Residents safer when services available

One of the realities of the recent emergency room closures at Western Hospital in Alberton is there is a physician shortage in Canada, and in rural Canada in particular. That shortage was already well documented prior to the temporary shutdown of emergency services that occurred on three occasions over the Christmas-New Year’s holiday period. Physician shortages have resulted in Western Hospital becoming the first hospital in Canada to pilot a ‘telerounding’ program, where hospital patients who do not have an attending physician are being seen by physicians over a computer screen. But that service is for patients already in hospital beds recovering from a sickness or an injury. It doesn’t cut it for emergency situations.

Emergency room physicians are available at Western during the day, and then the hospital’s emergency department becomes a collaborative emergency centre from 8 p.m. until 8 a.m., when emergency room nurses and paramedics are available to assess patients and then consult by phone with an on-call doctor.

Of course, that is the way it is supposed to work, but challenges occur when the right combination of emergency personnel is not available to keep the service going.

Dr. André Celliers, executive director of Medical Affairs and Legal Services for Health P.E.I., is being sincere when he suggests it would be unsafe to have the service running without all the necessary personnel. To be in an emergency situation would be horrifying enough without arriving at a hospital expecting to receive emergency care and get turned away.

Health P.E.I. has posted the times when emergency room services would not be available, and that’s fine for anyone who sees the notices, but what about those who didn’t see the notices, or who didn’t pay any attention because they never expected to be in an emergency situation?

The solution is simple enough: have enough staff available to cover all shifts. But getting to that point is anything but simple. To begin with, there is that physician shortage.

Long-term, there needs to be more seats in medical schools and more of a push to make rural practices enticing. There are illnesses, vacations and holidays to consider. And there are times, like holiday periods, when finding locums and casuals to take on extra shifts is challenging.

But none of this can be shrugged off as normal or acceptable.

For times when shortages could be expected, such as during the holidays, advanced planning for the just-in-case situations is critical.

There is, of course, the additional risk that, in light of the recent closures, some people might mistakenly believe the service is unavailable and, thus, bypass the hospital the next time an emergency occurs.

Closures cannot be seen as normal, and the best way to prevent that is for provincial health officials to assure the public they are taking all steps possible to prevent re-occurrences. Yes, that falls short of saying it will never happen again, but it would be irresponsible to make that assurance in light of current staffing realities.