ballots being delayed until after the date for assumption of office contemplated by these bylaws, then the retiring officers and Directors shall remain in office until the newly elected officers and Directors assume office on the date that the counting of the ballots is completed and the winners of the election are declared elected.

32.1 All meetings of the Forum, board and executive of the Association and any general or special meetings of the Association shall be conducted in accordance with the current version of Robert’s Rules of Order.

32.1 All meetings of the Forum, board and executive of the Association and any general or special meetings of the Association shall be conducted in accordance with Procedures for Meetings and Organizations, third edition (Kerr and King).

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

22 noMInATInG CoMMITTeeReport to the Fall 2015 Annual General Meeting

In accordance with the Alberta Medical Association Constitution and bylaws, the nominating Committee nominates candidates for office to be elected by the annual general meeting, to be elected by the Representative Forum, and to be appointed by the board of Directors of the association.

The nominating Committee submits the following nominations for consideration during the annual general meeting:

1. Representatives to CMA General Council 2016

NOTE: The president attends General Council by virtue of the position and is not included in the number of Alberta representatives allowed to attend (28). The nominating Committee recommends that the 2016 CMA General Council representatives be:

• President-elect

• Immediate Past President

• speaker or Deputy speaker

• nine representatives named by the board

• Ten representatives named by the nominating Committee

• Two physician appointees of the CPsA, at least one of whom must be an elected member of the council

• one dean or designate from his office

• one student representative

• one PARA representative

• Alberta representative on CMA Resolutions Committee

2. Speaker and Deputy Speaker 2015-16

a. Speaker: Dr. Fredrykka D. Rinaldi, General Practice, Medicine Hat

b. Deputy Speaker: Dr. susan J. Hutchison, General Practice, edmonton

In accordance with custom, brief profiles for these candidates follow on page 23.

3. Nominating Committee 2015-16

The bylaws require that the annual general meeting elect four (4) members to the nominating Committee. The current elected incumbents are:

• Dr. Graham M.D. Campbell, Diagnostic Radiology, Calgary

• Dr. Arlie J. Fawcett, Psychiatry, Calgary

• Dr. Michal s. Kalisiak, Dermatology, Calgary

• Dr. A. Robert Turner, Internal Medicine, Hematology, Medical oncology, edmonton

The nominating Committee is scheduled to meet Wednesday, november 4. Anyone who is a member of the nominating Committee cannot be the committee’s nominee for the board of Directors. This does not, however, preclude a member of the nominating Committee from being nominated from the floor.

Dr. Brendan J. Bunting – Ponoka

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

23PRoFIlesDr. Fredrykka D. Rinaldi

2014-present Deputy speaker

2012-present Member, Committee on Financial Audit, RF Planning Group, Council of Zonal leaders President, south Zone Medical staff Association section of General Practice member-at-large

2003-present RF delegate

2000-present AMA rep, AMA/CPsA/lsA Joint Medical-legal Committee

2013-14 Member, nominating Committee

2007-13 Member, IM/IT Coordinating Committee and Task Force

2011-12 Joint AMA/CPsA executive

2009-12 Member, executive Committee

2006-12 Member, board of Directors

2004-08 Member, section of General Practice executive

2006-07 Member, nominating Committee

1999-2004 Member, Health Issues Council

2002-03 Member, negotiations 2003 Job Action Group

2001-02 Member, AMA/WCb negotiating Committee

1996-97 RF delegate

2006, 2007, 2008, 2010, 2011, 2012 AMA delegate, CMA General Council

Dr. Susan J. Hutchison

2012-present Member, Representative Forum Planning Group

2010-present, 2004-07 Representative Forum delegate

2014, 2012 AMA delegate, CMA General Council

2013-14, 2010-12, 2005-06 Member, nominating Committee

2013 Member, PCn evolution Working Committee – Governance

2010-13 Member, Toward optimized Practice Review Committee

2009-12 Member-at-large, section of General Practice

2003-04 Member, CMA steering Committee on Primary Care Renewal, CMA sustainability Task Force

1997-2003 Chair, CMA Forum on General and Family Practice

1997-2002 Member, CMA Working Group on Privacy of Health Information

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

24 FInAnCIAl sTATeMenTs Responsibility for the financial statements

The management of the Alberta Medical Association (the Association) is responsible for the integrity and fair presentation of the financial statements.

