Signs to mark emergency room suspensions in Manitoba's Interlake

Emergency room service in Manitoba's Interlake – long-plagued by service gaps due to doctor shortages – is about to undergo changes that area health officials say they hope will "stabilize" delivery of care in the region.

Starting Sept. 6, bright lime green signs placed outside some emergency rooms at hospitals in the Interlake-Eastern Regional Health Authority (RHA) will signal to people that emergency services there are suspended.

As well, doctors' schedules will be posted online so that members of communities in the region can see in advance how a particular ER might be affected.

Doctors have pledged to provide at least a month of schedule in advance, and nurses will still be available at ERs to assist anyone seeking emergency care, said RHA CEO Ron Van Denakker on Thursday.

"We do want to make sure that if somebody does walk through the door that they get attended to," he said.

In addition, doctors will be on the hook to find replacements if they can't make a shift, he added.

"I want to be very clear … there is absolutely no intention to close hospitals," said Van Denakker. "There's no intention to close beds, and there's absolutely no intention to close emergency rooms. What we have are service disruptions when we do not have doctors."

The RHA has long dealt with doctor shortages and Sept. 6 also marks the end of nurse-managed care in its ERs.

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That initiative, where nurses would phone doctors in other hospitals to obtain medical direction to care for patients, was developed years ago as "Band-Aid" solution, said Van Denakker.

Over time, doctors and nurses became increasingly uncomfortable with it, Van Denakker said, prompting recent discussions about coming to the new arrangement.

The RHA has 10 hospitals across its 61,000 square kilometre service area, and serves a population of 126,000.

Van Denakker said the only hospital the RHA knows will not be affected is Selkirk General.

Paramedics concerned

Paramedics who work in the region say they're worried about what to do in emergency situations.

"For us … every day is kind of a different ballgame. We have to constantly keep updating ourselves to which … ERs are open," said Rebecca Chubaty.

"In this profession we know we have situations that are potentially life or death or fairly critical and the time to look it up on a website really isn't ideal," she said.

Van Denakker said the RHA has commitments from as many as 10 international medical graduates to come work in the region.

That's still fewer than the region needs to add, he said.

"In order for us to have all of our emergency departments 24 hours, seven days a week, we would need at a minimum probably somewhere between 20 to 25 docs," he said. "But when you start talking about some of the other specialists we could use, that number would swell up to about 40 to 45."

One of the issues affecting doctor retention in the RHA is the lack of a residency program, meaning there's limited opportunities for up-and-coming physicians to establish roots in the region, Van Denakker said.