Almost 1 in 4 emergency room visits in northeastern Ontario could have been avoided

An experienced emergency room doctor in North Bay says almost one quarter of emergency department visits in northeastern Ontario could have been dealt with by primary care instead.

News that primary care could have handled one in seven emergency department visits in Canada made national headlines, but Dr. Taylor Lougheed.says the situation is worse in northeastern Ontario.

The numbers are according to a recent report from the Canadian Institute for Health Information.

"In the Nipissing District, where I live and work, one in five patients don't have access to a family doctor or to a nurse practitioner," said Lougheed.

"And so the access to primary care is extremely limited."

Lougheed said the city of North Bay doesn't have physical walk-in clinics, so the hospital's emergency department gets patients who don't have a family doctor, or can't afford to wait for their next appointment.

"If anything, they're making a logical choice based on limited options," he said. 

Lougheed said an added challenge at the North Bay Regional Health Centre is that the emergency department is short eight full-time doctors.

"So we've had to be creative," he said.

"We have two nurse practitioners in our department. We have a physician assistant. We rely heavily on locums."

Locums are doctors who travel from other communities to temporarily fill holes in communities where there are physician shortages.

Lougheed said there need to be different incentives to attract doctors to northern Ontario communities, compared to those in larger urban centres like Toronto.

He added that NOSM University, which was created to train doctors for northern Ontario, has had some success.

NOSM says that 88 per cent of doctors who completed both their undergraduate and postgraduate studies at the school have stayed to practice in northern Ontario.

Dr. Dominique Ansell, the chief of emergency medicine at the Health Sciences North hospital in Sudbury, said Sudbury faces some of the same challenges as North Bay, although the issues are not as severe.

"Luckily for Sudbury we are not experiencing the emergency physician shortage that I think my counterparts in North Bay are seeing," she said.

But Ansell said the hospital's emergency department is too small for current needs.

She said the hospital is trying programs to make sure people don't end up at the emergency department, and they have shown some early success.

One example is an outreach program where nurses visit patients in long-term care facilities for preventable health care.

Ansell said administrators are currently looking at extending the hours for that program.

"That can offload some of the visits to our emergency department," she said.