Alberta emergency room doctors demand solutions to overburdened system

The Alberta Medical Association says persistent staffing challenges are taking a toll on all facets of the province's health-care system — causing major care deficits for patients. 

The AMA says those pressures are being felt most acutely in the province's emergency departments.

"Combined demand of treating emergencies, COVID-19 cases, pandemic-related delays in care and gaps in the management of conditions created by changes in family physician supply have overwhelmed emergency departments across Alberta and impacted untold numbers of Albertans," the association said in its latest care deficit assessment paper.

"The combined effect is a severe access block, where patients in the emergency department requiring inpatient care can't access the hospital beds they need, leading to overcrowding and delays in care."

'Beds don't look after people'

Dr. Warren Thirsk's first interaction every day in his role as an emergency room physician at Edmonton's Royal Alexandra Hospital is usually with someone who is really upset they've been waiting in the ER for hours. 

"The first thing we start off with is de-escalating everyone's anger and frustration of having sat there for 12 hours, and so I will tell them, 'I just started five minutes ago, I'm not actually responsible for your wait or any of the problems that have happened, but I'm here to help you now,'" he said.

"That talk is a typical experience that we're all having every day, and then it won't get better throughout the rest of my day."

Thirsk says the emergency department is generally the last resort for all aspects of the health-care system, so when his department is seeing these kinds of delays, it's a sure sign the rest of the system is already functioning in a deficit mode, and that impacts emergency rooms, too.

"For example, if someone needs an operation and there's no surgical bed to admit them to, they get stuck in the emergency department and an emergency bed waiting for their surgery," he said.

"I've actually admitted patients within the last month to hospital from an emergency stretcher or an ambulance stretcher in the hallway, because we have nowhere to offload them. We have nowhere to put them. We have no staff to look after them."

Thirsk said Alberta needs more than beds to make a significant change.

"Beds don't look after people. They don't help you to the bathroom. They don't check your pain. They don't change your bandages. They don't clean the room that you're in. The bed is just a physical thing," he said. 

"We missed the fact that we put a person in their bed and then we need staff around the clock to look after the person in the bed."

'Burnout rates are higher than ever'

Dr. Timothy Gash works in the ER at Red Deer Regional Hospital. He says COVID-19 has only exacerbated an already taxed system. 

"Our system frequently functioned before the pandemic at, you know, 95 per cent or even 115 per cent capacity at different times, which really leaves no room when there's additional need, which we've clearly seen over these past two years," he said.

"Burnout rates are higher than ever. The amount of providers that have been contemplating cutting back on the services they're offering has been a really frequent thing."

Gash said Alberta has also seen a slew of health-care workers leave the province over the last few years, and they're not coming back.

"We've been without a physician services contract for more than two years, and we've had a very contentious relationship with our current government, which has made attracting new positions really challenging."

AMA seeking solutions

To fix the problem, the AMA says there are several things the province could do.

In the short-term, the association is calling for Alberta Health Services to share specific data with physicians around wait times and access blocks to care and specialized care so they can track trends and offer advice on how to direct resources. 

In the long-term, the AMA says the province needs to work on attracting and making incentives for doctors to come work here, which would also help improve primary care access through family physicians.

It says AHS needs to consult with physicians and other front-line health-care workers on what the system needs to deliver the best care for patients and improve the efficiency and sustainability of the system, and put an emphasis on improving after-hours care from specialists.