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Alberta Medical Association says general surgery is at a tipping point with lives on the line

Alberta’s general surgery is at a tipping point, with lives on the line says AMA

According to a July 8 Alberta Medical Association news conference, Alberta’s general surgeons are facing increasing human resources shortages, which are limiting their ability to provide urgent, life-saving care to patients.

This news conference marked the start of the AMA’s general surgery information campaign, seeking to inform the public of the issues faced in their hospitals.

“General surgeons, to put it succinctly, are essential and the lifeblood of surgery in our hospitals,” said AMA president Dr. Paul Parks in the conference. “Hospitals simply cannot function without having general surgeons available.”

“These are the patients that need timely, lifesaving care,” he said.

According to a pre-meeting briefing, every full-service hospital requires general surgeons to function and provide safe, timely care.

“The vast majority of the emergency conditions treated by general surgeons, if not rectified promptly, lead to serious outcomes such as sepsis, long-term complications and sometimes death,” read the briefing.

 

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According to the AMA, patients are waiting too long for care, and the province has seen an increase of diversions, situations when patients are transferred to other facilities due to a lack of available services.

“We need to get ahead of this problem,” said AMA Section of General Surgery president Dr. Lloyd Mack. “It’s not safe and clearly a poor use of resources shipping patients around the cities.”

AMA is also calling for more transparency from Alberta Health Services on the full impact of these diversions.

Delays and diversions in care are serious issues, which Mack said could be resulting in patient deaths.

Growing staffing shortages is at the heart of this issue, and according to the AMA, it’s unprecedented in North America and has now reached a tipping point.

“The chronic shortages of health-care professionals that you’ve been hearing about are hitting general surgery patients particularly hard,” said Mack. “Hospitals just can’t run without general surgery care.”

The capacity to provide adequate general surgery relies on more than just surgeons; it also involves other health-care professionals and house staff, from administration to housekeeping.

 

 

To tackle the growing issue, the AMA is highlighting the need for adequate anesthesia support, surgical nurses, more hospital beds in cities, review of information systems that have been offloaded onto surgeons, increasing trained housekeeping for faster turnovers, and surgeon incentives.

Mack also noted that making sure the public understands the issue is essential, and investment must be made to ensure the province can become attractive to the workforce of the future.

“We need focus and a plan for investment on the workforce,” he said, noting general surgery has not been growing with the population or adequately replaced as professionals retire or leave.

“I personally think this is a crisis,” said Mack. “It’s only going to get worse if we don’t start taking action now.”

Pincher Creek’s surgeon, Dr. Jared Van Bussel, highlights that Pincher Creek, too, is affected by these gaps in surgical coverage.

“In order for an OR to run effectively, it requires the combined skills of several OR-trained registered nurses, certified OR cleaning technicians, surgical instrument processors, surgeons, anesthetists, surgical assists, as well as a supportive administration and a facility to bring it,” he said in a statement to Shootin’ the Breeze.

Being able to have these resources requires funding, training and hiring.

 

 

“Pincher Creek has suffered incremental losses to many of these areas,” said Van Bussel, highlighting loss to local instrument cleaning facilities, on-call OR nursing and resultingly several OR-trained nurses.

“We previously had three surgeons and three anesthetists in our small community and we are down to one of each,” he said. “More than that, we’ve lost vision.”

Workforce planning and the breaking down of barriers have not been prioritized, which has come with a lack of adequate training in the province and significant barriers within the privileging process of visiting surgeons.

“Visiting surgeons have faced significant barriers to working in Pincher Creek, with the privileging process for two of our recent surgeons taking longer than a year to complete,” he said.

The Pincher Creek hospital has also faced gaps in its capacity to provide maternity care, which Van Bussel describes as a keystone in rural health care.

“In order for this to change, decision-makers need to speak in specific, measurable, achievable targets and the system has to correct the currently insurmountable barriers for rural surgery,” said Van Bussel. “Otherwise we will see further loss in the OR services provided in Pincher Creek.”

 

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According to Health Canada, Paxlovid stops the Covid-19 virus from multiplying.

Health Canada ends Paxlovid coverage, Albertans to pay over $1.4K per treatment

During the Covid-19 pandemic, Paxlovid, a drug for immunocompromised individuals diagnosed with Covid, was covered by Health Canada on an emergency basis.  While private insurance may cover some of the cost, Albertans could now have to pay around $1,450 for the five-day supply of the drug, according to Alberta Health and confirmed by Pincher Creek Pharmasave.   As of the end of May, the Public Health Agency of Canada has discontinued coverage, now making the drug a provincial responsibility. 

Health and pharmaceutical care in Canada is a joint venture between federal and provincial levels, with federal agenda setting and provincial implementation. 

The Government of Alberta will cover the cost of Paxlovid for Albertans who have a government-sponsored drug plan, are immunocompromised and Covid-positive, according to a media response from Andrea Smith, Alberta Health’s press secretary.

