NEWS FILE PHOTO Emergency department physicians send a letter to Premier Jason Kenney and Health Minister Typer Shandro warning that emergency departments will feel the brunt of the changes being made to health care. Recently health care staff walked the sidewalk outside the emergency department at Medicine Hat Regional Hospital to raise awareness of changes to health care delivery. RN Rebecca Weisgerber and Rachelle Wenzel, Alberta Union of Provincial Employees.
gslade@medicinehatnews.com@MHNGillianSlade
Emergency physicians warn the premier and health minister that emergency departments will take the brunt of the changes to health care.
Dr. Paul Parks, emergency physician in Medicine Hat and spokesperson for southern Alberta emergency physicians, says changes introduced by Alberta Health will likely result in more people arriving in emergency departments.
A letter to government is signed by 14 Medicine Hat emergency physicians and 22 from Lethbridge. They warn the effect on EDs could start in April “due to reductions in local primary and specialist care.”
When patients can’t get in to see their family doctor, referrals to specialists take too long, surgeries are delayed and seniors don’t have access to long-term care beds, the patient inevitably ends up in emergency with a crisis.
“We really fear that changes that are done now will have major ripple effects down the whole system, ” said Parks. “Every change they’re making now will cost the system more and decrease the quality of care for patients.”
The letter cites, in particular:
– That the reduction and loss of complex care modifiers will make it difficult for family medicine and specialist clinics to remain financially viable unless visit lengths are significantly reduced;
– That daily visit caps imposed by the government on community physicians will shorten or eliminate evening walk-in clinics; and
– That daily visit caps will disproportionately affect high-volume orthopedic, surgery and cast follow-up clinics, meaning more patients will come to the ER as they cannot see their surgeon.
All of these changes will reduce the amount of primary care available in the community and thus lead to more emergency room visits, and the swamping of the system there, the letter states.
“Southern Alberta currently enjoys some of the best emergency department wait time indicators in the country. The average wait to see a physician in a South Zone regional hospital is about 55 minutes. Our zone has been identified in the past as one of the most cost efficient in the province. This is in large part due to an excellent primary-care system that is accessible to patients, and a network of specialists available to provide timely consultation, admission and follow-up for emergency department patients,” the letter adds.
It is not just a change to the fee structure for how physicians get paid but the ramifications that will change health-care delivery, said Parks. A cap on how many patients a physician can see in a day will ultimately result in more people to the ED.
When emergency departments become overloaded and hospital beds are full, patients lie and wait in EDs, said Parks. Elective surgeries start being cancelled because postoperative recovery space is not available.
“The government is not listening to anybody in the medical profession. I don’t know where they are getting their advice from,” said Parks. “They are not listening to us.”
Drew Barnes, MLA for Cypress-Medicine Hat, says timely access to emergency and medical services is essential.
“This can happen with tax dollars utilized to achieve maximum results,” said Barnes who has had several meetings with the health minister and premier about feedback from doctors and constituents.
“I will continue to ask for this to be a top priority and I have confidence Alberta’s excellent emergency and acute care will continue,” said Barnes.
Parks says the government’s assertion that it has not made cuts to health care is not true.
“They’ve made major cuts,” said Parks.
EDs in places such as Medicine Hat are disproportionately affected compared to Calgary and Edmonton, says Parks. Some emergency physicians in Stettler have recently said they will withdraw as emergency physicians and do only family practice. Parks says that could happen in smaller centres in this region and affect Medicine Hat’s ED.
“It’s going to affect our ability to deliver quality care,” said Parks.
Michaela Glasgo, MLA for Brooks Medicine Hat, says the health minister acknowledged in question period that “rural areas need different consideration than larger urban centres.”
“It is my understanding that conversations between the minister and the AMA (Alberta Medical Association) are not over and that input and constructive dialogue is still needed,” said Glasgo.
The letter emergency doctors have sent to government says there is abundant evidence that emergency department crowding increases costs to the health-care system and impacts lives.
Parks says palliative care is losing the stipend to cover the travel cost of home visits to vulnerable and dying patients. This could mean more people admitted to hospital.
Parks says ED physicians want government to give more thought to the cuts they’d planned.
— with files from the Lethbridge Herald
