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Portion of red emergency sign on hospital building

Fort Macleod Emergency Department to temporarily close Tuesday

The emergency department of Fort Macleod Health Centre will temporarily be closed from 8 a.m. to 5 p.m. on Tuesday, Sept. 19.

The temporary closure is the result of a physician shortage and regular 24-hour service will resume Friday morning.

Nursing staff will remain on-site during the closure to provide care for long-term care residents.

In the event of a medical emergency, Alberta Health Services advises residents and visitors to the community to call 911. EMS calls will be re-routed to Chinook Regional Hospital in Lethbridge (49 kilometres away).

Emergency services are also available at the health centres in Pincher Creek and Cardston, or at Chinook Regional Hospital in Lethbridge.

Non-emergency support is also available by calling Health Link at 811, and AHS advises that “individuals requiring non-emergency medical care are also encouraged to call their family physician.”

 

Related stories:

Fort Macleod Emergency Department to temporarily close

Recent Pincher Creek hospital closures worry residents

 

Portion of red emergency sign on hospital building

Fort Macleod Emergency Department to temporarily close

The emergency department of Fort Macleod Health Centre will temporarily be closed at 8 a.m. on Thursday, Sept. 7, and reopen at 8 a.m. on Friday, Sept. 8.

The temporary closure is the result of a physician shortage and regular 24-hour service will resume Friday morning.

Nursing staff will remain on-site during the closure to provide care for long-term care residents.

In the event of a medical emergency, Alberta Health Services advises residents and visitors to the community to call 911. EMS calls will be re-routed to Chinook Regional Hospital in Lethbridge (49 kilometres away).

Emergency services are also available at the health centres in Pincher Creek and Cardston, or at Chinook Regional Hospital in Lethbridge.

Non-emergency support is also available by calling Health Link at 811, and AHS advises that “individuals requiring non-emergency medical care are also encouraged to call their family physician.”

The Pincher Creek emergency department has been closed a number of times this summer, causing concern in the community.

Group of people, mostly seniors, seated at a meeting

Recent Pincher Creek hospital closures worry residents

Following three recent emergency department closures at Pincher Creek Health Centre, area residents are concerned over the facility’s future, something very apparent at an Aug. 15 engagement session with Alberta Health Services.

“It is not our intent to close the hospital,” Dr. Sandra Stover, associate zone medical director for AHS and a palliative care physician from the Beaver Mines area, told the audience of nearly 200.

“It’s our goal (as doctors) to keep the emergency department open,” added Dr. Bev Burton, the community’s acting medical director, when asked to speak to the large gathering.

Acknowledging there have been challenges in the past, Burton said she is hopeful that things will improve.

At the centre of the recent closures: the continuing struggle to recruit new physicians and the challenge to keep them, once here. The lengthy process, which can take up to nine months, even after an agreement is reached, doesn’t help either.

Right now, Pincher Creek is served by five doctors, plus one on maternity leave. In the past, the town has had up to 11.

“Some of the delay is the recruitment process but some of it is through the College of Physicians. It’s simply a lack of people who can mentor or sponsor,” Stover said.

Staffing shortages and ER closures aren’t isolated to just the southwest, or even Alberta. This can create hardship for families in rural communities where the next hospital is an hour or more away and, for some, the additional challenge of getting there is very real.

 

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“What happened? We came out of Covid and all of sudden there are no doctors,” said Edna Fairbrother, a member of Piikani Nation.

Getting in to see a doctor, for Fairbrother, was never a problem until recently.

“We need to find some solutions because it’s not just Pincher Creek. It’s my community as well,” she said.

“Retaining physicians is even more important than recruiting them,” Dr. Stover said, following the meeting.

“We can always recruit a physician but it’s harder retaining one. People want to have a long relationship with their doctor,” Stover said.

“We have a great relationship with the town and MD. They’ve even set up their own committee.” 

With an aging population, good health care is a big pillar of any community and several times during the course of the evening, AHS officials recognized the large turnout.

We can see the community here is very concerned about their health care and rightly so,” Stover said. “After all, they have a big stake in it.”

While obstacles remain in recruiting and retaining physicians, the news on the evening wasn’t all bad. In fact, there might be some promise.

