Last week, with one whole day warning, the Tumbler Ridge Emergency Department was closed between the hours of seven at night and eight in the morning, and again on weekends.
When the announcement was made, the community lost it’s collective mind. And with good reason, as there was no mention as to whether the closures would be temporary or permanent.
At the meeting on Sunday, Lisa Zetes-Zanatta, Vice President, Clinical Operations for Northern Health seemingly refused to answer the question: so, is this a temporary closure or a permanent one.
And, while it seemed she was prevaricating, the answer to the question is actually harder than it appears.
Northern Health does not employ any of the physicians who work in Tumbler Ridge, but gives them funds through the Alternative Payment Program, which is too complicated for my little brain to understand, but basically means that the doctors are not employed by Northern Health but act as subcontractors to the Health Authority, who in addition to paying the doctors offer up space for the doctors to use.
In addition to being able to have their standard office hours, the doctors who work here also cover the emergency department during office hours.
Northern Health does offer a contract to doctors to be able to operate the Emergency Room on-call under the Medical On-Call Availability Program. This is a provincial program “providing compensation to physicians participating in sustainable on-call rotations intended to address gaps in continuous coverage for new and unattached patients requiring emergency care.”
In order to operate under this program, a group of doctors needs to form what’s known as a MOCAP group, and, according to the BC Government website: “there must be a minimum of three physicians to participate. This is to keep the MOCAP arrangement sustainable and to avoid physician burnout.”
Currently, there are two physicians on-site.
And here’s what Zetes-Zanatta was trying to get across at the meeting. Even if there’s a third or fourth physician, there’s no guarantee that they’ll be willing to participate in the program.
And even if they are, there’s a chance that they won’t have the training to work in the ER department.
Northern Health can insist that the person who is hired is willing and able to work in ER, but then it might take longer to get a family doctor in place.
Historically, when we’ve been down a doc or two, they’ve been able to cover the shortfall with a locum—a doctor who travels from place to place to fill in.
But locums, like all manner of doctors, are becoming harder and harder to find. And while a locum will make $1627 a shift in Tumbler Ridge, plus up to $1500 in travel expenses, they can make the same or more working in Stewart. Or Burns Lake. Or Massett. Or Chetwynd. Or Fort St. James. Or Mackenzie. Or…indeed, there are 21 locations listed on the Northern Health locum opportunity page, eight of which are considered critical.
If this were real estate, it would be described as a “buyer’s market.”
Northern Health is currently looking for two more full-time doctors who can cover both family practice and the ER for Tumbler Ridge, but they’re also looking for one in Burns Lake. One in Dawson Creek. Two in Fort St. James. One each in Hazelton, Mackenzie, Quesnel, Smithers and Vanderhoof.
And if you don’t want to cover the Emergency room? Why, there’s 19 more positions across the north, from Prince Rupert to Dawson Creek, including a handful in Prince George.
And if you include the whole province? There’s estimates as high as 1200 open physician positions.
And for every Charles Helm who came to Tumbler Ridge, fell in love with the place and decided to live here, there is. Every. Other. Doctor. Ever. Who has decided to move on.
Reasons can vary. Some want to be closer to family. Some want to live in the big city. Some don’t want to do the whole on-call after hours emergency room thing. And they can basically go whereever they want to.
Don’t get me wrong. I am not defending Northern Health’s decision. They can be and should be held accountable for the way this went down. They did a terrible job communicating the issue. But we can’t blame them for not having success in finding physicians. It’s hard, and getting harder all the time.
Unfortunately, they seem to have got caught flat-footed playing the short game. Maybe they thought they would have filled one or both of these positions and nothing would have changed. I don’t know.
I do know that Mark Deeley put to words an idea that I’ve been considering for a while, which is the education for service model.
Higher education is expensive. But what would happen, he said, if Tumbler Ridge—the town or the people or the businesses—were to offer to pay for a doctor’s education, which can run close to $100,000. In exchange, the person who was trained would have to stay in Tumbler Ridge and work here as a doctor for … four years? Eight years? Basically, for a set amount of time. It would be expensive sure, but not that expensive. Less than one year of funding for the museum.
But is this something we want to do? Does this set a dangerous precedent? Because once we start paying for doctors, where does it stop? Nurses? Teachers? I don’t know. I think it is an idea worth investigating. We’re willing to invest in dirt and glorified oil to make our streets drivable; how much more important the health and welfare of the people who live here?
Trent is the publisher of Tumbler RidgeLines.
