In nearly 20 years of practicing family medicine, Dr. Sara Van Der Loo has never seen so many Northwestern Ontario hospitals struggle to keep their emergency rooms open.
“I’ve never seen it this bad,” said Dr. Van Der Loo, who is Chief of Staff at Atikokan General Hospital and also chairs the Northwest Regional Chief of Staff Council, a committee representing mainly small rural Northwestern Ontario hospitals. “I’ve never seen so many communities struggling at once.”
While her hospital in Atikokan, west of Thunder Bay, is currently well-staffed with physicians, Dr. Van Der Loo understands what it’s like to scramble to keep an ER running. At one point, she was the only non-locum physician staffing Atikokan’s ER.
In the past, northern communities could rely on an ample supply of locums, physicians who typically come from outside the community to temporarily provide care. But it has become much harder to attract locums since the onset of COVID-19.
Hospitals restricted physicians from travelling between communities during the pandemic to control the spread of the virus and airlines cancelled or scaled back flights to the north. “They became hospitalists somewhere or they settled down in a community,” Dr. Van Der Loo said. “So there's just a smaller locum pool.” At the same time, changes to compensation models made it less lucrative for physicians to travel to the north for temporary contracts when they could earn the same or more working as locums in Southern Ontario.
The shortage of locums has increased the pressure on local family doctors, who are the same physicians staffing Northern Ontario ERs. When that system works it can provide a wonderful continuum of care, Dr. Van Der Loo said. But when it’s short-staffed, too often it’s primary care that gets sacrificed as doctors struggle to keep emergency rooms open.
Dr. Van Der Loo has seen first-hand that when family doctor offices are closed because of hospital staffing issues, the number of patients turning up at the ER increases dramatically. “The patients are the ones who suffer from that because they can't see their physician,” she said.
Northern Ontario doctors living in the communities where they work feel a deep sense of duty to keep their hospitals running for their friends, neighbours and their own family members — even if that means working to the point of exhaustion and forgoing much-needed time off. “If you’re offered the choice of cancelling your holiday or closing your emergency department, most physicians are going to cancel their holidays to keep their emergency room open,” Dr. Van Der Loo said.
This situation is tenuous and unsustainable, but it doesn’t have to be this way. A rapid response from government and healthcare leaders could help to stabilize the current crisis. The Ontario College of Family Physicians (OCFP) and the OMA Section on General & Family Practice (SGFP) are calling for:
- Immediately enhance locum program supports to ensure temporary doctors are available where they are most needed right now. Longer-term rethinking of how locums are used in the North is necessary.
- Urgently fund recruitment programs to bring new physicians to the North.
- Retention is critical. Implement a comprehensive strategy and ensure positive working conditions to retain the remaining physicians in the North.
- Provide immediate peer support for family doctors working in these difficult conditions to maintain their mental health and wellbeing.
Read our full statement here.
