Health-care delays killing people, ER doctor says

`Nobody knows how broken the system is until they need it'

Dr. Paul Parks is fiercely direct, as usual. He says Albertans are dying because of “access block,” the clogging of emergency wards, primary care, EMS service, and many other choke points in the health-care system.

“We're missing some, for sure, we are missing some,” Parks said in an interview.

Does he mean people are dying because they aren't seen fast enough?

“Absolutely. We know some of these people have very serious outcomes and even deaths.”

Parks is the president of the Alberta Medical Association's emergency medicine section and a working ER doctor in Medicine Hat.

For 15 years he has been a fearless firebrand for better care, smarter government policy and serious involvement of medical people in designing the system.

He was in the trenches during the massive ER logjams of 2009-10. They caused a revolt in then-premier Ed Stelmach's government when Edmonton ER doctor Raj Sherman, then a PC MLA, said the premier had betrayed his personal promises on health care.

There was near failure — “catastrophic collapse,” the doctors warned then — but the risk was more limited than current threats that spread from the ERS to obstetrical care, EMS paralysis, staff shortages, widespread system exhaustion, and much else.

“It's as bad as it's ever been across the province for access,” Parks says. “The idea of a patient seeing the right person in the right place at the right time has completely fallen apart.

“ER doctors are in a sense the canary down the coal mine of health care. Well, the canary has keeled over and died. We are desperate, just desperate for Albertans to understand how bad this is.”

Parks is often accused of being partisan. That's not it, he says. “There is only one government making decisions and its policies are devastating.”

He traces today's problems as much to the government's cancellation of the doctors' pay agreement in February 2020 as he does to two years of coping with the COVID -19 pandemic.

The bizarre shredding of a legal deal made it hard to attract not only doctors but nurses and other medical workers. Parks simply doesn't buy the government claims that this is balanced off by doctors arriving.

“Look what they're doing to respiratory specialists, the very people who treated acutely ill patients with ventilators and oxygen, during a respiratory pandemic. They offered them a 10 per cent pay cut.”

According to information I received, the proposed pay cut for respiratory specialists was 8.05 per cent.

Even advanced care paramedics were facing a small pay cut. That's some friendly message for burned-out paramedics staffing ambulances lined up at ERS, sometimes 15 deep, waiting to leave patients so they can get back on the road.

There have been lineups of parents and kids outside the Alberta Children's Hospital emergency ward.

This is partly because of

COVID protocols, but the delays are mostly caused by staff shortages and many more people showing up for treatment.

“Never before has it taken 90 minutes to triage a child,” says Parks. “And that's just the start of the wait.”

The crisis has also spread in family medicine. There's a critical shortage of young doctors to work as “locums,” substitutes for vacationing doctors.

I spoke to a family physician Friday who also does shifts in another specialty.

She usually works seven days a week and sees no hope of time off until November — unless she simply ditches her patients, which she will not do.

She and many other doctors say the young ones just aren't coming here, because who wants to work for a government that tears up a signed agreement?

And yet these critical system problems run curiously under the public radar. Parks feels people are just exhausted with bad medical news and want to move on from the pandemic.

“It's difficult to get traction,” he says. “I don't think the general public gets just how bad this is. Nobody knows how broken the system is until they need it.”

Back in the 2009-10 crisis, it was always understood that specific action could fix the problem. The answer then was more longterm care spaces to make room in hospitals. Over a decade, the situation improved.

But now, there's a strong feeling among medical professionals that the troubles will only get worse because they have spread into so many corners of health care.

“What the government originally did to agreed compensation, that was the disaster,” Parks says. “The real damage is only now starting to show.”

However, he reiterates a home truth of the Alberta health system: once you're in, the care is excellent.

Gaining simple entry is the problem. It can take a long time. Even giving birth can force an expecting mom to travel a long way. Currently, there's no obstetrical care in Sundre, Whitecourt, Three Hills, Provost, St. Paul, Barrhead or Rimbey.

An AHS spokesman acknowledges there is “significant pressure on our health-care system, particularly our emergency departments and EMS, due to high volumes of seriously ill patients and the impact of COVID -19.” But he said plans include shifting staff to areas of highest priority and “using alternate models of care.”

Just as all this was growing more serious, the government dismissed Alberta Health Services boss Dr. Verna Yiu with a year left on her contract.

Parks says: “Verna Yiu actually knew what was going on, had the trust of the troops, and she got fired in the middle of her contract, maybe because she was trying to give them some expertise on the system.”

A new bunch of UCP politicians arrived in 2019, claiming to know exactly what was needed for health care.

This is what we got.