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The coverage is listed by Alberta Blue Cross as restricted benefit with special authorization, meaning provincial plans for seniors would cap the patient’s cost at $25, with plans like income support and child and adult health benefits still seeing full coverage.

Some employer-sponsored plans may provide partial coverage, but depending on co-pay could still see patients paying large amounts for the treatment.

According to Andrea Smith, pharmacists were only notified of this change on May 24, and physicians on May 30. 

According to the Centers for Disease Control and Prevention, a person’s immune response to having Covid can protect them from reinfection for several months, but protection decreases over time. 

Those with weak immune systems may have a limited immune response or none at all. This can result in hospitalization due to severe illness, and even death.

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New variants can bypass existing immunity and increase infection risk.

Although rare, reinfection can occur as early as several weeks after a bout with the virus.

Pincher Creek resident Shannon Peace is recovering from her third run-in with Covid. The first was in 2022, while the latter were contracted in March and May of this year.

With her immunity weakened by a daily dose of a chemotherapy drug that treats a rare blood disorder, Peace has done what she can to avoid contracting the virus since the onset of the pandemic. Asthma is a further complicating factor for her.

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In 2022, she was treated with Paxlovid at the onset of symptoms.

According to Health Canada, Paxlovid — brand name for a combination of  nirmatrelvir and ritonavir — stops the virus from multiplying. Once treatment begins, a patient’s symptoms should not get worse as the drugs help the body fight the viral infection.

Paxlovid treatment was relatively new at the time and Peace was advised not to take any pain relievers or decongestants. She felt miserable for about two weeks but believes it would have been worse without the drug.

Fast-forward to the spring of 2024 when fever and chills knocked Peace out of commission and a home test was positive for Covid.

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“My daughter reminded me that it was a rough go the first time so I consulted with 811 a number of times before choosing to forego a trip to the ER requesting treatment,” Peace says.

“I monitored my oxygen level and temperature, and promised the RNs I spoke with to go in if I went past certain thresholds.”

She wound up spending three full weeks in bed, sleeping up to 20 hours a day. Symptoms gradually subsided but fatigue and some breathing changes persisted.

“It was a complete shock to test positive again only two months later,” she says. “I hadn’t fully recovered yet when I got sick again in May.”

After conferring with 811 and her local physician, Peace was referred to the Covid Treatment Centre.

“At each step of the consultation, it was stressed that I would be responsible to pay for the Paxlovid prescription and to confirm with the pharmacist what that amount would be,” Peace says. “This was the first I heard that the drug was no longer being covered by Alberta Health.”

Fortunately, the prescription was filled the day before the change came into effect so there was no charge for the medication.

“While it was awful and I was still slow to recover, it was night and day compared to what I went through in March,” she says. “The medication absolutely makes a difference for me.”

Peace contacted pharmacist Amber Shepherd at Pincher Creek Pharmasave to find out what the medication would have cost and was astonished to learn that the five-day treatment would be more than $1,400 the next time it is needed.

“Amber was great with getting things looked after for me when it came to filling the prescription and helpful in providing a look at what will happen the next time I catch Covid,” Peace says.

Table setting of wedding venue — the Cowley Lions Campground Stockade near Pincher Creek in southwestern Alberta.

“She ran a test with my group insurance, which is through the Alberta Chambers of Commerce, and was able to tell me that half of the amount will be covered.

“This will leave me with a big decision if I get sick again — do I forego treatment or fork out more than $700? That’s a tough question,” she says.

“What happens when we don’t have the option to afford treatment?”

This is a concern for her and for others, especially as there has been no public notification of the change.

Shepherd has not yet seen new prescriptions after the change in coverage, but worries about what this will mean for local patients.

“If they’re not covered it’s a big impact because you have to decide between eating and whether or not you get the medication,” she says.

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“It’s certainly going to make people think twice about accessing the medication and potentially going without to make sure they can still live, basically.”

Shepherd encourages anyone with questions or concerns about coverage to reach out to any pharmacy to confirm accessibility of the drug to them.

“It’s just going to be a case-by-case basis,” Shepherd says. 

Peace acknowledges that the Covid-19 pandemic has had a hefty price tag for everyone but is concerned that the cost of treatment skyrocketing for those who are immunocompromised will have a different expense in terms of severe outcomes.

For more information about Covid-19 outpatient treatment with updated eligibility criteria for Paxlovid, visit bit.ly/PaxlovidPC.

Portion of red emergency sign on hospital building

24-hour emergency department closure starts Thursday in Fort Macleod

Alberta Health services has given notice that the Fort Macleod Emergency Department will be temporarily closed from 8 a.m. Thursday, May 23, to 8 a.m. Friday, May 24. 

Patients seeking care are encouraged to go to the Pincher Creek Health Centre, Cardston Health Centre or Chinook Regional Hospital in Lethbridge.

According to a media release from AHS Wednesday evening, this sudden closure is due to a lack of physician coverage. Nursing staff will remain on-site to provide care for long-term care residents.

