A patient is brought into South Okanagan General Hospital from an ambulance on a stretcher in this file photo. The hospital is temporarily limiting some services in the emergency department between 11 p.m. and 7 a.m. in January in non-urgent cases due to a staffing shortage. (Lyonel Doherty photo)
A shortage of available doctors forced the South Okanagan General Hospital to briefly shutter its emergency room doors late last month, but local doctors say staffing at the ER has been an ongoing problem for years.
During overnight hours the evening of April 23 and 24, the hospital closed its ER, due to what an official release called “limited physician availability” at the hospital.
The closure came on the heels of a temporary “change in service levels” earlier this year, when ER patients had to be assessed by a nurse between 11 p.m. and 7 a.m. for most of the month of January.
Dr. Jaco Bellingan is a physician who has an office at the Osoyoos Medical Clinic, but he also works in the ER at SOGH.
He says staffing levels at the ER are “not a new problem.”
For the last two years, local doctors have been struggling to fill all the shifts at the ER, often dealing with last-minute scrambles to get shifts covered and working double shifts, before returning to their private practices to see patients, he said.
“We cannot expect physicians to work double shifts and then have to go to their clinics to continue working – this is simply not safe,” he wrote in an email May 2.
Dr. Curtis Bell is the executive medical director of primary and residential care with Interior Health.
He explained that the recent gaps in coverage at the Oliver ER are a result of a dwindling number of physicians “who are capable or willing to work in the ER.”
He explained that physicians who work in the emergency room are not Interior Health employees.
They all have private practices, and sign up for shifts when they are available.
The ER generally operates two shifts for physicians each day – a 10-hour day shift and a 14-hour night shift, for a total of 14 shifts a week.
Until recently, there were approximately six doctors available in the community, who needed to split those shifts up among themselves.
Bell pointed out it only takes some basic math to illuminate the problem.
When there are more than two shifts a week per doctor – and when one is sick or away – that rate increases significantly, and closures can happen.
Bell said Interior Health tries hard to ensure an ER can always keep its regular hours, but because the doctors aren’t employed by his agency, there’s only so much pressure they can put on them.
“We’re sort of caught in this in between kind of thing, where we really have physicians who do have a lot of personal choice. We really can’t mandate that they have to do it.”
According to Bellingan, the problem isn’t just that doctors are being asked to cover the ER outside their regular practice.
He said there is an “imbalance in remuneration” from Interior Health for working ER shifts that acts as a disincentive for doctors to step up.
“You may find it hard to believe, but for me (and my colleagues) working in the Oliver ER, we basically get penalized financially. We all have clinics to run and the time spent in ER does not make up for the clinic hours lost,” he wrote in an email.
“Doing ER medicine in our community (a much busier ER than similar sized towns due to the large amount of snowbirds and holiday goers) is stressful, you are the only physician in the ER and you have to make life and death decisions. Compare that to a typical day in the clinic where patients are booked, you get time to have lunch, etc. it is obviously less stressful.”
“I know it is not all about income, but with the way medicine has evolved to more and more sub-specialties, it takes real passion and a sense of commitment from our local ER doctors (e.g. during the recent closure, we still had a physician sleeping in the hospital, without any pay), to work in this busy, stressful environment during all hours of the day and night and then basically get financially penalized for it.”
Bellingan said the first step to attracting more doctors to the area is fixing this imbalance.
Bell said it’s “not particularly difficult” for Interior Health to attract physicians to the area, because of the lifestyle options available.
He said the organization has been “aggressively recruiting” new doctors and pointed out that two new doctors will have set up shop in the area shortly.
One has just recently arrived, he said.
In the meantime, he said, Interior Health has “been meeting as a leadership group with physicians to talk about options that might be available to us.”
Interior Health will continue to try to recruit new doctors to this area, he said.
TREVOR NICHOLS
Regional Reporter
