'This is not good medicine. This is cruelty': Fredericton doctors speak out on ailing ER
By Laura Brown, CTV Atlantic
Published Wednesday, May 15, 2019 9:16PM ADT
A group of 18 emergency department physicians at the Dr. Everett Chalmers Regional Hospital in Fredericton have gone public, trying to draw attention to ER wait times and under-staffing.
In a letter, the physicians say some patients can wait up to 20 hours.
“Patients on stretchers are lined up in cold hallways and huddled in corners with their families,” the letter reads. “This is not good medicine. This is cruelty.”
The emergency room at the Chalmers Hospital was built in 1998 to handle 35,000 patients a year. Today, over 51,000 visit the ER according to Dr. Graeme Young.
“It’s just exactly like the turtleneck that used to fit you when you were in high school,” he said in an interview with CTV News. “It just doesn’t fit now.”
He says it’s not just from people visiting the ER when they don’t need to. Triage “one” indicates a patient in need of immediate attention. Triage “five” are those in need of non-urgent care.
The largest group that attends the Chalmers’ ER are triage “three” patients – people with serious ailments like pneumonia, a broken bone or a miscarriage.
In 2004, the ER saw 10,000 of those patients.
Today, that number has increased to over 19,000, but the amount of paid, approved hours doctors can work, hasn’t changed. In 2004, it was 46 hours a day. Today, it’s still 46 hours.
Those 46 hours cover two doctors in the morning and during the day, two in the evening and one overnight – all working an eight-hour shift. A third doctor covers a six-hour shift in the afternoon.
The ER doctors at the Chalmers Hospital are asking for that to increase, to 57.
“We have a problem now,” Dr. Young said. “We’ve had a problem for years, it’s just come to a head now. As we get so busy, we just don’t have the number of people to provide the care.”
Dr. Young says it’s because of a Medicare formula that’s underestimated the Chalmers’ needs for years. He says it’s resulted in long wait times and tired physicians.
“We don’t want things that have happened in other emergency departments, to happen in our department,” he said.
Health Minister Ted Flemming said he “would have preferred that they contacted me first …”
But in the letter, the 18 doctors say they have “made the Health Minister aware” of their concerns.
“Well, if they did, then I missed it,” Flemming said.
The Health Minister wouldn’t commit to meeting with the physicians that have come forward, but acknowledges it is a problem – and he’s not going to hide from it.
“I think that the challenge we have is managing the people who go to the emergency room when it’s not an emergency,” he said.
But according to the New Brunswick Medical Society, those people make up about 20 per cent of ER visits.
“That still leaves a lot of people in our ER department who are there appropriately, who are still waiting very long periods of time,” said Dr. Serge Melanson, President of the NB Medical Society.
Dr. Melanson supports the physicians’ and their push for more funded hours.
“We have relied on a very outdated formula, which government uses to calculate the amount of physicians that are needed to be working in a department at any given time.
“This is a formula that came out 40-some years ago and we’ve never revisited it.”
Horizon Health’s Vice President Medical, Academic and Research Affairs, Dr. Édouard Hendrikssays he’s also hoping that Medicare takes a look at the formula.
But he says it’s not the only solution to the problem.
“We need to enhance our primary health care model so our emergency departments are not a primary source for care,” he said.
The letter also says the Chalmers Hospital is in “desperate need of a modern emergency department.”
But Dr. Young acknowledges that’s likely not in the cards for at least a decade.