Alberta’s emergency room staffing shortages are getting worse in cities big and small, doctors warn

Alberta Health Services is looking for dozens of emergency physicians to fill vacancies across the province.

The health authority says it is hiring 39 full-time equivalent ER physicians for regional and large urban hospitals.

It is also trying to recruit 29 GPs for rural areas, who would be given priority in the emergency department of smaller hospitals.

The shortage of doctors is affecting emergency departments in the province.

One of the most recent examples comes in Lethbridge, where the Chinook Regional Hospital, which has been struggling with a persistent staffing shortage, faced a growing problem this summer.

Alberta Health Services (AHS) informed the public last week that there were longer wait times at its southern Alberta clinic in July and August due to the shortage.

“This is absolutely the worst thing we’ve ever had. It’s the only time we’ve had a whole month or two months where we’ve been short a doctor every day,” said Dr. Sean Wilde, an emergency room physician at the hospital.

The hospital in Lethbridge sees approximately 150 to 200 patients each day.

Normally, seven doctors work in a 24-hour period. This summer, the daily schedule is six doctors, and on some days only five.

This means that on quieter days there is only one doctor on duty.

“It’s a slightly riskier environment to practice in when we’re under that stress. There are people waiting to be seen and there’s not as much help as you would normally expect,” Wilde said.

The Lethbridge hospital, which has struggled with shortages for years, relies heavily on temporary locum tenens who fill in, but they are harder to find during the summer months.

Dr. Aaron Low, medical director of the AHS southern zone, said all patients are screened when they arrive at the emergency room.

“Those who have acute problems, such as concerns about a heart attack or stroke or trauma, are seen immediately.”

Patients considered less urgent will feel the impact, he said.

“Those patients will have to wait longer.”

According to Low, wait times at Chinook Regional Hospital have historically been shorter than many other hospitals.

“We don’t like it, but in the context it’s not as bad as other places,” Low said, noting that patients with concerning symptoms should still go to the emergency room for care.

Broader problem

Doctors warn the situation at the Lethbridge hospital highlights a growing problem in Alberta.

Wednesday AHS had 20 public announcements for disruptions to healthcare or temporary closures in the province since early July, many of which are related to the shortage of emergency room doctors.

The hospital in Lethbridge is the largest facility hit in recent weeks.

“The fact that the emergency department is now experiencing a physician shortage is a very bad sign,” said Dr. Paul Parks, president of the Alberta Medical Association.

According to Parks, other problems in the health care system, such as nursing shortages, delays in access to specialists, surgical diversion and a shortage of primary care physicians, are trickling down to the emergency room, causing doctors to burn out and quit their jobs.

The backlog of hospitalized patients stuck in emergency rooms due to a shortage of hospital beds and the lack of specialists available outside office hours also contribute to this, he said.

“You’re seeing the domino effects. More and more rural emergency departments are closing, which means more patients are going to the regional centers. The regional centers are understaffed … which means more people are going to the larger urban centers. And they’re insanely overburdened,” Parks said.

“Our teams are becoming more and more exhausted.”

According to Fiona Clement, a professor in the department of public health sciences at the University of Calgary, it is a vicious circle.

“The system is in trouble and I’m concerned,” she said.

“If you have fewer doctors than you need, the doctors who are left carry a heavier burden. They work longer hours.”

According to Clement, recruiting dozens of doctors for Alberta’s emergency room will not be easy or possible quickly.

“Doctors generally don’t just lie around waiting for a job. So we’re talking about taking them away from where they are, which is not easy… or we’re talking about training 70 doctors, which is not a quick fix.”

In addition to AHS’s recruitment efforts, Parks is calling on the provincial government to take several important steps, including completing a financing model for general practice and implementing a hospital stabilization plan his group submitted to the government in December.

The spokesperson for Alberta’s health minister said in an emailed statement to CBC News that the government is working to address the problems by reforming the health care system.

“A realignment of the health care system will allow AHS to focus on acute care and related human resources, while ensuring other key areas of health care, such as primary care, assisted living, and mental health and addiction, receive the resources and support they need,” Andrea Smith said in the statement.

“Efforts are currently underway to create more training opportunities for rural physicians and expand opportunities for nurses to provide primary care with government reimbursement.”

She also said the government is working closely with the AMA on the new reimbursement model for GPs.

“When fully implemented, we expect Alberta to become a national leader in recruiting and retaining primary care physicians.”