Local officials worried about the future of ER in Cold Lake

The City of Cold Lake and the Municipal District of Bonnyville are concerned that the community could lose important medical services due to doctor shortages at the Cold Lake Healthcare Centre.

Elected officials in the area have heard from front-line healthcare workers that the number of doctors at the Cold Lake Healthcare Centre is insufficient to run both private practices and keep the Emergency Room staffed 24 hours a day, the City said in a press release on Tuesday.

In 2006 and 2007, the community faced a similar crisis involving potential impacts to the emergency room service, as several doctors either retired or left the community for various reasons.

Physician positions were refilled, however, the community has not been able to make progress because of the attrition rate.

In 2020, Cold Lake is once again back down to eight physicians who may not be able to maintain the current level of service at the emergency room.

“Our physicians do a tremendous job of meeting our region’s healthcare needs, but they cannot keep up this workload indefinitely,” City of Cold Lake Mayor Craig Copeland said in the release.

“The Cold Lake Healthcare Centre serves a large area, and is known for its excellent health care services. It does not seem fair that they are staffed so that every time one doctor leaves, the rest see their quality of life evaporate as they pick up the slack to keep the emergency room open.

“Minimal staffing levels are not sustainable for a centre that serves the population the Cold Lake Healthcare Centre does.”

Copeland noted that the issues surrounding staffing have persisted since 2007, when he was first elected as mayor, and have remained unaddressed by successive governments, despite significant growth in the community.

The Cold Lake Healthcare Centre’s Emergency Room sees over 32,000 patients a year, drawing from a large geographic area that stretches into Saskatchewan.

“Even at the maximum approved staffing levels for physicians, we know that we will still be about four doctors short of everyone in the region being able to have a family doctor,” M.D. of Bonnyville Reeve Greg Sawchuk said.

“The community struggles to attract doctors despite having significant community and municipal incentive programs.”

According to the Alberta Health Services website, the hospital is currently looking to recruit four general practitioners and a general surgeon to bring it up to the approved staffing level.

Sawchuk noted that doctors are disincentivized to come to Cold Lake due to a long-standing inequity in the pay structure.

A physician’s pay structure allows for them to apply a variable rate to the services rendered, based on the community from which they operate.

These variable rates, also referred to as a “variable fee premium,” are assessed based on how isolated a community is from other health care supports.

While Cold Lake doctors get a 9 per cent rate increase due to their location, Grande Prairie’s rate increase is 16.36 per cent, Fort McMurray’s is 19.98 per cent, and nearby Lac La Biche has a 21.40% rate increase.

In addition to the approved physician staffing levels and the pay structure, a number of other solutions have also been suggested that would help alleviate the workload in Cold Lake.

These include hiring a full-time operating room assistant and changing the status of our emergency department from “City” to “Rural,” which also affects physicians’ compensation.

The shortage of family doctors in Cold Lake results in patients using the emergency room as a drop-in clinic which, in turn, elevates the emergency room’s numbers and results in the doctor pay rates for emergency visits dropping.

“We are grateful for the community’s support of its hospital and physicians, but we have seen that this support is not enough,” Copeland said.

“We hope that this government will be the one to step in so that the hospital in our community can meet the demand while also respecting our doctors’ health, well-being, and quality of life.”

Community leaders have heard that if staffing levels at the hospital are not increased, the Cold Lake Healthcare Centre Emergency Room’s 24-hour, seven-days-a-week operations may be impacted.

The community was also recently told that Alberta Health Services has put a freeze on hiring radiologists for Cold Lake.

Currently, the community has on-call, 24-hour radiology available. This service, however, is provided by only two radiologists.

“A sustainable health care system ought to suit the population and the resulting demand,” Sawchuk said.

“It seems that the healthcare system in Cold Lake was built to suit a budget rather than the demand that is being placed on it, and we are confident that this government will have a serious look at our situation. This is not a healthy situation for the doctors or the patients.”