Formal resignations not received, but coming if St. Paul doctor issues aren’t resolved

While formal resignations may not have happened yet, the threat of leaving has certainly been made by some St. Paul physicians.

Town of St. Paul CAO Kim Heyman confirmed Dr. Botha, Dr. Louw, and Dr. Vermeulen all gave the town their notice to end their leases of space at the St. Paul Wellness Centre earlier this week, which appears to stem from the relocation of a St. Paul based surgeon to Cold Lake.

“They have to give six months notice, so that starts Oct. 1 and becomes effective April 1,” said Heyman.

Adriaan Botha is the manager of the Independent Medical Practitioners clinic those three doctors work in.

“At this point, the clinic is carrying on, but the physicians have handed in their lease cancellations,” said Botha. “As to the complete resignation, that will have to wait until it comes out through the proper channels.”

He said he can not speak on behalf of the other physicians, “but Dr. Botha will leave if this is not resolved.”

“There’s no ifs, ands or maybes. None of us wants to leave, but our hands are being forced,” said Botha.

“Doctors feel unsure and uncertain”

Dr. Francis Adebayo is the Chief of Staff at the St. Paul Hospital. He said the primary concern which needs to be addressed is about the future of healthcare delivery in St. Paul.

“The doctors feel unsure and uncertain about the state of things and the long term plan for the St. Paul hospital. The major issue is that they want a concrete plan from Alberta Health Services to assure them that services are not going to be closed. But at this point there is no definite word from AHS that down the line the services are not going to fade away,” said Adebayo, speaking specifically of surgical and obstetrical services.

“Those two services they drive everything else. When those services are going downhill and there’s no commitment to sustain them, the doctors are unwilling to stay in that situation,” said Adebayo.

“When the surgeon goes away, and there’s no assurance there will be a new surgeon to replace, then anesthetists look to go someplace else. And when that happens it affects the delivery of obstetrics, and affects the emergency room function as well,” said Adebayo, noting St. Paul is a very busy hospital.

According to Adebayo, anesthetists are needed in the emergency room to help maintain airways. “And when doctors are working without them in a busy site like this, they are not comfortable and they may not be willing to stay in the emergency room and work because they feel insecure.”

“It’s not that they want to leave, but they feel very uncomfortable with the way things are going,” said Adebayo.

According to the acting medical director for Alberta Health Services north zone Dr. Albert Harmse, “AHS has not received a formal request to withdraw from hospital coverage from any privileged physicians.”

“AHS will recruit a second surgeon to support St. Paul patients. We will continue to update the community as recruitment progresses. Dr. Ahmad will continue to do surgery in St. Paul and Bonnyville, in addition to Cold Lake. In addition, a surgeon who currently practices in three communities – Cold Lake, St. Paul and Bonnyville – will continue his practice in all three communities. Surgical services will continue to be offered in St. Paul and Cold Lake now and into the future. We will continue to monitor local care needs and ensure the needs of patients are met,” he said.

“AHS is connecting with local physicians and community leaders today to share information and ensure that all parties are aware of the current surgical coverage plan as well as the plan to recruit an additional surgeon,” said Harmse.

Intent is to continue surgical services in St. Paul, says AHS rep

Cindy Harmata is the Senior Operating Officer for the AHS North Zone and has been involved in managing health care in north central Alberta for a number of years.

“I’m more the clinical workforce, so the non-physician,” said Harmata, noting that a number of support staff such as housekeeping, maintenance, and food services fall under the province.

“I have the care stream, so the nursing staff, the health care aides, PT [physical therapy], OT [occupational therapy]. I would have responsibility for the planning and the budgeting and projecting of need.”

She confirmed St. Paul is one of the busier sites in the region, and cited consistently high occupancy numbers of the beds in the St. Paul Hospital.

“In many of our sites we have a visiting surgical program, and usually it’s someone who is practicing in one community and servicing other communities. Because surgical practice, again we’re talking about volumes. You have to have a certain amount of volume to be able to retain a general surgeon.

“And he [Dr. Ahmad] was already was providing services up to Bonnyville; and Cold Lake patients and residents were coming to St. Paul. It has always been a bit of a corridor of surgery,” said Harmata.

“The intent is very much for him to continue to provide surgical services in St. Paul. We’ve met with him and he has assured us again and again that that is his intention,” she said.

“Trying our best to clear up misconceptions”

Asked about the impact of Dr. Ahmad’s departure on emergency and after hours care, Harmata said it’s an issue faced everywhere in rural Alberta.

“We can not put a surgeon in every single site. There isn’t volume to be able to do that. So we have processes that look at those emergency and after hours [cases]. One of the things Cold Lake has that is of assistance in that is a CT scan, and that certainly helps in that diagnostic process,” said Harmata.

Asked about the criticism that people who needed surgical care but were not urgent were being admitted and occupying beds in the acute care ward on the second floor, Harmata said it is an appropriate use of the bed, no different from the way beds are used at large facilities like the University of Alberta Hospital.

“I recognize there is a tremendous amount of upset here, and that’s truly unfortunate. We’re trying our best to clear up any misconceptions and to clarify where we can, but change is really really hard,” said Harmata.

She said AHS will continue to monitor the volume of patients.

“And if we see those waitlists start to lengthen or see that it’s not being managed then we will act on that. We will continue to review our data and see where people are going for what.”