An urgent communique signed by 11 doctors on behalf of the Lady Minto Hospital Medical Staff Association was sent to the Driftwood on Friday, May 19 — the most specific characterization of Salt Spring’s physician staffing crisis yet made public.
The full text is below.
Physician Shortage
• Lady Minto Hospital Emergency Department
• Specialties – Maternal Care and Psychiatry
The purpose of this communique is to advise our community of the physician staffing crisis that is impacting our community.
Emergency
1. There is a severe staffing shortage of physicians covering emergency room shifts at the Lady Minto Hospital. The current situation is there are twenty-five 12-hour shifts that are not covered for the period up until the end of August.
2. The Lady Minto Hospital Emergency Department has activated the diversion protocol which leaves the community at times without an on-site physician, like other rural communities on Vancouver Island. However, the situation on Salt Spring Island is unique as there is no opportunity for an ambulance or patients to drive down the highway to the next emergency department or urgent care centre. The medical staff would like to emphasize that the emergency department remains open 24/7 for medical assessments.
3. The staffing shortage and emergency department diversion is expected to continue through the summer and onward. There is significant risk associated with this as many medical problems cannot be managed by phone. Transportation off-island can be complex and may delay care even when the transport request is at the highest level. All Salt Spring Island Medical Staff emergency physicians feel an ethical obligation to provide care in these emergency scenarios despite an ever-depleting number of practitioners. They risk burnout attempting to provide 24/7 emergency care and inpatient care whilst continuing to run their own family practices. Unfortunately, the emergency department is as busy as ever due to the very high number of unattached patients that have no family doctor and the increasing medical complexity of the aging population of Salt Spring Island.
4. Medical staff continue to work with Island Health on solutions to this physician shortage. Unfortunately, it remains difficult to recruit emergency physicians who do not reside on Salt Spring Island. The medical staff is also actively involved in recruitment and retention efforts for more primary care physicians and a primary care network that will then alleviate the burden placed on the emergency department.
Specialties
1. Salt Spring Island midwifery services remain on diversion for births on Salt Spring Island due to a shortage of maternal care nurses and funding for these important staff. There is ongoing communication with Island Health to attempt to alleviate this issue.
2. A lack of any local psychiatrists remains a huge issue for those suffering from mental health issues on Salt Spring Island, particularly regarding the provision of longitudinal care. This in turn places a greater burden on the emergency department. The Medical Staff Association continues to be actively engaged in the recruitment effort here in partnership with Island Health.
The Lady Minto Hospital Medical Staff Association are bringing this to your attention to solicit your support. The emergency department physician coverage crisis will continue to impact our community over the summer months. The absence of key specialty staff on Salt Spring Island is negatively impacting patient care and our community. Your support and public knowledge are needed to work through this crisis and come together with solutions.
Medical Staff Association
Dr. Peter Verheul, Medical Staff Association President
Dr. Kesh Smith, Medical Staff Association Vice-President
Dr. Stephane Voyer, Medical Staff Association Treasurer
Dr. Christopher Applewhaite, Chief of Staff
Dr. Holly Slakov
Dr. David Beaver
Dr. Deborah vanVliet
Dr. Manya Sadouski
Dr. Paula Ryan
Dr. Clare Rustad
Dr. Ron Reznick
Thank you for sharing publicly. What can we as a community and individuals do to help?
Are we witnessing a new phenomenon, or is this simply the result of a longstanding systemic problem?
Perhaps we are not going to solve this until there is a deeper understanding as to what is actually going on here.
The crisis, as outlined, concerns the intersection of two issues. One is the general shortage of qualified workers across numerous fields on this island. In that sense, what is happening at Lady Minto might be similar to what is happening at BC ferries for example, where it is no longer uncommon for sailings to be cancelled for lack of staff. Everyone can see that something has changed, but do we really understand what lies at the root of it?
The other issue is the acute shortage of doctors and nurses in this country as a whole. This problem seems to plague virtually every jurisdiction in Canada. Either the problem is worse than it has ever been, or it just feels that way because the media is focusing more attention on the issue than it has in the past.
What about other countries? Is this happening anywhere else?
These are strange times. Perhaps we are having difficulty coping with specific challenges because the big picture eludes us.
One physician we know, who is currently doing his family practice residency (UBC Kelowna), sought to do a rural practice rotation on Salt Spring this fall. We invited him to stay with us, knowing how finding housing can be a challenge. Surprisingly he was turned down, with an indication that there was already one resident and a second could not be accommodated.
We used to live in Windsor, Ontario that had a terrible doctor shortage in the 1990’s. The problem was effectively solved by opening Windsor as a satellite teaching centre. Lesson learned: the more doctors that train in a place , stay in the place.
We need to look at facilitating more training on Salt Spring as part of a long term solution.
if every driver commits to driving much more carefully and less often, this will help us all.
What support can we offer?