Balancing Incentives Between Locum and Community-Based Physicians & Other Healthcare Workers to Support Family Practice
IT IS THEREFORE RESOLVED THAT Alberta Municipalities advocate to the Government of Alberta to review and amend physician and other healthcare worker incentive frameworks to reduce disparities between locum and community-based physicians and other healthcare workers.
FURTHER BE IT RESOLVED THAT Alberta Municipalities advocate to the Government of Alberta to support community-based family physician practice in rural and underserved communities, to strengthen continuity of care and ensure stable access to primary health services for all Albertans.
WHEREAS timely and reliable access to primary health care is essential to the health, safety, and well‑being of all Albertans, and the absence of stable primary care contributes to increased emergency department use and poorer health outcomes;
WHEREAS Alberta’s healthcare workforce includes both locum and community-based physicians and other healthcare workers, with locums providing important short-term coverage but not intended to replace ongoing, continuous primary care;
WHEREAS locum physicians are provided with flexible, short‑term practice opportunities without long‑term service commitments, while community-based physicians provide ongoing clinical services, manage administrative responsibilities and maintain continuity of care, creating differences that can discourage permanent community-based practice;
WHEREAS municipalities across Alberta, particularly in rural and remote regions, continue to face challenges recruiting and retaining committed family physicians and other healthcare workers, resulting in service disruptions, clinic instability and increased reliance on locum coverage;
WHEREAS ongoing recruitment and retention challenges increasingly require municipalities to divert limited local resources to physician attraction and retention initiatives; and
WHEREAS strengthening incentives for physicians and other healthcare workers willing to commit to rural residents could increase attraction and retention, therefore supporting workforce stability, continuity of care and the long-term sustainability of local health systems.
- Alberta Medical Association, AB’s Family Medicine Crisis
- Alberta Municipalities, Attraction and Retention Strategy for Rural Health Care Professionals (2024)
BACKGROUND:
Access to stable primary health care is fundamental to the health, safety, and economic sustainability of Alberta communities. Family physicians provide longitudinal care that supports prevention, chronic disease management, and appropriate use of emergency and acute care services. When residents are unable to access a regular family physician, pressures shift to emergency departments and neighbouring communities, increasing system strain and undermining public confidence in essential services.
Alberta’s healthcare workforce includes both locum and community-based physicians and other healthcare workers, each serving an important role. Locum healthcare workers provide critical short‑term coverage during periods of absence or transition. However, locum practice is designed to be temporary and does not require long‑term patient attachment, clinic management responsibilities, or sustained community presence. In contrast, permanent, community-based physicians provide ongoing clinical care, maintain long‑term patient relationships, oversee administrative responsibilities, and ensure clinic continuity. These roles support continuity of care and health system stability, but they also involve greater workload, risk and long-term commitment.
Current incentive structures can unintentionally make short-term locum practice more attractive by offering flexibility without equivalent incentives for sustained community-based practice. Evidence suggests that comprehensive, community-based care is increasingly perceived as unrewarded and unsustainable and further suggests that without a course correction, we risk creating a healthcare system in which continuity is the exception rather than the norm. Alberta municipalities continue to report clinic instability, reduced hours of service, periodic closures, and increased dependence on episodic locum coverage. In some regions, shortages in one community place additional strain on neighbouring municipalities’ health services and emergency departments.
The Government of Alberta has invested in physician recruitment, training and compensation, including more than $7 billion in the 2026–27 budget. The province has also offered the Rural and Remote Family Medicine Resident Physician Bursary, which is now fully allocated. However, the bursary was not limited to permanent, community-based practice; recipients could commit to a single community, move between communities or practise as locums in eligible communities.
Incentives for physicians and other healthcare workers fall under provincial jurisdiction as part of health service delivery. However, municipalities are increasingly compelled to respond to local physician shortages. Across Alberta, smaller and more remote communities are increasingly offering municipally funded subsidies and incentives for physicians. These expenditures place pressure on local budgets and property taxpayers, divert resources from core municipal responsibilities, and result in misaligned incentives between municipalities to attract and retain permanent, community-based physicians.
To keep incentives fair and sustainable, Alberta should review and amend physician and other healthcare worker incentive frameworks to reduce disparities between locum and community-based physicians. Where locum physicians receive benefits including no overheads paid for weekend coverage, travel honoraria, and accommodations, community-based physicians could be incentivized by general reduced overhead costs, and relocation and accommodation subsidies. Additionally, the Canadian Academy of Health Sciences suggests that financial incentives could be part of a larger, comprehensive strategy to improve the attractiveness of rural practice settings.
Addressing these disparities aligns with provincial objectives to strengthen primary care, improve patient attachment, and reduce avoidable pressure on emergency services. It also aligns with Alberta Municipalities’ strategic priorities related to community well‑being, sustainable service delivery, and appropriate alignment of responsibilities between orders of government.
- Alberta Medical Association, Information for Locum Physicians
- Okpalauwaekwe et al. BMC Primary Care, To stay or leave: an integrative review of factors, personas, and recommendations for retaining family physicians in Canada
- CBC, Hinton ER doctor shortage puts strain on region, local leaders say
- CTV, Alberta government announces $7.7B investment into physician recruitment in 2026-27 budget
- Rural and Remote Family Medicine Resident Physician Bursary, Rural and Remote Family Medicine Resident Physician Bursary
- Alberta Municipalities, ABmunis in the News: Q3, 2024,
- Alberta Medical Association, Information for Locum Physicians
- Canadian Academy of Health Sciences, Canada's Health Workforce: Pathways Forward
ABmunis is preparing correspondence to the appropriate ministry.