Obstetrical service gap a symptom of dysfunction in health care system: ER doc

By ZOE MASON on October 3, 2025.

zmason@medicinehatnews.com

For three days in September, there was no obstetrical services available at Medicine Hat Regional Hospital. According to local emergency physician Dr. Paul Parks, the disruption is a troubling indicator of more widespread dysfunction as the province transitions to a new health-care system.

Medicine Hat Regional Hospital services a catchment area stretching all the way past Brooks. Parks, who was previously president of the Alberta Medical Association, says it’s unusual for such a critical service to go offline at a key regional facility like this one.

“It probably serves at least a couple hundred thousand people. It’s absolutely not normal to have no obstetrical coverage, and it’s a trend in the absolute wrong direction,” he said.

The hospital has doctors who can deliver babies and general surgeons who can perform emergency C-sections. But in an obstetrical emergency, specialist expertise is essential and sometimes needed in a matter of minutes.

No patients required transfer during the disruption and eight babies were safely delivered. But Parks says the service gap should nonetheless be ringing alarm bells in the community.

“The last couple of years, with the refocusing, it has been devastating,” he said. “And it’s just going to get worse and worse.”

The province initiated a major overhaul of its health-care system in June. The new system consists of four agencies: Primary Care Alberta, Acute Care Alberta, Assisted Living Alberta and Recovery Alberta. All services were previously delivered under one integrated authority by Alberta Health Services.

The reorganization also involved elimination of geographical zones that previously formed the basis of the leadership structure for Alberta’s hospitals. Zones will be replaced by a decentralized, facility-based leadership structure the premier says would increase the authority of local hospital leaders.

The new model is expected to be implemented completely by summer 2026.

Parks says smaller regional centres like Medicine Hat will be disadvantaged by the changes, and may increasingly face shortages like this one.

“There’s no co-ordinated provincial workforce plan to try and make sure that we have specialists in the areas we need them, or even to delineate what our current workforce state is and what our future predicted state should be,” said Parks.

“The premier has openly stated that she wants every hospital to have local leadership and do its own thing. That will be disastrous for our province,” he added. “We were already having difficulty recruiting to a city of our size when there were groups that were trying to do it in a co-ordinated manner. Now, it’s going to pit the bigger cities like Calgary and Edmonton against the smaller communities.”

Disciplines like obstetrics are vulnerable to even more pronounced effects. Obstetrics is currently drifting in a no-man’s land of provincial policy, Parks says. Family medicine physicians and obstetricians both deliver babies, but in the new four-agency system, family doctors fall under primary care, while obstetricians working in hospitals fall under the acute care agency. It’s unclear which authority is even accountable for service gaps like these.

Dr. Duncan McCubbin, an obstetrician-gynacologist in Medicine Hat, falls into this category.

“I also do gynacology, so I do surgeries like hysterectomies that are hospital-based. But I also run a community practice. So where do I fall into?” he said in an interview with the News. “Under the corridor system, we don’t really know, as physicians, who to talk to when we have a problem.”

“Who is looking at the fact that we didn’t have obstetricians in Medicine Hat? Who’s actually working on it? Who has a province-wide ability to address this, to get obstetricians from Calgary or Lethbridge? It used to be in AHS, but it’s clearly not anymore. Who is actually trying to deal with this problem right now?”

The News contacted Alberta Health Services to clarify, but they offered no comment.

In Medicine Hat, the problem is complicated by a unique funding model that compensates physicians practicing obstetrics.

In this region, the demand for obstetrical services has historically been inconsistent. In order to retain specialists in the area, the Alternative Relationship Plan was created in 2004. Effectively a salary, the ARP was designed to substitute for the dominant fee-for-service model in circumstances like these, to guarantee physicians a consistent level of compensation. But the rate has not been modified for more than 20 years. There has been a vacant obstetrical position in Medicine Hat for five years.

When the hospital was in need of obstetrical coverage in September, it lined up an obstetrician from Saskatchewan.

“When he was told the amount that he would be guaranteed for the weekend, he said, ‘That’s a joke. I’m not coming.’ So that’s pretty telling,” said McCubbin.

McCubbin says he loves the City of Medicine Hat and the workplace culture at the hospital, but he thinks it’s no surprise that obstetricians aren’t flocking to the fill the vacancy.

“It kind of kicks us in the teeth. We’re wondering why we’re working here for that low an amount. Perhaps Saskatchewan is a better place to live.”

Cypress-Medicine Hat UCP MLA Justin Wright is aware that the system has shortcomings.

“As the Parliamentary Secretary for Rural Health South, I’ve had the privilege of visiting communities and health care facilities across southern Alberta. In speaking with frontline health care workers, one message was clear: we need more health care professionals,” Wright said in a statement to the News.

Wright pointed to initiatives that the government is undertaking to train 100 new physicians annually and streamline registration for internationally trained doctors to help bring in new personnel.

He also highlighted a $10-million investment in midwifery across the province.

But Parks says the root of the problem is structural.

“I’ve been pleading with government to work with us, to get some expert advice, some input. They’re not doing that. There is no co-ordinated workforce planning for the province. There’s no one even identified as to who would do it,” he said.

“Everything is totally siloed now. There’s no operational control, there’s no integration, there’s nothing being done in a coordinated fashion in our province, and it’s pure chaos.”

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