A new physician assistant is set to begin in September to fill a small part of the current gap. Negotiations are also underway with three international medical graduates, one of whom could be practising in the community by the spring of next year.

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Retired doctor decries ‘Shandro’s shambles’

The results of what is known as the “resident match” were announced recently. They clearly show serious damage continues to flow from the thoughtless changes that Tyler Shandro inflicted on Alberta’s health system while he was health minister.

Try as they might, the current minister and the AHS administrator have clearly not reversed the damage that was done to Alberta’s ability to attract new physicians.

For those not familiar with how new doctors finish their training, let me provide a bit of background to the opening paragraphs.

Medical students take their initial training in whichever medical school took them in. In their last year, the students must decide what career path they wish to follow, and where they wish to pursue further training. Those decisions are critical, because it is very difficult to change specialties or training sites after that.

During the fall of their final year, students file their choices with a national body, the Canadian Resident Matching Service, better known as CaRMS. This body compares student and program choices, and assigns students to specific programs and sites. Results are announced in late March. A second round is then conducted to fill vacant slots with Canadian students who did not match in the first round, or other candidates.

The total number of training slots, known as residency positions, in Canada is slightly more than the number of students expected to graduate from Canadian medical schools each year. Most years, there are a small number of vacancies in certain programs.

 

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In the past, family medicine residencies have had only a few vacancies. In southern Alberta, where most of the doctors that ultimately settle in this area train, there have typically been only a few vacant slots. Generally there are less than 10 vacancies for the whole province.

The results this year are devastating for Alberta. There are 42 vacant family medicine positions in the province. For comparison, there are two openings in British Columbia and none in Saskatchewan.

In the south, more than 20 per cent of the slots in Lethbridge are vacant, while Medicine Hat filled less than 30 per cent of its spaces. Those two cities have supplied most of the doctors that have begun practice in this area over the last few years.

In a setting where there is a desperate need for doctors in every area of Canada, the medical students have spoken clearly. They have decided that Alberta is definitely not a place that they want to work and live.

In essence, they have said that they have many choices, almost all of which are promising a stable and predictable work environment. Alberta offers the exact opposite, judging by recent history. Viewed from that perspective, choosing somewhere other than Alberta is a rational decision.

 

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Alberta, and especially rural Alberta, will be trying to attract its future doctors from a group where many of the potential recruits either did not want to come to Alberta or trained in another country initially. Those doctors are unlikely to see any place in Alberta as their desired location when choosing where they will set up practice.

The Shandro shambles will haunt the patients of Alberta, and especially rural Alberta, for years to come.

The two main parties have both promised to spend a lot of money trying to get doctors for rural Alberta. One of them has released a detailed plan on how they will do it. The other party has only promised to spend. Even the president of the Alberta Medical Association has written a note stating that they do not know how the second party will use the promised dollars.

When you vote in May, it would be a good idea to see which party has a viable plan to recruit more doctors to rural Alberta. If the voters make the wrong choice, the staffing woes in Pincher Creek are unlikely to improve.

Skull and crossbones with word poison, surrounded by multi-coloured capsules

Tips for parents, caregivers to prevent child poisoning 

Children are curious about the world around them. Their curiosity, smaller size and lower body weight, as well as the appealing taste of flavoured children’s medication or brightly coloured objects, such as laundry pods, can put them at risk for poisoning.

Last year, the Poison and Drug Information Service received approximately 55 calls per day for poisonings. Forty percent of calls were for children up to five years of age. Many of these calls involved acetaminophen and ibuprofen. While these medicines are safe for treating common aches and pains, they can be harmful if taken incorrectly.

In addition, household items — such as cleaners, personal care products, car supplies, batteries, medications and pesticides — can be poisonous if ingested or used incorrectly. Although we may not think of all these products as dangerous, they can cause poisoning and serious injury when misused. Other items — such as cannabis, e-cigarettes, hand sanitizers, bleach and laundry detergent pods — are items that can cause poisonings and harm.

