Saskatchewan amalgamated its 12 regional health authorities into one service in 2017, and the province says it is continuing to work to improve the system.

Members of the Saskatchewan Medical Association shared their opinions at the 2018 Fall Representative Assembly (RA) of the SMA on Friday. The SMA says there are no concerns with the process right now.

"It’s taking some time to fill the next level of leadership positions but we know they are getting there,” SMA president Dr. Siva Karunakaran said.

The SMA has doctors in leadership positions with the Saskatchewan Health Authority, and more roles like department and division leads still need to be filled.

"The secret is for high performing health care systems, there isn't a high performing healthcare system in the world that doesn't have physicians at the helm,” Saskatchewan Health Authority CEO Scott Livingstone said.

The SHA says it is also working to find ways to keep doctors healthy and avoid burning them out. But those watching the amalgamation worry whether local areas can still voice their opinion.

"As we see the SHA develop, are they actually finding space for northern communities, rural communities to have their needs heard?" NDP leader Ryan Meili said.

The meeting on Friday included a presentation from the CEO of Alberta Health Services.

"Most of us would say that we would never want to go back to a decentralized motto,” Alberta Health Services CEO Dr. Verna Yiu said during her presentation.

Almost 10 years ago Alberta amalgamated its medical care into the Alberta Health Service.

"Provincially we've done exceptionally well. We're in the top 100 employers. We've done incredible clinical best practices across the province. So no matter where you live in Alberta you can expect to receive the same type of quality care," Yiu said.

"Alberta has emerged as a leader in healthcare among the provinces. I've been attending the national physician health conference over the last year and a half or so and saw different provinces come and make presentations. And it's very clear anyone paying attention that they are leaders now," Karunakaran said.

Dr. Yiu says Saskatchewan has been more successful in some aspects of amalgamation. Alberta took a more rushed approach, while Saskatchewan took the time to roll out the new system in an organized fashion.

"I think they’ve done a great job. So, just to continue that dialogue is what I would suggest,” Dr. Yiu said.

Saskatchewan physicians say the amalgamation is working. They are still looking for a couple more changes, like a provincial electronic health record. It’s something the Saskatchewan health authority says it is busy working on.