CALGARY -- Premier Jason Kenney says he has "100 per cent confidence" in his health minister after some Calgary physicians say a lack of trust was one reason they voted to reject a tentative deal with the province and the Alberta NDP called for Tyler Shandro to be fired.

"Being the minister of health is always the toughest job in any provincial government," Kenney told reporters Wednesday.

"We absolutely want to sit down with the medical association and to continue the momentum we had going into this agreement."

The Alberta Medical Association (AMA) said 53 per cent of physicians who voted rejected the tentative agreement with the province.

"The main issues for me were the privatization of healthcare. I think the agreement was allowing for that and I didn't want it to seem we were in agreement with that possibility," said Dr. Christine Gibson, a family physician in Calgary.

"Then the other issues around binding arbitration and that the agreement would set a precedent for other union negotiations in the private sector."

Dr. Gibson said the 'no' vote from doctors wasn't all due to money, though finances is always a factor.

"I would say there has been a lack of trust. There's been some hurtful media comments around the motivation of physicians – primarily that we're economically motivated," she said, "but I know some family physicians who are literally paying to work right now or they're just barely breaking even."

The NDP opposition called on the premier to fire Shandro after the failed vote.

"Tyler Shandro, it's clear, has burnt so much goodwill. He has lost trust with physicians across this province," said David Shepherd, the NDP's health critic.

The tentative agreement was not made public, but the Canadian Press is reporting that the proposal specified that the collective baseline pay for doctors would remain static at about $4.6 billion a year over the four years of the deal.

The AMA said Monday it will first discus with its members about why the deal was voted down before heading back to the negotiating table with the province.