'We need people on call,' Health P.E.I. says as internal medicine specialist leaves practice

P.E.I.'s chief medical officer says a shortage of doctors on the Island is being felt by staff throughout the health-care system — just as another doctor quits her practice.

"We're asking less physicians to do the same amount of work that's had to be done in the past, which puts a strain on the physicians and staff as well," Dr. Kathie McNally said Friday, which marked the last day on the job for Dr. Nicole Drost, an internal specialist from Summerside.

Drost is the latest doctor to resign in the province, closing her practice at the city's Prince County Hospital this Friday.

She's one of two PCH internal medicine doctors who resigned in March, prompting some big changes at the hospital. 

In a letter to patients, she provided some details about why she quit. Drost said because of the shortage of internal medicine specialists, she had to be on call every three days, instead of every five to six days. 

"Due to these ongoing challenges, it is no longer sustainable for me to provide care in P.E.I. within the current system," she said in the letter.

McNally said being on call is tough, but it's expected when you take the job — especially when it's somewhere as small as P.E.I.

"We need people on call," McNally said. 

"If we don't have people on call, we can't have hospitals. We can't have emergency rooms. We can't look after the patients who are acutely ill and requiring urgent assistance. So [being on] call is the hardest work, and it is absolutely necessary to run a system."

Staffing impacts

The staffing changes have had an impact on hospital operations. The PCH has five funded positions for internal medicine in total, and one additional approved position, according to Health P.E.I. 

After Drost's resignation, only one of those positions is staffed.

In May, the province transitioned the Prince County Hospital's ICU to operate as a progressive care unit.

An ICU requires the presence of internal medicine staff around the clock, while a progressive care unit can be operated by family physicians, hospitalists and nursing staff. 

The most critically ill patients requiring ICU services are being transferred to the Queen Elizabeth Hospital in Charlottetown. Since the change, one to two patients a week have been moved.

McNally said the shift in ICU services does mean more work for staff at QEH, but said some ICU nurses from Prince County have stepped up to help out in Charlottetown.

"We have amazing physicians. We have amazing staff," she said. 

"Most of the people want to be here, want to do a generalist role, want to provide the service to patients. But the impact when one person leaves or doesn't want to do call is huge on our system because of our small numbers." 

Despite the challenges, McNally said she's confident if somebody is critically ill, they will still get the care they need. She said the province is hopeful recent recruitment efforts will soon pay off.

"In the last couple of weeks there have been a number of candidates that recruitment as well as Health P.E.I. and our physician leaders have spoken with that are promising. And so we're hopeful that we will be able to identify some additional help."