With the loss of five of Cariboo Memorial Hospital’s emergency room physicians in the last year it’s been a struggle for the existing physicians to carry on the burden of maintaining the 24-hour service and, in many cases, continue with their own practices in the community.
“Basically Williams Lake doctors have been working really hard to keep that emergency room open,” confirmed Dr. Jon Slater, Interior Health Authority senior medical director for acute services west.
But he says the situation may soon improve.
The Interior Health Authority is attempting to recruit new doctors to work full-time in the emergency room. In addition, IHA will require physicians — sponsored by the IHA — who come to Canada from abroad have emergency room skills and commit to work some shifts in CMH’s ER.
“We have identified Williams Lake and the emergency room in Williams Lake as an area of need so before we as a health authority will sponsor them we tell them that they have to commit to working in the emergency room,” Slater says. However, a shortage of physicians to fill the emergency shift rotation is not the only challenge. ER physician remuneration — particularly between the hours of midnight and 8 a.m. — has also been a concern. Typically, Slater says, physicians are paid a fee for service for each patient they see; however, because there are far fewer patients in the late evening and early morning hours it has made staffing those shifts in the ER department a challenge. To ameliorate the situation the physicians have submitted a proposal for an alternate payment plan that will see physicians working those shifts receive a prescribed rate regardless of how many patients they see. An answer to that proposal is expected from the Ministry of Health shortly; if it’s approved Slater thinks it will further improve the situation. He says it can be tough for physicians to balance their workloads and downtime.
“The group (ER physicians) has been doing work finding out what will work for everyone. It’s hard work and the family physicians have to balance off their office and they have to look at what they can reasonably do,” he says, adding it’s also important for physicians to spend time with their families.