Province has addressed MDs concerns about ‘impending disintegration” of ER, urgent care, health minister says

Concerns raised by hospital medical directors in a March letter warning about the “impending disintegration” of emergency room and urgent-care centres have been addressed, Health Minister Uzoma Asagwara said Monday.

“Our priority is making sure that our urgent cares and emergency departments remain open and that patients can count on getting that care when they need it,”Asagwara said.

In an interview, Asagwara outlined the steps government is taking to resolve the ER physician shortage cited in the eight-page letter to health-system leaders obtained by the Free Press.

The March 12 letter from medical directors at Seven Oaks, Victoria, Grace and Concordia hospitals called for “urgent action now to prevent a preventable death and to ensure Manitobans can count on timely, safe, compassionate emergency care when they need it most.”

“We do not want to stand at the bedside of another person who deteriorated due to preventable delays and gaps in care — knowing their outcome would have been different,” the letter, first reported by CBC, said.

It said that having one doctor in charge of the emergency department while also having to deal with critical situations in other parts of the hospital was a “daily” occurrence.

Doctors were taking higher-paying shifts elsewhere, where there was “far less acuity, liability, moral distress and shift work.”

The letter suggested that the Victoria Hospital, which is set to transition from an urgent-care centre to an emergency department in 2027, doesn’t have doctors with a full slate of up-to-date emergency department training.

“Rebranding without readiness will increase only risk, not patient access,” it said.

It warned of a physician staffing shortage and the “impending disintegration” of urgent care and emergency rooms. It projected that just over 28 per cent of physician shifts would be vacant in April. By summer, the shortage was expected to get worse, with 45 per cent of shifts at Seven Oaks expected to be left vacant.

The minister said Monday that there was a loss of physician hours in emergency rooms and urgent-care centres after the previous government redirected financial incentives to other areas of health care.

“We’re seeing the impacts of that today,” Asagwara said, adding a new incentive program is in place to retain ER and urgent-care doctors and incentivize family doctors and others to pick up more shifts “so the schedules are filled and people know that they can count on care being there when they need it.”

The one-year, $6-million pilot that runs until next March offers supplemental pay for physicians who work in ERs and urgent-care centres and commit to a regular schedule of coverage. It’s focusing on the six hospitals that had the biggest gaps in coverage, including Seven Oaks, Concordia, Victoria and the Grace, as well as the Brandon Regional Health Centre and Boundary Trails Health Centre, which is located between the towns of Morden and Winkler.

A doctor who formerly worked at the Grace ER said the issues mentioned in the letter are issues he’d been raising for the last two years that led to emergency-room resignations.

“Every day, every doctor took on 20 active patients that were signed over to us that had been there for several days,” said Dr. Doug Eyolfson, a Liberal MP who hit “pause” on taking ER shifts at the Grace last year.

“We’d be responsible for reassessing those patients, and then we would also have to see new patients and we would alternately be getting emails to the whole group saying we weren’t properly reassessing our long-term patients. And then, a few days later we’d get an email saying, ‘You’re not seeing a new patient fast enough.’

“We were in a catch-22,” said Eyolfson, who emphasized that he was commenting Monday as a physician, not a politician.

Doctors Manitoba president Dr. Alon Altman said that the physician advocacy group has been raising concerns about ERs and urgent-care centres for many years and that two important actions have been taken in recent months.

After Shared Health held town halls with emergency physicians at every major hospital across the province to hear their concerns and ideas, there’s been some “early progress” in addressing safety issues, improving social worker coverage and increasing recruitment efforts, Altman said in a prepared statement.

A pilot program to recruit and retain ER and urgent-care physicians has begun, starting with the six hospitals with the biggest gaps in physician coverage, he said.

“While our ERs and urgent-care centres still have major challenges and unreasonably long wait times, we are seeing foundational steps in the right direction from the health system to improve the situation for doctors and their patients,” Altman said.

Progressive Conservative health critic Kathleen Cook said Premier Wab Kinew is not living up to his promise to fix health care.

“Wait times for emergency rooms and urgent care in Winnipeg are the longest they’ve been in more than 10 years of public reporting,” Cook said in a statement, referring to figures released last week by the Canadian Institute for Health Information.

“This is not what Manitobans were promised when the Kinew NDP said they’d ‘fix’ health care. The data shows that the situation is getting worse, not better.”

carol.sanders@freepress.mb.ca