By Lyonel Doherty
Local doctors are warning Town council that more hospital emergency room closures are imminent if nothing is done to keep physicians in Oliver.
Three doctors (Jacob Bellingan, Peter Entwistle and Madia Smallwood) made a presentation to council Monday night regarding their concerns.
“Unfortunately we anticipate more issues going forward for potential closures, unfilled shifts, and we’re not finding solutions at the moment,” Dr. Bellingan said.
He noted there are many emergency room (ER) shifts that need to be filled.
He explained that the ER is staffed by a group of seven local physicians, who rely on locums (out-of-town) doctors to help out.
Bellingan said doctors in Oliver are remunerated by a fee-for-service, not per hour.
He stated the problem with ER coverage at South Okanagan General Hospital has been going on for the past 10 years.
“It’s a combination of offloading, high workload . . . and the competing priority of family practices.”
• Watch: Local doctors address Town council
Bellingan said due to the imbalance of pay and workload, retaining physicians in Oliver is “nearly impossible.”
He noted there is a significant gap in compensation between Oliver and other hospitals, such as Penticton Regional Hospital.
Bellingan said they applied for an alternative payment plan (APP) contract, which means you get paid per hour, not per patient. But that application was denied by the Ministry of Health.
He pointed out that doctors are seeing more people with chronic health problems, which makes their work more challenging.
The physician also pointed out there are a lot of people who come to the ER with minor complaints, which take time and resources away from the doctor on shift.
According to Bellingan, the ER is always at a crisis or on the verge of a crisis with last-minute shift filling and a constant loss of ER physicians to family practice or Penticton Regional Hospital. He also mentioned that patients from the Okanagan Correctional Centre add to the workload.
He said new family doctors are initially keen to work in the ER but quickly lose interest due to working conditions and the compensation issue.
“As a small group doing the ER shifts, we are trying our best to keep the ER open, but the group is starting to get burned out.”
• Read more: Doctors fear more closures at SOGH
Doctor Entwistle said the biggest issue from their point of view is that nobody is taking responsibility for providing emergency service in Oliver.
“If you ask Interior Health, they will say it’s the doctors. The doctors will say it’s Interior Health or the ministry, and the ministry will say it’s someone else.”
Entwistle said it has reached the point where the seven physicians are being given the option of stepping back and closing the emergency department.
“When it closes, it won’t open again,” he said, noting they will go from having an acute care unit to a long-term medical unit.
Entwistle said this will have a widespread impact on health care in Oliver and Osoyoos. The question (and fear) is how many deaths can be expected if the emergency department closes? the doctor asked.
Entwistle said if the responsibility for the department lands on doctors’ shoulders, then the doctors are beat . . . “we can’t keep doing this.”
There are solutions, he pointed out, but it all comes down to resources.
• Read more: New doctor wants to stay rural
He said that during the election campaign last year, Interior Health found the extra money to keep the emergency department open. But since then, that hasn’t happened.
“It’s frankly disingenuous of Interior Health to suggest they have no plans for closure. They don’t have plans at all; they are waiting for it to close, they are expecting it to close.”
However, in a recent letter to Town council, Interior Health said there are no plans for any change in service at SOGH.
Entwistle said the doctors are asking Town council to hold Interior Health and the ministry to account.
Councillor Petra Veintimilla said Town council recently got wind of impending changes to service levels at SOGH.
She said Interior Health supported the doctor’s APP last year, and two years ago at the Union of BC Municipalities convention, the Ministry of Health said it supported whatever Interior Health supported.
But she noted the ministry denied the application this year, saying it was too heavily focused on the emergency department. Yet the APP that Penticton doctors have in place is for their emergency department, Bellingan said.
Veintimilla asked if Interior Health has offered any backup or solution in light of these unfilled ER shifts in Oliver.
Dr. Smallwood said no, adding that IH is essentially asking local doctors to take on more shifts.
“We told them that, with the limited doctors that we are, that we’ve all basically taken more than we are capable of taking.”
Smallwood said there are 90 emergency shifts in a month that are covered by the seven local physicians. Doctors also have their family practice and long-term care coverage at SOGH.
Councillor Larry Schwartzenberger said it would be devastating to Oliver to lose the ER department. “But it would be doubly devastating to Osoyoos because they have an extra 20 minutes to Penticton.”
The councillor suggested that perhaps Oliver join forces with Osoyoos council to take up this problem with Interior health.