The Yukon’s doctors are “surprised and disappointed” by a government promise to overhaul the territory’s health system without proper consultation, according to the Yukon Medical Association (YMA).

Last Thursday, Health Minister Pauline Frost committed to implementing all of the recommendations laid out in an independent review of the Yukon’s health and social services.

“The doctors of Yukon are very concerned about the announcement to accept all 76 recommendations contained in the report without properly consulting first with the YMA,” Dr. Ryan Warshawski, the acting YMA president, said in a statement his morning.

The 207-page Putting People First report, released last May, provides a road map for improving health and social services in the Yukon.

The recommendations include a plan for establishing a network of polyclinics and changing doctors’ payment structures. 

The report envisions that the Yukon’s current system of private doctor’s clinics will be replaced with the polyclinic network, managed by the territorial government.

“Many of these recommendations will have a direct impact on the lives and livelihoods of all Yukoners, not just doctors, and we have not yet had a chance to discuss the implications of the report with the government,” Warshawski said.

The YMA says a joint committee between its organization and the government to review the recommendations was recently established. That committee met a few days before last Thursday’s announcement.

The government’s plan to publicly accept all the recommendations wasn’t communicated at that meeting, the press release said.

The YMA is currently compiling perspectives on the report from the Yukon’s doctors.

“We have been consulting with our members and preparing a detailed critique of the expert panel report and its recommendations as it relates to health care which we had planned to share with the government as a basis for future discussions,” Warshawski said.

The YMA will still present this analysis to the government. 

Katharine Smart, the YMA’s president, told the Star last May she envisioned doctors gradually transitioning into new ways of practice as the report’s recommendations were implemented.

She noted that some doctors would likely be on board with the changes, while others prefer traditional methods.

The change in payment structure, for example, would signify a major change for Yukon doctors.

In the current system, doctors are paid according to how many clients they see every day. 

The Putting People First report noted that some Yukoners feel rushed through doctor’s appointments. The change in payment structure was recommended as a possible fix for that problem.

Smart said alternative payment structures could pay physicians an hourly or daily rate, relaxing the desire to see as many clients in one day as possible.

Smart said last May that doctors needed to be at the discussion table before the recommendations could be implemented.

“There’s a recommended shift here…. What does that mean for physicians, what is the impact on individual doctors, how does that get taken into consideration moving forward?” Smart said.

“There is still a lot of work to be done in defining those relationships, looking at the impact, figuring out how and who we all move forward together.”

Today’s YMA release called Frost’s acceptance of the recommendations “pre-emptive” and urged the government to undertake better consultation.

“The YMA notes that it has a longstanding positive relationship with the Yukon government but that this can only be maintained if there is trust and open communications between both sides,” the press release stated.

The YMA says it’s committed to helping implement the recommendations with the best interests of patients, families and caregivers in mind.

“Experiences elsewhere in Canada have demonstrated that effective primary care reform – the core element of the expert panel proposals – is only achieved if the medical association and frontline physicians are closely involved in the process,” Warshawski said.

The Putting People First report’s recommendations also include:

• the creation of Wellness Yukon, a broad-sweeping organization delivering services and managing Yukon’s hospitals; 

• increasing the use of virtual care; 

• doubling the medical travel subsidy;

• expanding vaccine programming; 

• enhancing First Nations programming; and

• providing fully-funded early childhood education.

Frost said Thursday that some of the recommendations, like early childhood learning, doubling the travel subsidy, implementing 1Health and expanding the vaccine program are already underway.

The larger systemic shifts, like the polyclinic and establishment of Wellness Yukon, will take more time, Frost said, though she called the establishment of the polyclinics a priority for her department.