The Association has developed prudent financial controls that give management reasonable assurance that the assets are safeguarded and reliable financial records are maintained. These controls, which are reviewed by the Committee on Financial Audit, include written policies and procedures, technology controls and an organizational structure that segregates duties.

The Association’s independent auditors, PricewaterhouseCoopers llP, Chartered Accountants, have been appointed to express an opinion as to whether these financial statements present fairly the Association’s financial position and operating results in accordance with Canadian generally accepted accounting principles. Their report follows.

The board of Directors has reviewed and approved these financial statements. To assist the board in meeting its responsibility, it has established the Committee on Financial Audit. The committee meets with management and the independent auditor to review accounting principles and practices, financial controls and audit results.

Michael A. Gormley Cameron n. Plitt Executive Director Chief Financial Officer

Report of the Independent Auditor on the Summary Financial Statements

To the Members of Alberta Medical Association (CMA Alberta Division)

The accompanying summary financial statements, which comprise the summary statement of financial position as at september 30, 2014, the summary statement of operations and net assets and the summary statement of cash flows for the year then ended, and related notes, are derived from the audited consolidated financial statements of Alberta Medical Association (CMA Alberta Division) for the year ended september 30, 2014. We expressed an unmodified audit opinion on those financial statements in our report dated February 6, 2015.

The summary financial statements do not contain all the disclosures required by Canadian accounting standards for not-for-profit organizations. Reading the summary financial statements, therefore, is not a substitute for reading the audited financial statements of Alberta Medical Association.

Management’s responsibility for the summary financial statements

Management is responsible for the preparation of a summary of the audited financial statements on the basis described in note 1.

Auditor’s responsibility

our responsibility is to express an opinion on the summary financial statements based on our procedures, which were conducted in accordance with Canadian Auditing standards (CAs) 810 – engagements to Report on summary Financial statements.

Opinion

In our opinion, the summary financial statements derived from the audited financial statements of Alberta Medical Association (C.M.A. Alberta Division) for the year ended september 30, 2014, are a fair summary of those financial statements, on the basis described in note 1.

PricewaterhouseCoopers llP Chartered Accountants edmonton, Canada

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

25sUMMARY sTATeMenT oF FInAnCIAl PosITIonFor the year ended september 30, 2014

2014 2013

$ $

Assets

Current assets

Cash 3,650,101 8,282,202

Funds held on deposit 1,115,652 711,541

Accounts receivable and prepaid expenses 1,170,832 459,669

Due from administered programs 2,926,090 2,363,180

Due from Alberta Medical Foundation 720 -

Due from AMA Health benefits Trust Fund 107,598 25,952

Portfolio investments (note 3) 8,970,993 11,842,544

Property and equipment (note 4) 26,309,365 24,590,241

7,502,310 6,505,798

42,782,668 42,938,583

Liabilities

Current liabilities

Accounts payable and accrued liabilities 4,714,435 4,022,548

Payable to Canadian Medical Association 806,475 1,117,315

Deferred membership revenue 2,504,226 3,430,650

Deferred leasehold inducements and other 130,469 56,728

8,155,605 8,627,241

Deferred leasehold inducements and other 456,096 -

Employee future benefit obligation (note 5) 2,945,431 2,045,112

11,557,132 10,672,353

Net Assets 31,225,536 32,266,230

42,782,668 42,938,583

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

26 sUMMARY sTATeMenT oF oPeRATIons AnD neT AsseTsFor the year ended september 30, 2014

