ER, women's-health doctors raise the alarm about unsafe conditions

Health Minister Adrian Dix is facing a “staggering” health care crisis as dozens of physicians at five B.C. hospitals have come forward to raise the alarm about unsafe conditions they say are putting patients at risk.

The latest open letter was from women’s health providers at Surrey Memorial Hospital who say inadequate resources are compromising patient care and were a factor in the death of a newborn baby in 2020.

Another letter from emergency room doctors at Royal Columbian Hospital in New Westminster and Eagle Ridge Hospital in Port Moody says a critical shortage of hospitalists — the doctors in charge of admitting patients from the ER and looking after them in hospital — has resulted in some patients waiting in the emergency room for up to 72 hours.

And one Nanaimo emergency room doctor said he’s seeing more patients being admitted to hospital with no doctor assigned, which means no one is directly managing their care.

Trevor Halford, B.C. United MLA for Surrey-White Rock, said the growing chorus from concerned physicians is “staggering.”

“It’s past the tipping point,” he said. “It’s an absolute crisis.”

Dix acknowledged busy hospitals such as Surrey Memorial, Nanaimo Regional and Royal Inland have had an increase in patients in recent months, leaving them over capacity.

“When the very, very busy days are every day, that’s a huge stress on everybody in the system,” he told Postmedia News on Tuesday. “And that’s what we’ve been seeing over time.”

An open letter released Monday by 36 physicians in obstetrics and gynecology at Surrey Memorial Hospital said the “critical scarcity of resources has created systemic issues compromising safety for our patients,” and has “resulted in one newborn death, countless near misses, and moral injury to our care providers.”

Dr. Claudine Storness-Bliss, an obstetrician and gynecologist and co-head of the department, told Postmedia News on Tuesday that she and her colleagues are mentally and emotionally drained as they try and deal with “acute situations and not being able to address them in a timely fashion because of the lack of resources.”

“We continue to move mountains to do what we can to take care of patients,” she said. “But the number of patients requiring care is rapidly growing. We are already falling short and unless we act today, it is going to be a disaster within the next few years.”

Fraser Health CEO Dr. Victoria Lee confirmed that the health authority launched a review after a newborn died in 2020. While Lee could not go into details about what caused the infant’s death, citing privacy rules, she said the review led to seven recommendations and an additional $3 million spent to add staff and support services to the family birthing unit.

Storness-Bliss said that funding has not been enough to keep up with demand and Surrey’s rapidly growing population. For example, the letter notes Surrey Memorial’s family birthing unit has half the number of beds of similar units in Vancouver.

“We’re putting out fires as opposed to planning for the fires that are coming,” she said.

The obstetricians and gynecologists released the letter to back up the concerns from Surrey Memorial emergency room physicians. The ER doctors said in an open letter earlier this month a shortage of physicians and acute beds have created “unsafe conditions” that have caused “severe adverse outcomes including death.”

Lee told Postmedia News after the letter was released that no one has died due to delays in care or a shortage of beds.

On Tuesday, Lee acknowledged that “there’s frustration and challenges and at this time” including “delays in care, increasing demand, stretching of current services.” But she said the health authority is working to recruit staff to deal with that increased demand.

A group of physicians from Royal Columbian Hospital in New Westminster and Eagle Ridge Hospital in Port Moody added their voices last week with a letter slamming the government and Fraser Health for failing to acknowledge the severity of the emergency department crisis.

“Our community is at a breaking point,” they wrote. “Wait times have skyrocketed. Emergency departments are overcrowded. Patients are leaving without being seen, despite seeking care.”

The dire shortage of hospitalists — doctors employed directly by hospitals — means patients are waiting up to 72 hours in the ER before being admitted, they wrote.

One Nanaimo emergency room doctor told Postmedia News the “crisis” shortage of hospitalists is leading to patients being admitted to hospital with no doctor assigned.

Dr. Chris Rumball, who has worked at Nanaimo Regional General Hospital since 2009, said that increasingly means patients “being handed from one emergency doctor to the next. So at least some physician knows vaguely about their existence, but no one is specifically directly managing their in-patient care.”

Rumball has dubbed these “IOU patients” — inpatients orphaned and unassigned. Rumball, who has been practicing for 47 years, is frustrated at seeing patients “languish in already overcrowded (emergency department) hallways. These are people that we owe a standard of care and we’re not giving it to them.”

Dr. Joshua Greggain, president of Doctors of B.C., confirmed there’s been an increase in patients being admitted to hospital with no doctor attached.

“That’s not a safe way to provide care,” he said. Greggain said while a shortage of hospitalists is one factor putting stress on emergency departments, other factors include the number of people coming to emergency rooms because of the opioid crisis, the mental health crisis and the shortage of family doctors.

Dix said the Health Ministry is working with hospitalists on a better compensation model, similar to the deal made with family doctors.

“What you have to do to improve the system is you have to recruit more (health workers) and that’s what we’ve done,” Dix said.

kderosa@postmedia.com