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Doctor shortage in Northwestern Ontario remains severe with no clear relief in sight

Emergency rooms in northwestern Ontario are severely understaffed, and hospital leaders in the region are warning that the risk of emergency room closures could continue into the summer.

Three months ago, the emergency room in Red Lake, Ontario, closed for 24 hours on a weekend because no doctor was available. Officials say a similar situation could unfold elsewhere if no relief is found.

“To be frank, if the health care workers in our region had not continued to work hours that put their personal health at risk and that go far beyond reasonable expectations, many more service closures would have taken place. said Dr. Sara Van Der Loo. , Chairman of the Northwest Regional Chiefs of Staff Council.

Doctors are exhausted from working excessive hours while trying to keep wards open, she said, and the situation is not isolated to any particular hospital.

Emergency room patients across Ontario are waiting record times to be admitted to hospital, a situation that medical professionals say is getting worse.

Ray Racette, CEO of Lake of the Woods District Hospital in Kenora, warns the public of “a very difficult challenge this summer” at the hospital’s emergency department, which faces a 41% vacancy rate for all positions.

“There are heroic efforts — people taking extra shifts and so on, maybe giving up their summer vacations and things of that nature, just to try to keep those services open,” Racette said. . “But it means people can wait longer for service.”

Have you or someone close to you recently endured a long stay in a Northwestern Ontario emergency room? Email CBC News to tell us about your experience.

The Ontario government announced on June 1 the expansion of its temporary COVID-19 summer respite program, which allows hospitals to offer bonuses to help attract temporary replacement staff to wards. rural and northern hospital emergencies.

Dr. Sarah Newbery, associate dean of physician workforce strategy at the Northern Ontario School of Medicine (NOSM), is skeptical of the program’s ability to make a big difference.

“Without the people in the system to do the work, it may not be as successful as I think had been hoped.”

Ray Racette, president and CEO of Lake of the Woods District Hospital in Kenora, Ont., warns of potential service delays this summer due to staffing shortages. (Logan Turner/CBC)

Work on several possible short-term solutions to the doctor shortage that have been proposed by doctors and recruiters themselves have been delayed by the recent provincial election, Newbery said.

Since then, there have been regular conversations about these proposals. They include funding for postgraduate learners to accompany replacements from their institutions who come to serve in the rural north of the province, and providing real-time virtual access to specialists for physicians working alone on wards. rural northern emergency department, which Newbery said would allow more doctors to feel comfortable taking such shifts.

“We are now in a window of time where we need to move quickly to implement many of these initiatives,” she said, adding that she hoped to see progress in July.

The physician recruiter for the Fort Frances and Rainy River area said it still faces obstacles trying to meet supervision requirements for physicians working with restricted licenses, such as international medical graduates seeking to obtain a license in Canada.

In 2015, Todd Hamilton said, he went through the process of bringing a US-trained doctor to the Fort Frances and Rainy River area, and had to arrange for three other local doctors to provide supervision and mentoring as per college requirements – something many small communities don’t have the resources for.

Doctor shortage in Northwestern Ontario remains severe with no clear relief in sight
Dr. Sarah Newbery, associate dean of physician workforce strategy at the University of Northern Ontario School of Medicine, says work on solutions to the shortage of emergency physicians in the Northwest were delayed by provincial elections. (Dr. Sarah Newbery/Twitter)

The College of Physicians and Surgeons of Ontario told CBC News in March that it allows small communities to have a single supervisor or to be supervised remotely by doctors outside the community. Hamilton said he was never told of those options.

However, he said, the region recently responded to interest from a surgeon who was seeking to reinstate his license with the college due to a gap in service, “not his fault.”

The College of Physicians and Surgeons declined the remote supervision option, Hamilton said.

“We spent quite a bit of time on it, so it was a little disappointing for us,” he said.

“You get these lifelines from time to time. And then, as quickly as they’re shown to you, you go through the process, you realize, well, that’s not going to work for us either.”

Doctor shortage in Northwestern Ontario remains severe with no clear relief in sight
Todd Hamilton of the Fort Frances and District Physician Recruitment Retention Committee says he wanted to recruit a physician whose Ontario license had expired but could not meet the supervision requirements of the College of Physicians and Surgeons of Ontario. (Submitted by Todd Hamilton)

Shae Greenfield, spokesperson for the College of Physicians and Surgeons, said it was impossible to discuss a specific case without knowing the name of the doctor in question, which Hamilton said he could not divulge.

“We want to work with people to resolve as many issues as possible within our mandate and within the limits imposed by law and other factors,” Greenfield said.

Racette said he hoped to get help in his emergency this summer from Manitoba doctors vacationing in the area, but delays in getting their Ontario work permits created a hurdle.

“A three-month delay on a license would be seen as, you know, potentially doable. But if we have someone coming in two weeks, maybe it’s coming to their cottage… how do we get that doctor cleared? ” He asked. “Because that might be the advice.”

Hospital chiefs appeal for help

Greenfield denied the college takes three months to process license applications from out-of-province doctors, saying its standard is two to three weeks.

But Dr Sean Moore, chief of staff at Lake of the Woods District Hospital, said that was not his observation.

“A lot of people just said, ‘I would never apply for a license in Ontario. I did that many years ago, and it took so long that I would never see that again.’

Greenfield said delays in processing license applications could be caused by missing documents or incomplete applications.

In Kenora, the hospital’s chief executive, Ray Racette, pleaded with “anyone with the slightest discretion” to use it to help northwest hospitals this summer.

“Everyone has problems,” he said.