Doctor shortage in northwestern Ontario forces Red Lake hospital’s ER to shut for 2nd time this year

The hospital in Red Lake in northwestern Ontario is closing its emergency room for the second time this year due to a doctor shortage that hospital leaders say is dire, and while some remote First Nations are experiencing a surge in COVID-19 cases that’s also straining staff.

Margaret Couchenar Memorial Hospital’s ER will close for 12 hours, starting at 8 p.m. CT on Thursday, said Meghan Gilbart, the hospital’s chief nursing executive.

“Unfortunately, we are again in a position where we just don’t have enough physician resources to stretch for that 12-hour period,” Gilbart said. “And so, unfortunately, it will result in us having to close our emergency department for that time.”

The hospital’s ER also closed for 24 hours over a weekend in March. 

Gilbart said the hospital has been working to address its physician shortage, which is a longstanding issue, hitting the region especially hard this spring. Hospital leaders across the region say the situation is dire and are looking for any physicians to come to northwestern Ontario. 

Doctors and patients across Ontario describe record-setting bottlenecks in emergency rooms across the province, with staggering wait times and health-care staff burning out due to staff shortages and the COVID-19 pandemic. 

“Prior to our closure in March, it wasn’t something that was really well known,” said Gilbart. “There has been a lot of efforts toward advocating for things like equitable funding, which considers the realities of northern travel.

“We know that travel right now is super challenging for many people.”

Difficulty recruiting doctors

The Red Lake hospital is also focused on recruiting more doctors, and working with regional and provincial health-care providers to bring in more locum (temporary) physicians. However, that’s proved difficult.

We’re all tired of this pandemic. It has placed so many restrictions on our lives. The health-care workforce is so burned out and we don’t have the number of staff to address, in this point in time, even the surge in COVID-19 cases.– Dr. Lloyd Douglas, Sioux Lookout First Nations Health Authority

Bringing in more nurse practitioners, or physician assistants, can also help with shortages, Gilbart said.

“I think more funding will always help, but it’s not the one and sole answer to this problem, unfortunately. I think there is just a pervasive lack of physicians.”

Gilbart said another issue is many staff physicians at the hospital are reaching the end of their careers, and not enough new physicians are coming to live and work in Red Lake to replace them.

Have you or someone close to you recently endured a long stay in an emergency room in northwestern Ontario? Email CBC News to tell us about your experience. 

Some extra positions for Northern Ontario School of Medicine (NOSM) graduates have been created, but Gilbart said that’s a long-term solution and still leaves short-term gaps that will need to be filled.

The good news, Gilbart said, is the ER closures have raised awareness of the problem.

“Nobody wants to see that happen in any of our communities,” she said. “I think there’s been a lot more focus and recognition that this is a problem and we have to make actionable steps towards finding short-term and long-term solutions.”

Shortly after news of the upcoming closure was announced, NDP MPP Sol Mamawka wrote to Ontario Health Minister Sylvia Jones, calling on her to do something about the physician shortage. 

Mamakwa wants the province to implement a series of measures that have already been proposed by health leaders in the region, including:

  • Creating better incentives for physician recruitment in northwestern Ontario. 
  • Expediting licensing requirements for internationally trained physicians to work in the region 
  • Increase opportunities — or even mandate — return-of-service obligations for students and residents at the NOSM  to work in the region. 

NDP MPP Sol Mamakwa, shown speaking at Queen’s Park during question period, is calling on Health Minister Sylvia Jones to address the physician shortage in northwestern Ontario. (Legislative Assembly of Ontario)

“It is unnacceptable that in a province like Ontario, thousands of northerners are being left without lifesaving care. This is made worse by the fact that this closure is not a surprise — we anticipated it,” he said. “Therefore, we should have been prepared for it.” 

This week’s 12-hour ER closure in Red Lake will end at 8 a.m. CT Friday. 

“During that time, patients unfortunately are not able to present to the emergency department, but if they are experiencing a serious emergent health issue, they are able to call 911,” Gilbart said. “EMS services will be available.

“They also have the option to transport themselves to the next nearest hospital. We also are just advertising the Telehealth line as well as another resource.”

First Nations experiencing COVID-19 surge 

Health workers at remote First Nations are dealing with similar fatigue amid a COVID-19 surge, said Dr. Lloyd Douglas, the public health physician for the Sioux Lookout First Nations Health Authority. 

Currently, there are more than 500 cases, about twice the total two weeks ago, Douglas said. 

“Every nursing station is still open, none have been closed, but they have minimal staff,” he said. “In terms of services that could be provided, that could come down to emergency service and urgent services.” 

A patient is tested for COVID-19 in Bearskin Lake First Nation during an outbreak there earlier this year. There are currently about 500 cases in northwestern Ontario’s remote First Nations. (Submitted by Sharon Angeconeb)

Similar to hospitals across Ontario, Douglas said, staff at First Nations are dealing with burnout as the pandemic drags on, there there are also long-term structural systemic issues. 

“We’re all tired of this pandemic. It has placed so many restrictions on our lives,” he said. “The health-care workforce is so burned out and we don’t have the number of staff to address, in this point in time, even the surge in COVID-19 cases.”

Thunder Bay staffing stable

In another part of northwestern Ontario, the emergency room at the Thunder Bay Regional Health Sciences Centre’s will continue to operate 24 hours a day.

Staffing at the TBRHSC is stable, although the ER has seen a 30 per cent increase in visits since the start of 2022.

A hospital spokesperson said ER visitors are waiting 1.6 hours on average for an initial assessment by a doctor. The average visit to the TBRHSC ER lasts just under three hours for minor health issues, and 4½ hours for more-serious issues.

The spokesperson said that is in line with provincial averages. 

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