Province cuts physician position for Red Lake, a blow to those hoping for relief amid doctor shortage

The first hospital in Ontario to temporarily close its emergency room due to a physician shortage in 2022 may now have to make do with even fewer physicians in the community.

The province has reduced the physician staffing complement in Red Lake, Ont., from seven full-time equivalent positions to six. 

The Red Lake Clinic in the northwestern Ontario town notified patients last week that it is ending its regular Saturday urgent care clinic and will no longer respond to email or phone messages.  It also warned that emergency room closures may become more common.

"This devastating change will negatively impact the ability to recruit doctors, draw locums and keep physicians working locally," the clinic wrote on its Facebook page. "It will further challenge medical services at the clinic, the hospital and beyond." 

The cut was the result of a review of physician staffing complements in the 38 Ontario communities covered by Rural and Northern Physician Services Group Agreements – a funding model under which doctors agree to collectively provide needed services for a small community. 

The 2021 Physician Services Agreement called for the Ministry of Health and the Ontario Medical Association to strike a working group to carry out the review.

Some physicians had hoped that the initiative would lead to more positions being funded, said Dr. Lisa Habermehl, a rural family physician who works in Red Lake.

But at least two communities in the northwest – Red Lake and Atikokan – lost positions.

Habermehl called it "a huge blow to morale."

It has contributed to a further loss of physicians, said Sumeet Kumar, the CEO of Margaret Cochenour Memorial Hospital in Red Lake. 

"One person, after they heard this announcement, they put in their resignation and their retirement," he said. 

Possibility of increased staffing offered hope

Red Lake had been unable to fill all seven full-time equivalent positions it's funded for, but doctors used the balance of the funding in part to offer premiums to attract locums, physicians who do temporary placements in the community, Kumar said.

"Last week from Aug. 1 to Aug. 6, we would have been closed because we did not have any physician coverage, so we had to increase the premiums significantly to make it attractive for the physicians to come," he said.  

"Ornge had to help us transport a physician from Durham region."

The potential to hire more help also gave hope to a team of doctors struggling to try and serve an aging population with increasingly complex needs, Habermehl said. 

"Healthcare's become a very busy, very tough place to work sometimes," she said. "It's always in the background that if somebody wanted to come, that would be wonderful, and that will keep us going, and that will refresh us, and that'll make this more sustainable… If I just hang on for another six months maybe we can bring somebody else on board."

Hambermehl has met with representatives from the Ontario Medical Association and is waiting for direction on how to appeal the decision, she said.

The hospital, meanwhile, is writing a letter to the Ministry of Health to protest it, according to Kumar. 

He believes the ministry and the medical association may have made their decision without properly taking into account the medical services provided in the community to patients from northern First Nations and patients who work in the mining industry in Red Lake but do not reside there, he said. 

Review leads to more positions overall, province says 

Neither the Ministry nor the Ontario Medical Association (OMA) provided details to CBC News about how they assessed physician need in communities.

However the OMA provided an excerpt from the Physician Services Agreement stating that the review might take into account matters such as emergency department volume, community staffing needs, demographics, population morbidity, obstetrical care requirements, the needs of women physicians in terms of sustainable workload, migration patterns, and maintaining patient choice of physician.

The Ministry of Health did not provide CBC News with the results of the review when asked. 

"This review, based on right sizing and providing service in communities where it is needed most, resulted in an overall increase of physician complements in rural and northern communities," said Hannah Jensen, a spokesperson for Health Minister Sylvia Jones, in an email.

"The RNPGA physician complements will be reviewed by the Ontario Medical Association and the Ministry of Health in two years. We will continue to work together with communities across the province to connect Ontarians to the care they need."

A spokesperson for the Ontario Medical Association said it could not comment on challenges faced by individual communities in recruiting and retaining family physicians.