Queensway Carleton Hospital, which describes its emergency department as one of the busiest in Ontario, has fewer physicians on duty there as of this week, and emergency doctor hours will be cut further in April, officials say.
The cuts are the result of the provincial government winding down special COVID-19 pandemic funding.
The situation, in the midst of a widespread emergency department crisis, is causing alarm.
“It means we are not going to be able to provide as many physician hours of coverage and care. It means we have to cut back shifts,” said Dr. Michael Herman, an emergency physician at the hospital who is a spokesperson for the Canadian Association of Emergency Physicians.
“Canada-wide, we see the state of emergency departments. We see people waiting hours on end, and we hear about the harms that are coming from people waiting hours and hours. Cutting these hours is only going to exacerbate the problem.”
The funding cuts are part of the Ontario government’s move to end special pandemic funding for hospitals. During the pandemic, the government increased the number of emergency physician hours it would pay for by 20 per cent. It began to gradually reduce those physician hours starting last April.
Because physician emergency department staffing is based on volumes, the cuts weren’t felt at Queensway Carleton until now. Last week, the hospital learned the province would fund four fewer hours a day of emergency physician coverage than it had been supporting. As of April, there will be 10 fewer hours a day of physician coverage in the hospital’s emergency department, a hospital spokesperson said.
Although that suggests volumes in the emergency department are now closer to what they were pre-pandemic, Herman says that is misleading and that it will worsen wait times in emergency departments.
“I think anyone who has been in an emergency department knows that quote-unquote lower volumes are still really high and we are certainly not in the pre-pandemic world anymore,” he said.
Herman says the acuity and complexity of patients coming to the emergency department has changed in recent years, in part because many of them no longer have primary caregivers. That means many required more time than the current funding formula allows for. That funding model for determining how many emergency physicians are required is based on an old study, he said. It is currently being updated by the province. He also notes that the funding model does not count patients who leave without being treated, a growing problem as emergency department waits increase.
Over the weekend, the hospital posted an advisory on its website asking people who were coming to the emergency department to be prepared to wait. “Please be patient as we experience longer than usual wait times in our ED due to patient volumes.”
Emergency departments across Ontario and Canada have been experiencing historically long wait times for care due, in part, to nursing shortages, shortages of hospital beds and increasingly complex patient needs. Reducing the number of physicians working will make the situation worse, Herman said.
This past week, Premier Doug Ford and Prime Minister Justin Trudeau signed a $3.1-billion health funding deal under which Ontario will hire more health workers. During a media conference, Ford suggested stretched emergency departments would be on his radar.
“I’m going to be zoned in on these emergency departments,” he said in response to a question about ballooning emergency wait times.
In a statement, a spokesperson for Health Minister Sylvia Jones said the additional funding for emergency physicians “was part of temporary, extraordinary measures funding given to hospitals during the COVID-19 pandemic to reimburse them for the costs incurred as a result of patient surge due to the global pandemic. Hospitals across the province received this temporary reimbursement funding and were notified well in advance of when this temporary funding would be wound down.”
Herman says the timing to roll back the funding for emergency doctors doesn’t make sense.
“I think our volumes and wait times reflect that this is absolutely necessary (physician) coverage. This is coverage that is keeping our head above water with us paddling as fast as we can,” he said.
“For all the talk of investing in health care, this sure feels like the opposite.”
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