Healthcare woes are an all too familiar reality for rural British Columbians, with residents of many small towns growing accustomed to hearing that their local hospitals are struggling to keep up with the needs of the community.In recent months, however, things have taken a turn for the worse as emergency departments across the province announce temporary interruptions due to a shortage of physicians. Impacted hospitals have largely relied on emergency-trained nurses, or simply turned patients away and directed them to medical facilities in larger communities elsewhere.Such interruptions have increased in both frequency and duration as of late, going from a few hours every so often, to half-days, or in some cases longer, multiple times per week. The notice given to prospective patients has gotten shorter, with some finding out right before the changes are implemented.The interior has been among the regions hardest hit. Between August 18-23, for example, the emergency department at Lillooet Hospital and Health Centre was closed more often than it was open, with one "temporary service interruption" lasting a whopping 49 hours..The closures were blamed on "limited physician ability," and patients were told they could access care by calling 911, or heading two hours east to Royal Inland Hospital in Kamloops.Similar situations have played out in northern BC, where residents are more isolated than their neighbours to the south and the next hospital over is further than many people's summer road trip. Since the beginning of the year, nearly 200 emergency department closures have been announced in the region, with many lasting as long as 24 hours.In preparation for further service interruptions this month into next, both Interior Health and Northern Health have advertised a slew of urgent locum opportunities for emergency department physicians, enticing prospective applicants with hefty compensation, as well as travel, accommodation, and car rental coverage.Earlier this month, Health Minister Adrian Dix addressed the crisis during a video call with Williams Lake City Council."People know this is a national and international problem," Dix said, citing the fact that in neighbouring Alberta, 31 communities had experienced emergency department closures. "This has been an extraordinary period, and one where BC has led Canada in the recruitment of doctors, recruitment of nurses, recruitment of health sciences professionals, and recruitment of healthcare workers," he continued. "It's a national problem and we're doing better than everyone else, but clearly not well enough."According to Dix, over the past 15 months 831 family doctors have started practising across BC. While that has helped deal with one issue, it has done little to address emergency department closures and disruptions, which have quickly become perhaps the biggest healthcare hiccups in the province.In an interview with the Western Standard, Doctors of BC president Dr. Ahmer Karimuddin said that while locum opportunities such as those incentivised by the aforementioned health authorities could help in the short term, the long term focus should be on increasing the pool of eligible emergency department physicians, even if that means seeking them out from other areas of the healthcare system."There are a number of doctors who work in places like urgent care or walk-in clinics who may have some of the skills needed to work in the emergency room," he said. "There probably are physicians who used to work in the emergency room and have stepped away to do other work; they're in family practices in other areas, or even more interesting, they could be doctors in other jurisdictions outside British Columbia."Karimuddin noted that the establishment of the SFU medical school, increasing the capacity of the UBC medical school, and upping the number of postgraduate residency training spots will ensure more physicians enter the system in the coming years, but that until then, fast-tracking doctors trained in other parts of Canada or internationally could be "an important next step." He added that the process, which is overseen by the College of Physicians, "could always be done faster" to "reduce some of the stress about bringing in new doctors."While the problem has almost exclusively impacted rural communities, a small number of hospitals in the Fraser Health and Vancouver Coastal Health regions have also had to deal with closures. Mission Memorial Hospital, for example, has been forced to shut its emergency department doors four times this month.When asked whether he believed things could spiral out of control in urban centres as they have in more remote parts of the province, Karimuddin pointed out that the situations in the two areas are quite different.He explained that in rural communities, there are "a small number of doctors that provide all the services the town needs," working in the family doctor's office to the emergency room, and everywhere in between."If even one person leaves or has to retire, or changes the way they practice, that can impact 10 or 20% of the workforce," he noted. "[The hospitals are] always under significant stress about what could happen if someone left, and after COVID, we saw increasing numbers of people retire. That problem for the rural communities has become much more acute."Karimuddin argued that in urban settings, the issue has less to do with a shortage of physicians in the community and more to do with overworked emergency department doctors not having eligible replacements to take over when they need a break, which creates gaps in the schedule when they eventually do need time off."Most emergency room doctors work more than 60 to 70 hours a week in order to provide coverage for the places that they work," he said, "and that … has led to increasing rates of burnout, fatigue, and really just a situation where they are getting to a point where there's no more extra that they can do."Interior Health and Northern Health were reached for comment, but did not respond by the time of publication.
