E.R. 'at the verge of crisis'

Photo: Contributed

Emergency room doctors from the South Okanagan General Hospital stood before Oliver town council Monday warning that unless something changes in the way they are compensated, they may be forced to close the department. 

Currently, the E.R. is staffed by seven doctors, plus two on contract and then fillers from out of town. 

"We rely heavily on the out of town physicians to fill our schedule," said Dr. Jacob Bellingan. Unfortunately, he said, it's hard to attract those doctors, since compensation in the E.R. is per patient, rather than by the hour.

He explained that's because the population the hospital serves has a uniquely high number of patients that take more time to treat, double the national average of what's called "end of life" patients and those with chronic diseases.

"The E.R. is always at the verge of crisis," said Bellingan, between struggling to recruit new doctors as well as retain the existing one, forcing long hours and last-minute shift extensions. 

The doctors had a series of meetings with Interior Health back in 2017 discussing the possibility of moving to a payment plan that would see them compensated per hour, rather than per patient. In January they submitted an official application, but in April, learned it had been shot down. 

"Soon after, we started seeing the consequences," said Bellingan, pointing out that they lost one of their contract physicians and several more started pulling back the hours they worked the E.R. in favour of their private practices. 

The group pointed out that the largest issue facing them is the fact that nobody seems to want to take responsibility for the problem. 

"If you ask Interior Health they will say it's the doctors, the doctors will say it's Interior Health or the Ministry, the Ministry will say it's someone else," said Dr. Peter Entwistle. "We few physicians, seven of us, unelected, are being given the option of stepping back and closing emergency. When it closes, it won't open again."

The beleaguered unit has already seen intermittent closures due to being short staffed this year. 

"As elected councillors and mayor, you need to be stepping up and saying whose responsibility is it to provide emergency services," Entwistle said. "It's frankly disingenuous of Interior Health to suggest they have no plans for closure, they don't have plans, they're waiting for it to close, they're expecting it to close."

The doctors made the argument that they are currently sacrificing a lot of quality of life in order to fight what they see as a fruitless battle to keep the emergency department doors open. 

"If you think of the compensation for it, if you work 8 to 5, Monday to Friday in your office, compared to a doctor that does a lot of E.R. shifts, the guy that works 8 to 5 has the better lifestyle, and he financially comes out better than the person doing E.R. shifts," Bellingan said. 

Council thanked the doctors for the presentation, and discussed reaching out to Osoyoos town council to partner up in lobbying Interior Health and the Ministry of Health for action. The doctors will be presenting to Osoyoos town council in December. 

The current E.R. schedule is in place through March, and it is unclear what will happen after that.