CancerCare board acknowledges doctors’ concerns in letter to staff By: Tyler Searle Posted: 5:31 PM CDT Tuesday, Oct. 1, 2024

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This article was published 01/10/2024 (726 days ago), so information in it may no longer be current.

CancerCare Manitoba’s board has issued a letter intended to reassure its staff after allegations of excessive workloads, wait lists and a poor working environment were made public last week.

“The Board recognizes there are workload challenges here at CancerCare Manitoba; we also know you have been heroic in delivering excellent patient care despite those challenges,” chair Jeoffrey Chipman wrote in the letter, obtained by the Free Press.

“As a Board, we take our responsibility and these issues seriously, recognizing the impacts they may have on all those who work at CCMB and patient care.”

The document was sent to all staff Friday, three days after the Free Press and other media reported details of an examination launched by Doctors Manitoba.

The advocacy organization, which represents physicians throughout the province, wrote to oncologists and hematologists at CancerCare this month to inquire about working conditions after being “contacted by a number of physicians raising serious concerns.”

Allegations included: excessive workloads; limited engagement, communication and trust in CancerCare leadership; poor workplace culture and support; a fear of reprisal for speaking out; and issues with recognition and payment for extra work.

When contacted last week, Doctors Manitoba said such letters are routinely sent out to physician groups after concerns are raised. A spokesperson stressed the organization was “at the very early, diagnostic stage of understanding the problem and how widespread the concerns are.”

CancerCare president and CEO Dr. Sri Navaratnam acknowledged the agency’s workload challenges in an interview, saying recruitment and retention efforts are underway to alleviate some of the strain.

She noted such challenges are being seen in health-care systems across the country, and were exacerbated by the COVID-19 pandemic; Chipman’s letter said the same.

He reassured employees the board has “confidence in the efforts to improve workload conditions at CancerCare Manitoba.”

He also pointed to a new physician services agreement, saying it “addresses many of the identified concerns.”

Complaints about staffing levels within the provincial agency have been brewing for some time — with some evidence suggesting such worries pre-date the pandemic.

CancerCare oncologists raised alarms in a separate letter to Dr. Joel Gingerich, co-head of the department of medical oncology and hematology, sent in May.

It was sent after a section meeting discussing recruitment and retention efforts.

“We understand that… hiring new oncologists is challenging when there are more jobs nationwide that trained oncologists to fill them,” the letter said. “However, in the meantime, we remain short staffed… therefore we believe it paramount to communicate directly to you that there is significant concern among the current medical oncology group.”

At the time, at least four full-time oncologists had left CancerCare within the past 12 months, it said.

According to the letter, one person had retired and three others resigned. One of the people who left intended to remain in Manitoba working in a non-medical oncology role, while others left to practise medicine elsewhere in Canada, it said.

“We appreciate that workplace turnover is a natural process but so many resignations in such a short time is unprecedented at CCMB and, to the best of our knowledge, cannot be blamed on peri-pandemic issues,” the oncologists wrote.

Understanding and openly discussing the reasons for the departures was a “critical issue,” they said.

“The Board recognizes there are workload challenges here at CancerCare Manitoba; we also know you have been heroic in delivering excellent patient care despite those challenges.”–CancerCare board chairman Jeoffrey Chipman in letter to staff

CancerCare lost 16 physicians to retirement and other causes in the past five years, but added 19 in the same period. Six new oncologists have been recruited this year, Navaratnam said last week.

The agency polled staff in the medical oncology and hematology department in May 2019, asking them to assess their working environment. Only 12 of the 37 people who received the survey responded.

The Free Press obtained a copy of those survey results.

While the low response rate limited the scope of the results, physicians generally reported high workloads, low sense of control over institutional decisions, limited research ability due to clinical loads and a lack of recognition for productivity.

Half of the participants disagreed or strongly disagreed that the department had sufficient human resources to work in an environment safe for patients. Half said the department was organized in a manner that provided optimal inpatient and outpatient care for Manitobans.

A little more than half (58 per cent) disagreed or strongly disagreed the department had sufficient nurses, clerks, pharmacists, social workers and other staff to support outpatient clinical practices. The same amount either disagreed or strongly disagreed they had satisfactory access to electronic medical records.

Half said they had adequate infrastructure in the form of control, examination and procedure rooms to support outpatient clinical practices.

Only 25 per cent described their in-patient service workloads as manageable.

Some of the physicians said their immediate superiors were responsive to feedback and concerns, but it was unclear whether institutional leaders valued such feedback.

“Leadership handcuffed by the institution’s vision,” the survey’s comments on leadership said.

“Section leadership seems to support us in our clinical and academic endeavours, but these are either inadequately advocated for at the higher levels of administration, or that there are political conversations guiding decisions.”

tyler.searle@freepress.mb.ca