2014 2013

$ $

Revenue

Members’ dues 13,983,109. 13,415,953

Member levy -. 924,976

Fees and commissions 1,833,041. 1,668,490

Investment income 1,879,908. 1,333,221

other 924,934. 908,165

18,620,992. 18,250,805

Expenditures

Corporate affairs 6,746,881. 5,986,954

executive office 3,185,768. 3,261,070

Health policy and economics 1,969,517. 2,703,981

Committees 2,161,506. 2,474,483

Public affairs 2,015,373. 1,703,655

Professional affairs 951,892. 1,063,085

southern Alberta office 504,019. 610,748

Priority projects 831,713. -

18,366,669. 17,803,976

Actuarial (loss) gain on pension obligation 254,323. 446,829

Realization of insurance experience (note 6) (1,699,128) 3,561,217

Net (expenditures) revenue for the year 404,111. 2,065,201

Net assets – Beginning of year (1,040,694) 6,073,247

Net assets – End of year 32,266,230. 26,192,983

31,225,536. 32,266,230

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

27sUMMARY sTATeMenT oF CAsH FloWsFor the year ended september 30, 2014

2014 2013

$ $

Cash provided by (used in)

Operating activities

net revenue (expenditures) for the year (1,040,694) 6,073,247.

Items not affecting cash 883,136 . 676,732.

Amortization (note 4) (564,363) (356,032)

Gain on portfolio investments 900,319. (4,117,499)

Unfunded actuarial (gain) loss on pension obligation (1,776,090) (4,381,174)

Net change in non-cash working capital items (1,597,692) (2,104,726)

Investing Activities

Additions to property, plant and equipment (1,879,648) (414,342)

Purchase of portfolio investments (2,282,575) (7,365,036)

Proceeds from sale of portfolio investments 1,127,814. 502,152.

(3,034,409) (7,277,226)

Decrease in cash during the year (4,632,101) (9,381,952).

Cash – Beginning of year 8,282,202. 17,664,154 .

Cash – End of year 3,650,101. 8,282,202. .

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

28 noTes To sUMMARIZeD FInAnCIAl sTATeMenTsFor the year ended september 30, 2014

1. Basis of presentation

The summary of financial statements are derived from the audited financial statements, prepared in accordance with Canadian accounting standards for not-for-profit organizations, as at september 30, 2014 and for the year then ended.

The preparation of these summary financial statements requires management to determine the information that needs to be reflected in them so that they are consistent in all material respects with, or represent a fair summary of, the audited statements.

Management prepared these summary financial statements using the following criteria:

• The summary financial statements include a statement for each included in the audited financial statements with the exception of the statement of changes in net assets, as this statement is readily available upon request;

• Information in the summary financial statements agrees with the related information in the audited financial statements;

• Major subtotals, totals and comparative information from the audited financial statements are included; and

• The summary financial statements contain the information from the audited financial statements dealing with matters having a pervasive or otherwise significant effect on the summarized financial statements.

The audited financial statements of the Alberta Medical Association (C.M.A. Alberta Division) are available upon request by contacting the Association.

2. Administered programs

In addition to its principal activities, by agreement between the Alberta Medical Association (C.M.A. Alberta Division) (the Association), and Her Majesty the Queen in Right of Alberta (the government), the Association is the administrator of certain programs. These programs are audited separately and reported to the government. As the Association is an administrator of the programs, the assets, liabilities, revenues and expenses of these programs are not included in these summary financial statements. The costs recovered by the Association to administer these programs have been included in these summary financial statements.