 

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There are things you can do as a parent or caregiver to help keep children safe:

  • Ensure all medications and potential poisons remain in their original containers and are locked up and out of sight.
  • Use childproof latches on your cupboards.
  • Always put medicines away after use.
  • Keep visitors’ coats and bags out of reach of children, as they might contain medicines.

For more information on preventing poisonings, visit Poison and drug information.

If you are concerned that someone has been poisoned, call 911 or PADIS at 1-800-332-1414.

 

Read more from the Breeze

How developmental screenings can benefit your children

Maternity care on the ropes in Pincher Creek

Pincher Creek Soccer Association prepares for 2023 season

 

 

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Opinion: Alberta hates rural maternity care

Alberta hates rural maternity care

I have been working as a rural physician for 16 years. My focus and my expertise has been surrounding maternity care and, to that end, I have worked as a low-risk maternity provider and a provider of rural surgery primarily to provide access to rural maternity care. I’ve been on numerous boards and committees to try to address access to labour and delivery services close to home.

Unfortunately, none of these have been successful to prevent the ongoing death of rural labour and delivery services.

Most heartbreaking to me, I no longer can support ongoing labour and delivery in my own community of Pincher Creek beyond May 31.

Perhaps this is just the sentiment of modern thought – we can no longer as a society accept the risk inherent in providing medical assistance to people who live outside of city limits. In order to access that quality of care you deserve you must live in communities where mail is delivered to street addresses instead of box numbers. 

I don’t know for sure whether all Albertans despise rural maternity care, there seem to be quite a few that prefer the personal nature of it. I don’t even know whether it is purely a maternity care thing, or if we really hate all rural medical care. 

I don’t want to generalize, but this could even be a Canadian thing: rural care appears to be disappearing across the country. What is clear to me, is that when there is a question on whether to support rural maternity care, they always decide against. 

The barriers to excellent rural maternity care are many: 

Due to risk, or lack of role-models, many family physicians have decided that maternity care, labour and delivery is an optional skill. There was a time when we counted it as a required skill to work here. It is not trained well in many programs, and low-risk maternity groups are often poorly supported. 

Rurally, there is no on-call funding to be available for delivery services. When advanced skills are needed for c-section and for neonatal resuscitation, the team size expands to at least four physicians and an army of allied health workers, such as RNs, LPNs and respiratory therapists, as well as the many lab and imaging technicians, EMS and other support staff working in the background. 

We are down to six physicians from 11 to serve a patient population of 10,000, and our emergency department has only become more busy. 

I have had the joy of working with many dedicated caregivers who attend when they are needed, even when not on-call. This care costs significantly. 

However, often forgotten is that when these services are not in place, the costs increase greatly due to emergency transportation, delivery en-route, increased NICU admissions, and emergency deliveries at a rural facility not set up for labour management in training or equipment. 

We already have managed high risk maternity patients beyond the scope of our site who were unable to get to a higher level hospital and we could no longer transport. This will continue to happen with even fewer resources. These harms are borne unevenly by those who don’t have the resources to access care. 

Gaps in the availability of this team impacts maternity before and after care as decisions are made based on when services may not be available. 

As a cost saving method, our hospital site manager will not provide OR or maternity nursing coverage when anesthesia or surgery is scheduled to be away. This creates further gaps as it blocks partial days or a day that later could be covered by changes to vacation plans or finding last-minute locum coverage.

There is no dedicated maternity nurse, which means each time a maternity patient arrives there is a scramble to see who is available, and a sense of frustration at the lack of staff availability, and that maternity coverage is considered additional work instead of being appropriately planned for with adequate staffing. 

More distressing, where I used to look forward to labour and delivery, now I have apprehension about whether I have the time or support to provide good care. 

Despite all these challenges, our goal has always been to provide as much coverage as possible to ensure the best care for our maternity patients. 

As the lone surgeon in Pincher Creek for the last five years, I have been on surgical call 24/7, barring scheduled time off. 

Management at AHS has noticed, and for reasons of well-being and safety have indicated they will cease paying me for on-call days past a certain number each year. I agree with the sentiment, this isn’t a reasonable call burden, and there are times I suffer more burnout than I care to admit.

