No band-aid fix for hospital physician shortage
Committee’s focuses on recruiting family physicians and nurse practitioners
By Jon Thompson
Posted 3 years ago
Staffing shortages at Lake of the Woods District Hospital’s nearly forced the closure of the emergency department last weekend, prompting a permanent scheduling change by not having a physician on-site at night.
“We need to do better,” said hospital board member Orlo Mejia. “I would not be here if not for the emergency department. It kills me, I guess, to think that this almost happened.”
Mejia survived a stroke two years ago. Had he not made it to emergency, the incident would likely have proved fatal.
Emily Goss took over as the chair of Kenora’s Physician Recruitment Committee in January.
The committee’s focus has been on recruiting family physicians and nurse practitioners. She says their strategy “has lots of irons in the fire”. Representatives will be recruiting at both campuses of the Northern Ontario School of Medicine where she sees great potential, having attended job fairs in the past.
“It’s like nailing Jell-o,” she said of the difficulties in recruiting medical professionals to the community. “The doctors themselves have been more successful and Health Force Ontario has been filling our ER for some time.”
Locum doctors, visiting physicians from elsewhere, continue to play a large role in the health care delivery at the hospital.
Laua Kokocinski, senior director of Local Health Integration Network has been working with the local hospital on the regional locum project, flying doctors and specialists to Kenora to fill the gaps in scheduling left by the staff shortage. Ultimately, she said, the hospital is responsible for providing physician coverage.
“Locums have been helping for years,” hospital president Mark Balcaen said. “Lately it has become more necessary.”
Locums are now taking five to ten per cent of shifts each month with higher concentrations of work in the summer. Under the provincial funding formula, “underserviced areas” can approve up to eight shifts a month to be performed by locums. In the past four to six months, Balcaen described, there has been an increase in the number of doctors who are flown to Kenora to take emergency room shifts with car rental and accommodation also provided. In some cases, private recruiting firm MedEmerg receives an additional finder’s fee for mobilizing support.
Brian Sinclair is the executive director for Health Force Ontario, the public agency coordinating recruitment. His emergency department coverage demonstration project covers the hospitals in Ontario with the greatest need, of which Kenora is one. He said “it would take an accountant” to determine the real costs of using locums because they’re funded with several government departments.
“What we have here is a systemic issue where lots of groups own a piece of the solution. Fortunately in the Northwest, we have a strong (local health integration network), Shaun Visser, and the Lake of the Woods hospital is working very hard.”
Visser, the emergency department network lead, says doctors are working at 125 per cent and are burning out across the region. While Kenora is competing against “well oiled machines” in the form of hired recruiters of Dryden and Thunder Bay, even those strategies are failing to attract sufficient help. Doctor shortages in Toronto, Ottawa, and London are taking precedence due to their proximity to physicians and Visser sees “simply too many holes to fill.” “There just isn’t enough manpower,” he says. “What I’ve pushed for very strongly is a separate model for the north because if you’re in a locum position and you want to work in these areas, we’re not competitive.”
The Ministry of Health has agreed to strike a committee with Health Force Ontario to address competitiveness in the region.