As Salt Spring physicians speak up to warn islanders of the severity of the medical professional shortage, the health authority has admitted plans to prioritize having doctors at Lady Minto when the hospital is busiest, and that patients could expect “an alternative model of care” in the emergency department at other times.
For months, patients have reported arriving at Lady Minto Hospital some weekend nights to find a sign on the door — or warnings from staff — asking islanders to triage themselves or call 811 to evaluate whether their condition required immediate care; patients with non-urgent concerns were advised to return in the morning “when staffing levels improve.”
Island Health officials told the Driftwood early this year those warnings were the result of an “unforeseen short notice limited staff ability,” emphasizing that patients were still assessed and treated. But now, as a letter from the Lady Minto Hospital Medical Staff Association (LMHMSA) warns there are hundreds of hours scheduled this summer with no physician in the emergency department, the health authority revealed it has been using a shortage protocol since March.
When an in-person doctor isn’t available overnight, according to Island Health, plans call for an off-site physician to support the emergency department care team remotely.
“This model of care has been successfully used on four occasions this spring,” said Island Health in a statement. “The emergency department continues to triage and provide emergency care to those who need it.”
The communique from LMHMSA offered the community its first quantitative information regarding the local doctor shortage, and was an extraordinary move from the typically quiet association; indeed, medical professionals within Island Health generally are compelled to refer press questions to the health authority’s public relations staff, declining individual comment.
According to the letter, signed by nearly a dozen hospital physicians and published on page 7 of this week’s paper, there are currently 25 12-hour shifts in the emergency department without an assigned doctor between now and the end of August — and while patients elsewhere in B.C. might be able to simply head to another hospital, a diversion protocol on Salt Spring presents unique challenges.
“There is significant risk,” read the LMHMSA letter. “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.”
LMHMSA’s missive also warned of follow-on effects that would result from other unfilled staffing slots — such as the diversion of midwifery services due to the shortage of maternal care nurses, and the lack of a local psychiatrist to provide “longitudinal care” for mental health on Salt Spring. These shortages, combined with the burden Lady Minto already carries stemming from the large number of islanders without a family doctor seeking care — as well as the “increasing medical complexity” inherent in Salt Spring’s aging population — leave doctors scrambling to fill the gaps.
Staff feel an ethical obligation to provide care, LMHMSA said — and are at ever-increasing risk of burnout trying to do so.
Meanwhile, Island Health said it remained committed to addressing staffing challenges, revealing recruitment efforts over the winter had led to 17 new nursing hires since January, and that a new physician was expected to join in July. Recent communications from the Lady Minto Hospital Foundation (LMHF) have referenced more than 40 vacant staff positions unfilled at the hospital, including medical and support positions.
Several analyses have found limited housing choices to be one contributing factor in worker shortages across Salt Spring Island; Island Health specifically thanked LMHF for its continuing work “to build dedicated health-care worker housing and make Salt Spring Island an even more attractive place to live and work in health care.”
LMHF’s recent efforts to re-purpose a motel it purchased for hospital staff housing have however stalled for over a year. As legal challenges surrounding the former Seabreeze Inne drag on, a request for an injunction was sought in April that, if granted, would require people still living there to vacate while the merits of their cases were adjudicated. That application was heard last week, and awaits a judge’s decision.
LMHMSA emphasized its letter was intended to solicit the community’s “support and public knowledge,” saying both were needed “to work through this crisis and come together with solutions.”
Salt Spring’s residents responded to the communique with concern and alarm; a press release from the Copper Kettle Community Partnership announced a call for volunteers and community organizations to support petitions, public gatherings — and even parades — to further alert islanders to the depth of the crisis and spur action.
“The time for planning committees is now past,” said spokesperson Marsha Goldberg. “It is time to act. Our political system needs to evolve from a culture of ‘no’ to one that is open to environmentally sound new builds not dependent on existing waterworks or provincial mandates.”
The Copper Kettle invites inquiries about how to help at 250-537-1027.
