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Doctor shortage in northwestern Ontario remains dire with no clear relief in sight

Emergency rooms in northwestern Ontario remain critically short-staffed, and hospital leaders across the region warn the risk of emergency-room closures could continue well into the summer. 

Three months ago, the emergency room in Red Lake, Ont., closed for 24 hours during a weekend because no physician was available. Officials say a similar situation could happen elsewhere if relief isn’t found. 

“To be frank, if health-care workers across our region did not continue to work hours that are putting their personal health at risk and are far beyond reasonable expectations, many more service closures would have occurred,” said Dr. Sara Van Der Loo, chair of the Northwest Regional Chief of Staff Council.

Physicians are burning out from working excessive hours while trying to keep services open, she said, and the situation isn’t isolated to one particular hospital. 

Patients in emergency rooms across Ontario are waiting record lengths of time to get admitted to hospital, a situation medical professionals say is getting worse. 

Ray Racette, chief executive officer of the Lake of the Woods District Hospital in Kenora, warns the public of “a very tough challenge this summer” in the hospital’s emergency department as it faces an all-position vacancy rate of 41 per cent.

“There’s heroic efforts — people picking up extra shifts and so on, maybe giving up on their summer vacations and things of that nature, just to try and keep these services open,” Racette said. “But it does mean that people can be waiting longer for service.”

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

The Ontario government announced an expansion of its COVID-19 temporary summer locum program on June 1, which allows hospitals to offer premiums to help attract temporary fill-in staff to emergency rooms in rural and northern hospitals. 

Dr. Sarah Newbery, associate dean of physician workforce strategy for the Northern Ontario School of Medicine (NOSM), is skeptical that program will make much of a 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 chief executive officer of the Lake of the Woods District Hospital in Kenora, Ont., warns of possible delays in service this summer due to staff shortages. (Logan Turner/CBC)

Work on several possible short-term solutions to the physician shortage that were put forward by physicians and recruiters themselves was delayed by the recent provincial election, Newbery said.

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

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

The physician recruiter for the Fort Frances and Rainy River area said he’s still running into roadblocks trying to meet the supervision requirements for physicians working on restricted licences, such as international medical graduates seeking licensure in Canada.

In 2015, Todd Hamilton said, he went through the process of bringing an American-trained physician to the Fort Frances and Rainy River area, and had to arrange for three other local physicians to provide supervision and mentorship in accordance with college requirements — something many small communities don’t have the resources to do. 

Dr. Sarah Newbery, associate dean of physician workforce strategy at the Northern Ontario School of Medicine University, says work on solutions to the emergency room physician shortage in the northwest was delayed by the provincial election. (Dr. Sarah Newbery/Twitter)

The College of Physicians and Surgeons of Ontario told CBC News in March that it permits small communities to have a single supervisor or have supervision provided remotely by physicians outside the community. Hamilton said he had never been made aware of those options.   

However, he said, the region recently responded to interest from a surgeon who was seeking to re-establish his licence with the college due to a gap in service, “not through any fault of his own.”

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

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

“You get these lifelines once in a while. And then, as quick as they’re shown to you, you go through the process, you realize, well, that’s not going to work for us either.”

Todd Hamilton of the Fort Frances and District Physician Recruitment Retention Committee says he wanted to recruit a physician whose Ontario licence had lapsed, but he could not meet the College of Physicians and Surgeons of Ontario’s supervision requirements. (Submitted by Todd Hamilton)

Shae Greenfield, a spokesperson for the College of Physicians and Surgeons, said it’s impossible to discuss a specific case without knowing the name of the physician in question, something Hamilton said he could not disclose. 

“We want to work with people to address as many issues as we can within our mandate and within the limitations placed on us by the law and other factors,” Greenfield said.

Racette said he hopes to get help in his ER this summer from Manitoba physicians vacationing in the region, but that delays in licensing them to work in Ontario created a barrier.

“A three-month turnaround on a licence would be viewed as, you know, potentially doable. But if we have somebody coming up in two weeks, that’s maybe coming to their cottage … how do we get that physician licensed?” he asked. “Because that might be the notice.” 

Hospital leaders appeal for help 

Greenfield denied the college takes three months to process licence 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 hasn’t been his observation.   

“We’ve had several people just say, ‘I would never apply for an Ontario licence. I did that many years ago, and it took so long I would never go through that again.”

Greenfield said delays in processing licence applications could be caused by missing documentation or incomplete applications. 

In Kenora, hospital chief executive officer Ray Racette pleaded with “anybody who has any discretion at all” to use it to help hospitals in the northwest this summer.

“Everybody’s in trouble,” he said.

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