I hear about how much they are spending to pay for the many locum obstetricians in Lethbridge, when we have been asking for support the last six years. They have not, instead, found additional coverage for surgery in Pincher Creek, or encouraged physicians to work here who have undergone my level of training, or even called to see how I’m coping with the call demands.

These steps might have a real impact on physician well-being. I don’t count my call by number of days, but by my kids’ volleyball games I’ve missed, family events I’ve not attended, robotics teams I haven’t coached, and the number of maternity patients transferred on my wife’s birthday when I was out of town. 

Alberta does not have a training program for advanced skills for family physicians. Once we have been trained to perform various procedures and surgeries, specialist physicians in the cities decide which of our procedures they don’t want us to do. This is called privileging. 

Being declined privileges has a real impact on applying to work in other regions. There has not been a surgeon privileged in Pincher Creek to provide all the skills they trained for in the last 12 years, myself included, and this may have impacted other surgeons choosing not to stay. 

Despite decisions being made in regional centres, there is not a reciprocal responsibility to provide support for the rural sites. Many models of creating a network of care have been suggested over the last several years. 

At its best this would create a seamless transition between rural sites and the referral centres, and a cohesive team of professionals from both rural and central facilities who could support at-risk rural sites with education, training, and perhaps even call coverage. All of them have collapsed without funding. 

So where is the leadership? Well, it changes frequently. Some new manager in a new role, with no memory of the prior issues, is surprised I’m not ecstatic when they have a new “Pathway Through Privileging.” 

I’ve continued to ask for a statement from AHS – “We support rural maternity care.” It has never come from any level of its bloated bureaucracy. 

There is no doubt that government has a role to play, and I won’t lessen the negative impact the last four years have had on rural physician supply. However, this is not a partisan issue. The reality is, rural health care does not matter to politicians. Rural votes are counted as won before the polls open and no one feels they need to pay anything except lip service to improvement of rural medical care. 

It’s not just that labour and delivery is special to me in particular, it is emblematic of how we care for vulnerable people in our society. It should be an equalizer, we all were once born; but the care women get is divided sharply along socioeconomic lines. In order to provide this care well, you need a dedicated team of people working within a well-supported system. 

Despite our dedication, we do not have that support. Most times, a rural maternity program collapses after a bad outcome where the lack of support results in finger-pointing to deliver blame. Often providers leave the profession. I can shoulder the work, and the call, but I can’t face the injury to my colleagues if I keep it going when I don’t believe any help is coming. 

Each person who could have some positive impact doesn’t feel it is their responsibility to help. 

If I were a younger man, I might be looking for greener pastures. I may yet look for other rural programs I can support for a little longer, but I intend to remain planted in Pincher Creek for now and I still have many other surgical skills that will remain useful. 

I know what happens to communities who end their maternity programs though, as they lose the need for a cohesive team to come together to celebrate new life and in doing so gain a little joy in a job well done. 

Jared Van Bussel MD CCFP ESS FRRMS
Pincher Creek, AB

 

Shootin’ the Breeze welcomes submissions about local issues and activities. Personal views expressed in Mailbox articles are those of the writers and do not necessarily reflect views of Shootin’ the Breeze management and staff. 

 

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Dr. Jared Van Bussel – smiling white male wearing blue paisley shirt

Maternity care on the ropes in Pincher Creek

Dr. Jared Van Bussel, who specializes in obstetrics, will stay on as a general physician and trauma surgeon at the Pincher Creek Health Centre and will continue his practice at the attached Associate Clinic, he told Shootin’ the Breeze on Thursday.

“If I were a younger man, I might be looking for greener pastures. I may yet look for other rural programs I can support for a little longer, but I intend to remain planted in Pincher Creek for now,” he wrote in an open letter.

“If my colleagues call me, I’ll always show up,” he said.

But it’s unlikely that the health centre can handle scheduled births, especially routine C-sections, without a dedicated obstetric surgeon.

The man has been on call for 70 per cent of his waking life for years, apart from his scheduled time off. The burnout is real, but Van Bussel repeatedly stressed that he’s scaling back his practice because of what he considers an acute and profoundly systemic lack of provincial support. 

