Alberta's ER staffing crunch getting worse in big cities and small, doctors warn

Alberta Health Services is trying to find dozens of emergency room doctors to fill vacant positions across the province.

The health authority said it's recruiting for 39 full-time equivalent ER physician positions in regional and big city hospitals.

It's also trying to recruit 29 rural family medicine physicians, who would have emergency department privileges in smaller hospitals.

Physician shortages are impacting emergency rooms around the province.

One of the most recent examples can be found in Lethbridge where the Chinook Regional Hospital, which has an on-going shortage, is facing a worsening problem this summer.

Alberta Health Services (AHS) notified the public last week to expect longer wait times in the southern Alberta facility during July and August due to the shortage.

"This is definitely the worst that we've been. It's the only time we've been looking at a full month or two months where we're short a doctor every day," said Dr. Sean Wilde, an ER physician at the hospital.

The Lethbridge hospital sees about 150 to 200 patients a day.

Normally it has seven doctors working in a 24-hour period. This summer, the daily roster is six physicians, and, on some days, only five. 

That will leave just one doctor on duty at less busy times on some days. 

"It's a bit of a higher risk environment to practise in when we're under that stress.… There's people waiting to be seen and there's not as much help as you would normally expect," said Wilde.

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The Lethbridge hospital, which has been dealing with shortages for several years, relies heavily on locum physicians who fill in on a temporary basis. But they're harder to come by during the summer months.

Dr. Aaron Low, medical director for the AHS south zone, said all patients are triaged when they arrive in the ER.

"The ones who have acute problems — so they have concerns for a heart attack or stroke or if they have a trauma — those patients are immediately seen."

Patients who are considered less urgent are the ones who will feel the impacts, he said.

"Those patients will wait longer."

According to Low, wait times at Chinook Regional Hospital have traditionally been lower than many other facilities. 

"So we don't like this but in context it's not as bad as some other places," said Low, noting patients with concerning symptoms should still go to the emergency room for care.

Wider problem

Doctors are warning the Lethbridge hospital situation highlights a growing problem in Alberta.

As of Wednesday, AHS had issued 20 public service announcements for care disruptions or temporary closures around the province since the beginning of July, many of them relating to ER physician shortages.

The Lethbridge hospital is the largest facility affected in recent weeks.

"The fact that emerg is now getting pinched with workforce shortages of physicians is a really bad sign," said Dr. Paul Parks, president of the Alberta Medical Association.

According to Parks, other health system pressures — including nursing shortages, delays in specialist access, surgical diversions and family doctor shortages — are trickling down to the ER, and physicians are burning out and leaving those jobs.

The backlog of admitted patients stuck in emergency rooms due to hospital bed shortages and the lack of specialists on call after hours is also contributing, he said.

"You're seeing the domino effects. More and more rural emergency departments closing means more patients go to the regional centres. The regional centres are understaffed … meaning more people go to the bigger urban centres. And they're crazy overloaded," said Parks.

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"It starts burning our teams out more and more and more."

It's a vicious cycle, according to Fiona Clement, a professor in the department of community health sciences at the University of Calgary.

"The system's in trouble and I'm worried," she said.

"When you have fewer physicians than you need, the physicians who are left practising are carrying heavier loads. They're doing longer hours."

Recruiting dozens of physicians to work in Alberta's emergency rooms won't be easy and it won't happen quickly, according to Clement.

"Generally, doctors aren't just lying around waiting or a job offer. So we're talking about either … recruiting them away from wherever they are right now, which is not easy … or we're talking about training 70 physicians, and that is not a quick solution." 

Beyond the AHS recruitment efforts, Parks is calling on the provincial government to take some key steps, including finalizing a funding model for family medicine and implementing a hospital stabilization plan his group provided to the government in December.

The press secretary to Alberta's health minister said, in a statement emailed to CBC News, that the government is working to address the problems through its health system overhaul.

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"A refocused health-care system will ensure AHS can focus on the acute care system and related staffing concerns, while other important areas of health care, such as primary care, assisted living and mental health and addiction, receive the resources and supports they require," the statement from Andrea Smith reads in part.

"Work currently underway includes creating more rural medical training opportunities and expanding the scope for nurse practitioners to be able to provide primary care with government compensation."

And she said the government is working closely with the AMA on the new family physician compensation model.

"When it's fully implemented, we expect it will make Alberta a national leader in recruiting and retaining primary care physicians."