Calgary doctors say health region contract muzzles them

Some Calgary physicians say they're being gagged by the health region and told that they cannot speak to the media, CBC News has learned.

A specialist spoke out earlier this month about the Calgary Health Region's funding freeze. After he was interviewed by CBC Radio, the doctor, who now requests that his name be withheld, said he was forbidden by health region officials from speaking further.

Family physician Dr. John Fernandes called that appalling, because he believes doctors are ultimately responsible to their patients.

"I think it's absolutely wrong and reprehensible," he said. "He should be encouraged to speak out."

Other doctors have told CBC News they feel threatened if they speak out on issues affecting their patients and their workload. One surgeon described his contract with the health region as essentially a gag order.

"There may eventually be no one to complain and stand up for our patients," he said.

Health minister has not received complaints

The physicians have signed a special contract with the region, province and Alberta Medical Association, called an alternative relationship plan (ARP), which is an alternative to the fee-for-service payment plan.

'You tell me who it is. You tell me what they're not allowed to speak on and then I'll comment on it.' —Ron Liepert, Alberta health minister

The agreements guarantee a steady income for specialists who want to do research as well as treat patients, while fee-for-service practices compensate doctors per treatment or patient visit.

But Don Stewart, a CHR spokesman, insists the region's doctors are free to talk to whoever they want. He said patient confidentiality is the only thing that would ever limit a doctor's ability to speak to the press.

Alberta Health Minister Ron Liepert said he hasn't heard of the complaints.

"You tell me who it is. You tell me what they're not allowed to speak on and then I'll comment on it," he said. "I'm not commenting on a whole bunch of 'what ifs' that are out there."

Juliet Guichon, a medical ethicist and lawyer, said the ARP is a legal contract that doctors are bound to — but should not have signed because they're ultimately responsible to their patients.

"If you have an ethical duty to speak out in the interests of patients, and you are limiting yourself by contract, then you are not able to carry out your ethical duty," she said.

Doctor chooses to opt out

Dr. Michael Giuffre, a pediatric cardiologist, said he opted out of signing an ARP contract because he believes it takes away a physician's autonomy.

"It is a form of censorship, but I think they have to fulfill their contract first of all and if it's there that they cannot do that, then they shouldn't do that," he said.

"I felt that through my practice of 20 years, I enjoyed that autonomy. I enjoyed being in control of my life and I didn't want to hand that over to a health authority, so for me, it's important."

"There has been balance problems in terms of making it so that the region has fair representation as well as the physicians," said Giuffre. "There are, I think, 2,200 physicians within the Calgary Health Region alone, so I think it's their way of trying to keep some type of control."