By Kalinowski, Tim on March 5, 2020.
Emergency room doctors in Lethbridge and Medicine Hat are saying changes to the health-care system being brought in by the Kenney government could swamp emergency rooms and negatively impact patient care in the AHS South Zone.
A letter signed by 22 emergency room physicians in Lethbridge and 14 in Medicine Hat says the changes, slated to come into effect April 1, are poorly considered.
“We are concerned that the current government either does not fully understand the above relationship, or does not understand how the unilaterally imposed changes that were vehemently resisted by the Alberta Medical Association will rapidly decrease access to quality community health care, resulting in poorer health for Albertans, and a rapid increase in the utilization of expensive emergency and hospital-based care,” it reads.
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.
Dr. Sean Wilde, a Lethbridge emergency department physician who acted as spokesperson for the 22 local physicians who signed the letter, says they wanted to add their voice to ensure patients in southern Alberta really do understand what they will be losing once the Kenney government imposes its unilateral changes on April 1, changes which ignore the best advice of practising physicians.
“We are saying some of these things are not a good idea and probably should be thought through and done in a different way that is going to result in better cost savings without compromising patient care,” he said. “I think it is possible to save money without impacting frontline care, but the way they are going about it right now seems to be the wrong way.”
Wilde says the Kenney government has chosen to engage in an antagonistic way with the province’s physicians on this issue, and on others like its recent decision to tear up its working agreement with physicians, and it is everyday Albertans who will likely reap the consequences of that antagonism.
“I know there are already physicians thinking about leaving,” he says, “and I know there have been several stories of physicians who were planning to come that are now a little more uncertain. The key point here is without an agreement it is very hard to have any certainty and stability. There is a lot of uncertainty about where things are going to be at (in Alberta), and particularly for family practice at this time. That uncertainty makes it hard to run a small business like a family clinic, and harder to have confidence you can practise the style of medicine you have been trained to practise without (political) interference.”
The letter released by the group goes further in stating some of these changes could lead to poorer patient outcomes and greater instances of preventable trauma-related death.
“Of particular concern is the potential loss of the stipend supporting the Acute Trauma on-call service, which provides general surgeon coverage in hospital to respond to trauma team activations,” the letter reads. “This seven-year program has decreased adult and pediatric trauma death in Lethbridge by 65 per cent. In 2018 there were 107 major trauma patients treated in Lethbridge, and 63 in Medicine Hat. Time is critical in these instances, and an increase in preventable traumatic deaths is highly likely should it be lost. The status of this program is unclear due to government’s lack of response to requests for clarification, and is expected to be lost on April 1.”
To read the full letter visit The Lethbridge Herald’s website at
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