I'm a numbers guy, so let's talk numbers. Specifically, let's use CIHI data to look at why it is so absurd to compare physician compensations across provinces which have massively different non-physician staff wages and overhead operating costs. (thread)

#abhealth #ableg https://twitter.com/SteveBuick2/status/1252846821447069697

The CIHI doesn't directly report operating costs such as hiring staff e.g. technologists, nurses, NPs, physiotherapists, receptionists, janitors in an outpatient setting. These are a big part of overhead costs. However, we can get insight into using the CSHS...

CIHI's Cost of a Standard Hospital Stay (CSHS), is a hospital’s total patient expenses divided by the number of hospitalizations. Important note: that this cost EXCLUDES physician compensation. i.e. CSHS measures non-physician staff salaries (71%), drugs, medical supplies (<10%).

Take a look. In Alberta the CSHS is a whopping $1846 higher than the Canadian average, and $2523 higher than Ontario. To reiterate, this difference has nothing to do with how much we are paying doctors, and everything to do with much higher cost of healthcare delivery in Alberta.

So what factors influence CSHS?

CIHI is very clear on this. CSHS is outside of a hospital's control, just as much of the cost of running a clinic is out of a doc's control. CIHI cites wage differences as a key factor that should be considered when comparing provinces.

One might ask, could the massive differences in CSHS in Alberta versus other places be due to administrative inefficiencies? CIHI tells us it is the opposite. In fact, Alberta is a national leader, with far lower percentage of healthcare costs going into administration expenses.

All of this reinforces the fact that the higher spending on healthcare in Alberta is a direct result of so much that is out of physicians' and administrators' control, and is simply a reflection of much higher costs of capital, infrastructure, hiring staff, medical supplies, etc.

The UCP of course love to take the doctored McKinnon report as gospel. They repeat ad nauseam that Albertan physicians are the highest billing in Canada, while completely ignoring that Alberta physicians have to pay the most overhead because of higher wages and operating costs.

The McKinnon report also slandered the decades of innovation that went into building Alberta's world-class healthcare system, with it's myopic focus on comparing operating costs between provinces, and falsely concluding that Albertans are not getting value for their tax money.

And that my dear Albertans, has been the entire justification the UCP has relied on to decimate Alberta's physicians' fees, triggering mass resignations and exodus out of the province.

P.S. As an incidental side note, I have perused the Ernst and Young report on AHS performance, and I did not find a single citation related to CIHI's CSHS data. If anyone can find it, let me know, because this would be a glaring omission in a report we paid $2 million for.

Addendum: putting these CIHI numbers into percentages, Alberta pays about 46% more than Ontario, 22% more than BC, and 30% more than the Canadian average in non-physician wages. But we already knows this, everything costs higher in Alberta. AB ≠ ON, BC . https://twitter.com/DrAmirPakdel/status/1253435476293283840?s=20