Healthcare woes are an all too familiar reality for rural British Columbians, with residents of many small towns growing accustomed to hearing that their local hospitals are struggling to keep up with the needs of the community.In recent months, however, things have taken a turn for the worse as emergency departments across the province announce temporary interruptions due to a shortage of physicians. Impacted hospitals have largely relied on emergency-trained nurses, or simply turned patients away and directed them to medical facilities in larger communities elsewhere.Such interruptions have increased in both frequency and duration as of late, going from a few hours every so often, to half-days, or in some cases longer, multiple times per week. The notice given to prospective patients has gotten shorter, with some finding out right before the changes are implemented.The interior has been among the regions hardest hit. Between August 18-23, for example, the emergency department at Lillooet Hospital and Health Centre was closed more often than it was open, with one "temporary service interruption" lasting a whopping 49 hours..The closures were blamed on "limited physician ability," and patients were told they could access care by calling 911, or heading two hours east to Royal Inland Hospital in Kamloops.Similar situations have played out in northern BC, where residents are more isolated than their neighbours to the south and the next hospital over is further than many people's summer road trip. Since the beginning of the year, nearly 200 emergency department closures have been announced in the region, with many lasting as long as 24 hours.In preparation for further service interruptions this month into next, both Interior Health and Northern Health have advertised a slew of urgent locum opportunities for emergency department physicians, enticing prospective applicants with hefty compensation, as well as travel, accommodation, and car rental coverage.Earlier this month, Health Minister Adrian Dix addressed the crisis during a video call with Williams Lake City Council."People know this is a national and international problem," Dix said, citing the fact that in neighbouring Alberta, 31 communities had experienced emergency department closures. "This has been an extraordinary period, and one where BC has led Canada in the recruitment of doctors, recruitment of nurses, recruitment of health sciences professionals, and recruitment of healthcare workers," he continued. "It's a national problem and we're doing better than everyone else, but clearly not well enough."According to Dix, over the past 15 months 831 family doctors have started practising across BC. While that has helped deal with one issue, it has done little to address emergency department closures and disruptions, which have quickly become perhaps the biggest healthcare hiccups in the province.In an interview with the Western Standard, Doctors of BC president Dr. Ahmer Karimuddin said that while locum opportunities such as those incentivised by the aforementioned health authorities could help in the short term, the long term focus should be on increasing the pool of eligible emergency department physicians, even if that means seeking them out from other areas of the healthcare system."There are a number of doctors who work in places like urgent care or walk-in clinics who may have some of the skills needed to work in the emergency room," he said. "There probably are physicians who used to work in the emergency room and have stepped away to do other work; they're in family practices in other areas, or even more interesting, they could be doctors in other jurisdictions outside British Columbia."Karimuddin noted that the establishment of the SFU medical school, increasing the capacity of the UBC medical school, and upping the number of postgraduate residency training spots will ensure more physicians enter the system in the coming years, but that until then, fast-tracking doctors trained in other parts of Canada or internationally could be "an important next step." He added that the process, which is overseen by the College of Physicians, "could always be done faster" to "reduce some of the stress about bringing in new doctors."While the problem has almost exclusively impacted rural communities, a small number of hospitals in the Fraser Health and Vancouver Coastal Health regions have also had to deal with closures. Mission Memorial Hospital, for example, has been forced to shut its emergency department doors four times this month.When asked whether he believed things could spiral out of control in urban centres as they have in more remote parts of the province, Karimuddin pointed out that the situations in the two areas are quite different.He explained that in rural communities, there are "a small number of doctors that provide all the services the town needs," working in the family doctor's office to the emergency room, and everywhere in between."If even one person leaves or has to retire, or changes the way they practice, that can impact 10 or 20% of the workforce," he noted. "[The hospitals are] always under significant stress about what could happen if someone left, and after COVID, we saw increasing numbers of people retire. That problem for the rural communities has become much more acute."Karimuddin argued that in urban settings, the issue has less to do with a shortage of physicians in the community and more to do with overworked emergency department doctors not having eligible replacements to take over when they need a break, which creates gaps in the schedule when they eventually do need time off."Most emergency room doctors work more than 60 to 70 hours a week in order to provide coverage for the places that they work," he said, "and that … has led to increasing rates of burnout, fatigue, and really just a situation where they are getting to a point where there's no more extra that they can do."Interior Health and Northern Health were reached for comment, but did not respond by the time of publication.
