Doctors say the Red Deer hospital’s surgery program is on the “brink of collapse” due to a severe lack of staff and resources.
Surgeons fear that there may be periods of time in October when no anesthesiologists will be available for surgeries.
“A lapse in anesthesia coverage would be unthinkable for a regional hospital of this size. Every urgent procedure, from C-sections to appendectomies to major traumas, would have to be diverted to Edmonton or Calgary, centres that cannot accommodate this extra workload. The consequences of such a collapse would have catastrophic effects on the health, safety, and survival of our patients,” wrote Red Deer surgeons in a letter to Health Minister Jason Copping sent Sunday.
Doctors say over the past two years the hospital has experienced significant attrition of operating room anesthesiologists and nurses due to years of inadequate infrastructure, and human resources planning and funding.
“Loss of these personnel has resulted in a dangerous reduction in the availability of OR resources and has crippled our surgical program.”
They say it has resulted in a severe backlog of elective surgery, stable patients becoming emergency cases, delayed cancer surgeries, and worsening outcomes for patients.
The emergency surgery list at Red Deer Regional Hospital Centre has 20 to 40 patients on a daily basis, while hospitals in Edmonton and Calgary typically have five to 10.
Surgeons are asking for emergency funding to encourage the recruitment of anesthesiologists, an increase in stipends and overhead relief that is provided to anesthesiologists and surgeons in Calgary and Edmonton, and more support personnel to match their counterparts in those cities.
Anesthesiologist Dr. Arun Anand, who wrote his own letter the health minister, said no anesthesiologists are scheduled to cover on-call services at the hospital at the end of October.
“It’s unacceptable and sad it even had to get to this point, that we’re really facing this kind of a crisis and nothing has been done,” Anand told the Advocate.
He said the hospital has the full-time equivalent of about 10 anesthesiologists and it needs 16. At a certain point, you reach a breaking point.
“The hospital here is doing the workload of two, if not three, other hospitals. It’s astounding we have such good results. It’s a testament to the people who work here.”
On Thursday the health minister met with Red Deer hospital staff. It was one of the workshops being held around the province to look at health care challenges and possible solutions.
Anand said after speaking to the minister he was optimistic answers could be found.
Copping said he appreciated the doctors’ concerns. There is a shortage of anesthesiologists across Canada and many countries and Alberta Health Services (AHS) is taking steps to attract them, particularly in Red Deer.
“Our government has actually provided significant funding to increase capacity across our entire system, an additional $600 million this year, $1.8 billion over the next three years. Our expectation is AHS will allocate that funding across our regions to be able to get the results that we need,” Copping told the Advocate.
“As part of the Alberta Surgical Initiative we are investing in ORs and equipment and people across the province, including in Red Deer, to perform more surgeries. The Central Zone has reached 105 per cent of their pre-COVID surgeries.”
He said if Red Deer had more anesthesiologists even more patients could access surgery in Red Deer. AHS has also been working with anesthesiologists to develop a way for them to oversee other trained staff instead of having one anesthesiologist for every surgery.
“We are making progress, but I appreciate the input I have from our health care professionals and we’ll take a look at that and see how we can improve even more,” Copping said.
Internal medicine specialist Dr. Kym Jim also commended Copping for visiting Red Deer, but said immediate action is needed to solve the hospital’s problems.
He said there are nights in September, October and in the future when there will be no physician coverage in some critical areas of the hospital, like internal medicine and cardiology because there’s not enough doctors.
Doctors have been asking for additional help at night for over six years, he said.
“Specialists here in Red Deer are at the hospital all hours of the day and night, and our colleagues in other jurisdictions are not,” Jim said.
He said the wait time in the emergency department was over 14 hours at one point Wednesday night. His colleagues saw over 10 ambulances lined up waiting to drop off patients, and over 20 patients were waiting to be admitted to the hospital Thursday morning. Many people waited far longer than they should to be treated in the ER.
He said the biggest day-to-day problem is that medical patients who don’t need specialist’s care are being transferred to other hospitals for care because Red Deer hospital can’t accommodate them.
“I can guarantee you that they were shipping people out (Thursday). They would have had to to get through the backlog in ER,” Jim said.
NDP health critic David Shepherd said an AHS presentation on the Alberta Surgical Initiative revealed that while the UCP increases the use of private surgeries, they are missing targets within the public system by nearly 37,000 surgeries. Despite Minister Jason Copping’s claims, Alberta has not regained pre-pandemic surgical capacity.
He said surgeries had to be diverted from Red Deer earlier this year to other communities, causing already overwhelmed hospitals to deal with added pressure, and then need to cancel and divert surgeries.
Now the UCP are seeking offers to build a private surgery facility in the Central Zone.
“New buildings don’t make new surgeons, or new anesthesiologists, or new nurses. A private facility will pull more staff and resources away from the hospital,” Shepherd said.