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Specialists leaving busy Gander hospital, documents show

Documents obtained by CBC News show the James Paton Memorial Regional Health Centre lost five specialists between December and February.

Departures include recently-recruited ob-gyn, surgeon

The emergency department at the James Paton hospital in Gander is frequently overburdened, according to documents obtained by CBC News. (CBC)

A string of specialists have quit their jobs at Gander's James Paton Memorial Regional Health Centre, leaving a hospital that has seen long wait lists and a busy emergency room in the past eight months.

A radiologist, pediatrician, general surgeon and internist all left the hospital between December and February, according to minutes of a doctor's working group meeting that were obtained by CBC News.

The list also includes an ob-gyn who was brought to the region in August in an effort to restart obstetrical services at the hospital.

He left in early February, six months later.

"I would say in most of the cases, there's different reasons," said Dr. Jeff Cole, Central Health's vice-president of medical services. "There hasn't been a one, predominant reason that would group them all together."

The new recruits have an expectation of lifestyle.- Meeting minutes of James Paton Memorial Regional Health Centre's Medical Advisory Committee

Cole said the organization is "always concerned" when it loses a specialist, but said that the number of departures hasn't negatively affected operations — even if it is a "little bit above average."

"Even though the perception is that, you know, things are not well, I would actually counter that to say that things are probably looking better at James Paton now then they have in a long time," he said.

Workload, salaries a factor

Meeting minutes of the doctor's working group suggest that working conditions at the hospital contributed to decisions by several staff to resign their posts.

"The new recruits have an expectation of lifestyle, can't do that with no locums to cover, been a problem in [obstetrics and pediatrics] this month," meeting minutes from January read.

My perception is, we've come a long way- Jeff Cole

The minutes also show that Central Health has struggled to secure locums — temporary, fill-in doctors — in the anesthesiology and general surgery departments of the hospital.

In one case, the salary for a potential anesthesiologist locum was a sticking point in negotiations.

Jeff Cole is the vice-president of medical operations for Central Health, and an anesthesiologist. (Courtesy Central Health)

Cole agreed that workload is playing into the decision by some doctors to seek other jobs.

"It's probably a more prominent reason for newer graduates. It seems like the newer graduates definitely value their lifestyle and time off more than, you know, say 20 years ago," he said.

With the departure of the ob-gyn, delivery and labour services have once again been diverted to the hospital in Grand Falls-Windsor.

Stretched thin

CBC News obtained the meeting minutes from the hospital's medical advisory committee. It's a group made up of doctors at the hospital and administration from Central Health.

The minutes run from September 2017 to February 2018. Through that time, the committee heard in five of six monthly meetings that the hospital was wrestling with long waitlists or heavy traffic.

The hospital's emergency department had the most mentions. High traffic in the emergency rooms were blamed on a lack of family physicians in Gander and surrounding areas.

Health Minister John Haggie has ordered a review of Central Health. He has said inadequate recruitment and retention of specialists was one concern he heard about in the organization. (Sherry Vivian/CBC)

"Most patients have family doctors, but they are there because their family doctor is away, or the family doctor has requested that they get extra tests done," the meeting minutes read. "Shortage of family doctors … if there were more in the community, there would be less visits to the ER department."

In February, Central Health administration told doctors that the hospital was "in an overcapacity" and would be looking to cancel or postpone surgeries. 

According to Cole, both situations are "fairly global" problems among hospitals in the province — explaining a lack of beds in one part of the hospital can mean emergency room patients are stuck waiting longer.

Because one of its recent recruits has resigned from his position, Central Health has diverted obstetrical delivery and labour services to Grand Falls-Windsor. Some maternity services are still available at the Gander hospital. (CBC)

Although workload can be a factor in physicians deciding to leave their jobs, he said the departures aren't making crowding at the hospital any worse.

"The overcapacity problem and the linkage to what our physician complement is, actually, it's not linked at all." 

Cole said when Central Health is forced to cancel surgeries, they look to elective and non-urgent surgeries first.

Turning the corner: Central Health

Central Health is the subject of two external reviews, one ordered by Health Minister John Haggie in February.

Following that announcement, Rosemarie Goodyear resigned as CEO of Central Health.

Cole says there is a negative perception of the organization both inside and outside hospital walls, but he said it is unearned.

"Even though most of the messaging right now seems negative, my perception is we've come a long way," he said, adding that specialist staffing levels in many parts of Gander's hospital are more stable now than they have been in years past.

"The hospital is good, it's safe, it's quality. It's made a lot of inroads in the last six months or twelve months."

ABOUT THE AUTHOR

Garrett Barry

Journalist

Garrett Barry is a CBC reporter, working primarily with The St. John's Morning Show.