Dr. Paul Magnuson, chief of staff at Cariboo Memorial Hospital, said everyone is working to find solutions after two more emergency room (ER) physicians resigned last month.
This is just one more blow to an already short-staffed department, which has been experiencing a number of staffing challenges in recent years, with no end yet in sight.
The department will now be down to two and a half staff physicians where Interior Health (IH) has allocated for eight or nine to consider it fully staffed.
Magnuson said he does still hope the physicians leaving might remain in the community and support the department.
“I can honestly tell you my emerg team are an unbelievable group of individuals and physicians,” said Magnuson. “I love them dearly, care for them, want them to thrive, want them to go to work, be happy at work. I say the same thing about the nurses.”
He said Interior Health (IH) is working with other organizations and local government to try and find solutions. A Collaborative Services Committee is meeting once a month to work on strategies to address the healthcare shortages in our community and includes Divisions of Family Practice, Doctors of BC, the Emergency Network, First Nations Health Authority, Emergency Health Services, and more.
“Right now, more than ever before, we’re all on the same page,” said Magnuson, noting IH has been reaching out to local government as well.
While he said the resignations are “multi-factorial” and they are conducting exit interviews, the most recent resignations did come shortly after staff physicians learned of pay inequity between local and visiting short-term locum physicians.
Staff had already been dealing with the loss of an ER doctor last year, combined with a shortage of other key roles which support emergency room physicians like internal medicine specialists and respiratory therapists. ER physician Dr. Gisele Adam left the department last year after her husband CMH surgeon Dr. Dan Brosseuk resigned. The two have since relocated to Nelson where Adam now works in the ER there.
In a continued effort to attract locums and staff to the emergency department to fill holes in the schedule, IH was offering a significant bonus, in excess of what staff physicians would be earning on the same shift.
Magnuson said he understands those bonuses could be very frustrating, given all his team has given over the past few years as their department struggled to keep up with high volumes during Covid and as a result of a lack of primary care in the community with an estimated 8,000 patients currently with no family physician.
Over Christmas, when locums were not able to make their shifts due to weather-related travel issues, local staff physicians put aside their holiday plans to cover those shifts.
“My beleaguered team stepped up to the plate yet again,” said Magnuson.
He said he recognizes the message of how much the staff is appreciated has not been getting through.
“I can tell everybody how much people care … but if you’re on the front line and you don’t see change happening and in the meantime you feel like there’s attrition happening, then it’s very difficult,” explained Magnuson.
IH have now offered matching incentives for staff physicians to pick up any additional shifts in order alleviate this disparity until a better answer can be found.
Magnuson thinks a key part of the solution will be shoring up long term incentives for the group that is located here.
The problems at CMH also go beyond emergency room physicians.
Some nurses have also left, and the hospital has a shortage of other support staff for emergency physicians to rely on, including a pending shortage in maternity. Two maternity physicians are scheduled to retire this year.
The maternity department has experienced a previous closure. In February 2019, maternity was shut down due to “critical maternity nurse” shortages but was able to reopen for low-risk deliveries in April 2019.
A lack of family physicians and walk-in clinics in the community further exacerbates the issue, as many patients must rely on the emergency room for basic non-urgent care, in an area with vulnerable populations.
“I think the message right now is being heard loud and clear that our site is challenging,” said Magnuson.
The CMH emergency department sees around 60 to 90 patients a day, which is similar to larger population centres like Salmon Arm.
He said there is a possibility for some changes to local health care delivery models and they are looking at how to support younger physicians coming into the workforce who may have different expectations in terms of a work-life balance.
Magnuson, who moved to Williams Lake as a young physician, said while the situation is challenging, he knows the Cariboo is also very resilient.