More very sick central Albertans will have to be flown to larger centres, or face longer waits at rural hospitals, because of inadequate acute care resources at Red Deer hospital, say two Alberta doctors.
Dr. Paul Parks, president of the Alberta Medical Association, warned of "an escalating crisis in acute care" in Alberta because the growing numbers of patients with chronic and complex health issues is surpassing the ability of general internal medicine specialists to treat them in hospital emergency rooms.
Specialists in general internal medicine care for patients with more than one serious conditions, such as diabetes, kidney or lung disease, heart failure, and drug or alcohol withdrawal. Right now, "no one else can solve these problems" on ER shifts without GIM coverage, said Dr. Troy Pederson, president of the AMA's General Internal Medicine section.
With flu season fast approaching, he fears fear poor health outcomes for many patients unless a solution is found, either bringing in more GIMs to emergency rooms during off-hours weekends and evenings, or pulling together special teams of nurses, therapists, etc to help fill these gaps, said Pederson.
He and Parks agreed the situation at more isolated acute care hospitals, such as Red Deer's, is even more dire.
Red Deer Regional Hospital Centre is the only acute care facility between Calgary and Edmonton and is currently short of internal medicine specialists. Alberta Health Services has been recruiting with some success, but more ongoing recruitment is needed, said Pederson.
When GIMs aren't available at Red Deer hospital some evenings or weekends, Parks said rural patients will spend more time waiting to be transferred out of rural hospitals, or have to be medivaced to hospitals in Edmonton or Calgary — adding to the patient load in the larger centres.
"I do feel for a place like Red Deer, because they are driven to do more with less than the rest of us," Pederson added,
Park said Alberta Premier Danielle Smith has admitted her government has not funded health adequately, factoring in inflation and population growth — and he believes this is unacceptable at a time when Alberta is gaining people from other provinces and the "Baby Boomer Bubble is aging."
The doctors say more "incentivization," including financial compensation, is needed to motivate GIM doctors to work evening and weekends in hospital emergency rooms. Some specialists have opted out of working at hospitals entirely, and are now just caring for patients in the community. They need to be induced to return to help out at hospitals, said Pederson.
The doctors also urged for better organizational planning and scheduling at hospitals. Teams nurses, therapists, etc need to be pulled together to help shoulder the load for GIMs, and perhaps help fill in the gaps during shifts when GIMS are not available.
Parks said while the AMA put forth some proposals or action plans for Alberta Health's consideration 10 months ago, nothing has happened yet — and fall's flu season is quickly approaching.
But Andrea Smith, press secretary to the health minister, said Alberta Health has already incentivize after-hours care. "In fact, in 2023-24 physicians received approximately $200 million total in after-hours time premiums." She added physicians are compensated for after-hours care provided in an advanced ambulatory care centre, urgent care centre, active treatment hospital, nursing home or auxiliary hospital during defined after-hours time periods.
"Our number one priority is the health of Albertans," said Smith, which is why the government is refocusing the health care system to allow Alberta Health Services to "focus on providing quality acute care to Albertans that need it."
The AMA negotiated the latest agreement with the government on physician compensation in 2022, where there was an opportunity to bring forward any issues facing physicians, such as changes to after-hours provisions, or any other issue facing specific practice settings such as acute care, said Smith.
"The Government of Alberta remains committed to working with the AMA through the agreement on any concerns physicians have, as there are multiple avenues in which these specific items can be discussed and negotiated appropriately."
According to Alberta Health Services, the general internal medicine workforce in Alberta has grown by 11 per cent since 2019/20. But AHS acknowledged that it is still experiencing difficulties recruiting doctors outside of main urban centres.