A summary of these programs administered by the Association as at and for the year ended March 31, 2014, which is the most recent fiscal year of the programs, is as follows:

Program Revenue ExpensesNet Change in reserves

$ $ $

benefit Plans 116,152,884 116,152,884 -

Physician locum services 28,689,795 28,689,795 -

electronic Medical Records Completion Project 28,226,184 28,314,494 (88,310)

Alternative Relationship Plan Program Management office 1,800,000 1,800,000 -

Primary Care Initiative Program Management office 3,149,425 3,149,425 -

178,018,288 178,106,598 (88,310)

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

293. Portfolio investments

2014 2013

$ $

emerald Canadian short-Term Investment Fund 18,676,082 17,146,444

emerald U.s. Market Hedged Fund 2,929,090 2,879,329

emerald International equity Fund 2,587,392 2,625,592

emerald Canadian equity Index Fund 1,579,022 1,472,342

emerald Canadian bond Index Fund 537,779 466,534

Total portfolio investments – at quoted market value 26,309,365 24,590,241

Total portfolio investments – at cost 25,284,439 23,967,927

The asset mix for the portfolio investments is determined by management, taking into consideration the purposed of the reserves as prescribed by board policy.

4. Property and equipment

2014

CostAccumulated amortization

Net

$ $ $

land 550,000 - 550,000

building 5,270,000 632,400 4,637,600

Fixtures and improvements 1,397,505 307,277 1,090,228

Computers 3,450,986 2,524,289 926,697

office furniture and equipment 1,175,587 877,802 297,785

11,844,078 4,341,768 7,502,310

2013

CostAccumulated amortization

Net

$ $ $

land 550,000 - 550,000

building 5,270,000 421,680 4,848,320

Fixtures and improvements 2,460,326 2,160,973 299,353

Computers 3,030,915 2,494,236 536,679

office furniture and equipment 1,126,177 854,731 271,446

12,437,418 5,931,620 6,505,798

Amortization for administered programs is recognized in the administered programs. In the current year, amortization was recognized in the capital fund for a total expense of $883,136 (2013 - $676,732).

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

30 5. Pension plan and obligation

The Association sponsored defined benefit pension arrangements which cover substantially all employees. The Association uses actuarial reports prepared by independent actuaries for funding and accounting purposes. The most recent actuarial valuation of the pension plan was performed at December 31, 2012. The next actuarial valuation of the pension plan for funding purposes must be effective no later than December 31, 2015. The following significant actuarial assumptions were employed to determine the periodic pension expense and the accrued benefit obligations.

2014 2013

% %

expected long-term rate of return on plan assets 5.25 5.25

Discount rate 4.10 4.70

Rate of compensation increase 2.75 2.75

Information about the Association’s define benefit pension plan, in aggregate, is as follows:

2014 2013

% %

Fair value of plan assets – end of year 19,794,119. 15,649,200.

Defined benefit obligation 22,739,550. 17,694,312.

Funded status – Plan deficit (2,945,431) (2,045,112)

The Association’s net defined pension plan gain (expense) includes a $418,687 actuarial gain (loss) (2013 - $5,919,160).

6. Reconciliation of carrier experience

The Association maintains a Group Insurance Policy for the benefit of the members and enters into an annual Financial letter of Understanding. It is the intention of the Association that insurance products operate on a break-even basis over the long-term. over the short-term, the Association participates, out of reserves, in experience surpluses and losses as calculated at December 31 of each fiscal year. An experience gain of $404,111 (2013 - $2,065,201) was recognized during the year with $1,115,652 (2013 - $711,541) recorded as funds on deposit.

As a result of the positive experience, the Association has provided premium rate reductions of 15% - 25% for a number of years. The 2014 premium reduction of $2.2 million (2013 - $1.6 million) is funded from the premium reserve.

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

31noTes

2014-15 Repo

Rts to th

e An

nu

Al G

eneR

Al M

eetinG

AlBeRtA

MeD

iCA

l Asso

CiAtio

n

32 noTes

Alberta Medical Association12230 106 Ave nW edmonton Ab T5n 3Z1

T 780.482.2626 Toll-free 1.800.272.9680 F 780.482.5445

E amamail@albertadoctors.orgwww.albertadoctors.org