“Alberta hates rural maternity care,” he wrote, telling the Breeze that in his 16 years in rural family medicine, he’d seen too many gaps in patient care and professional training for new doctors, and too many shortsighted cost-saving measures he said were untenable.

 

 

Things came to a head on his birthday, Jan. 16, when he received a letter from Alberta Health Services reminding him of the funding limits for on-call services paid for by an Alberta Health grant program.

“Please be advised AHS is unable to compensate you for (physician on-call) services in GP Surgery after you have reached 255.5 days of service,” the letter states.

AHS South Zone declined an interview for this story, but explained in a written statement that Van Bussel would continue to be paid, including for his on-call services.

“The South Zone recently sent a courtesy letter to physicians who were approaching the limited days paid for on-call time under the provincial Physician On Call Program,” the statement reads.

“We do not believe that any physicians (in Alberta) will go over their 255.5 days of on-call coverage,” AHS said in a followup statement.

The South Zone added that these courtesy letters “go out each year,” while other doctors at the health centre also received letters in the new year.

 

 

Van Bussel said  he’d never received any such letter before Jan.16, especially not in his six years as the town surgeon.

“They’ll always pay me for coming in, but they won’t pay to support physicians or the community in general,” he said.

As heartbreaking as it was for him to write his letter, he said he’d been crafting it for a long time. He’d told his Pincher Creek colleagues it was coming about a month ago.

“I’m willing to reconsider, but I just don’t see it,” he said.

The Government of Alberta is plainly not about to prioritize rural health care, he explained, and “when it feels like everything is pushing against it, it feels to me that we’re approaching a breaking point.”

 

 

Setting aside AHS’s “tone-deaf” letter,  Van Bussel reiterated that he wasn’t concerned about his take-home pay.

“I want to pull attention away from any one event and draw that attention to rural maternity care.”

With AHS insisting that “Physicians are a cornerstone of our health-care system,” Van Bussel said he’d made it known for years that it wasn’t sustainable for him to live on call while resources dwindled at the health centre.

The health centre serves around 10,000 patients over a broad swath of southwestern Alberta.

Its team of doctors is down from 11 to six and, instead of asking how the province could do more to help, AHS sent Van Bussel a letter that seemed to say no help was coming.

“I hope this will become a discussion point in the community. I hope that people will start asking their decision-makers why this is the case,” he said.

 

Read Dr. Van Bussel’s open letter

Read AHS letter to Dr. Van Bussel

 

 

 

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Man blowing nose into handkerchief while woman wearing non-medical mask has hands in the air fending off germs

Respiratory illness outbreak at MHHS

A “respiratory illness outbreak” was announced at Matthew Halton High School in Pincher Creek on Tuesday, Nov. 22, according to Darryl Seguin, superintendent at Livingstone Range School Division. 

The outbreak came into effect at MHHS after at least 10 per cent of the 278 students stayed home with respiratory symptoms.

Schools are asked to notify Alberta Health Services’ Co-ordinated Early Identification and Response team whenever absenteeism due to respiratory illness hits 10 per cent or when there’s an unusual number of individuals (off sick) with similar symptoms.

Tuesday’s announcement came one day after an outbreak was declared at Pincher Creek’s Canyon School.

No further outbreaks were reported within LRSD as of Wednesday afternoon. A prior outbreak had been announced at the school division’s early-learning program at the Horace Allen School in Coleman. 

 

Seguin didn’t say if LRSD has the authority to impose masking mandates. Premier Danielle Smith announced earlier this month that “Our government will not permit any further masking mandates of children in Alberta’s K-12 education system.” 

A Court of King’s Bench judge had previously ruled that a health order to this effect by Dr. Deena Hinshaw, formerly Alberta’s chief medical officer, “was made for improper purposes.”

Justice G.S. Dunlop ruled that the chief medical officer has the authority to mandate school health measures, but that Hinshaw had based her order on a political decision by cabinet.

Custodial staff at Canyon and MHHS are taking extra care to clean surfaces, while teachers are being encouraged to rearrange classrooms to allow for more social distancing, Seguin said. 

The outbreak seems to have spared teachers at MHHS, with Seguin saying staff absences due to illness have been normal for this point in the school year.

The division is home to about 3,750 kids in K-12.