 

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EMS calls will be re-routed to Chinook Regional Hospital in Lethbridge, 49 kilometres away. An AHS media representative clarified with Shootin’ the Breeze that this shouldn’t mean any increase in transportation fees. 

Patients should still call 911 for health emergencies, and 811 for non-emergency health questions.

 

 

Chelsae Petrovic

Petrovic ‘eager to collaborate’ with front lines through health-care appointment

Livingstone-Macleod MLA Chelsae Petrovic will use a new government role to continue advocating for front-line health-care workers, she said on social media last week.

Named by Premier Danielle Smith as the parliamentary secretary for health workforce engagement, Petrovic is “eager to collaborate with heath-care professionals across the province, engaging directly with those on the front lines to understand their needs and concerns,” she posted on Instagram.

“Together, we will work towards building a health-care system that prioritizes the well-being of both patients and providers.”

Just before her successful run last year to represent Livingstone-Macleod, the UCP candidate was accused of victim-blaming and made cross-country headlines. She suggested in a podcast that some heart patients could be held accountable for their condition because of health and lifestyle decisions.

Petrovic, who spent more than 13 years working in Livingstone-Macleod as a licensed practical nurse, admitted then that she could have chosen her words more carefully. But she did not apologize, saying comments pulled from a full-length podcast failed to capture nuance and context.

Petrovic’s appointment comes as the UCP government prepares to restructure Alberta Health Services into four specializations: primary care, acute care, continuing care, and mental health and addiction.

 

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After attending public-engagement sessions on the restructuring in Livingstone-Macleod earlier this year, the former Claresholm mayor said she was continuing to take a deep dive into the local situation before returning to Edmonton for the post-Christmas resumption of the legislative assembly.

Petrovic said then that she had confidence in Health Minister Adriana LaGrange

“I was probably her biggest critic when it comes to this,” Petrovic said.

But after Petrovic shared problems and scenarios from the front lines, LaGrange won her over. “She gave me hope for the future of health care,” Petrovic said in February.

A provincial news release on Petrovic’s appointment said that consultation with health-care workers is vital.

“Alberta’s government has been clear that throughout this refocusing process and as the system changes, health-care workers must be empowered in their roles,” the release said, adding that Petrovic will help in that work.

 

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“Albertans deserve a better, stronger health-care system,” said Premier Smith, the member for Brooks-Medicine Hat, in the release.

“Addressing issues that have been allowed to grow for decades is a major job. Chelsae will play a pivotal role in ensuring that we continue to hear from the hard-working men and women who serve on the front lines of health care. I am confident her work will help lead to a stronger system.”

LaGrange said in the release: “I look forward to collaborating with Chelsae in the weeks and months to come. With her health-care background, she will bring a very important perspective to our refocusing work.

“The voice of every health-care worker is critical to understanding what is actually happening on the front lines and what needs improving. Chelsae will help us incorporate those voices to strengthen the health system for all Albertans.”

The Opposition NDP was not enthusiastic about the government’s choice. A release quotes NDP health critic Luanne Metz calling the appointment “incredibly poor judgment” from the premier that will “cause more chaos” in health care.

Undeterred, Petrovic posted on Instagram: “Our government has emphasized the pivotal role of front-line health-care workers in our health-care system’s refocusing from the onset. In my new capacity, I am committed to ensuring this principle is not only upheld but actively put into practice.”

 

 

Aerial view of the Cowley Lions Campground on the Castle River in southwestern Alberta
Map showing Pincher Creek, Alberta, and the number of hours the ER was closed in 2023.

Alberta ERs closed for 38,000 hours in 2023

Emergency departments in Alberta were forced to close for more than 38,000 hours, or about 4.3 years, in 2023.

Disruptions ranged from a few hours without a physician to communities losing ER services for months on end. Of the 26 emergency departments that shut their doors in 2023, more than half had closures lasting 20 days or longer.

In almost all cases, these service disruptions were caused by staffing shortages, and the communities left without access to emergency care were in rural Alberta.

This data comes from biweekly hospital service disruption updates published by AHS, which were collected, analyzed and mapped by Great West Media.

Compiling and quantifying the extent of emergency care disruptions shows it is more than a random event, said Dr. Warren Thirsk, president of the emergency medicine section of the Alberta Medical Association and a practising emergency physician.

“It is evidence of the resource gap between what Albertans need from an emergency health-care system and what is being provided,” Thirsk said.

“I think that is important to understand that there have been cuts throughout the health-care system — in terms of personnel, in terms of training of personnel, in terms of facilities and infrastructure building — that have been going on for a long time.”

As the cuts go deeper, and the gap between the population and available resources widens, emergency rooms close as a last resort, Thirsk said.

“Then it just becomes more obvious that the system is not doing well. And it’s not funded adequately or resourced adequately to meet the needs of Albertans.”

 

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Total length of emergency department closures in 2023

David Shepard, Alberta NDP rural health critic, said it’s troubling how access to care in rural parts of the province has been impacted, and called it “a direct result of a lot of decisions that were made by the UCP government, going back to the war on doctors in 2020.”

Since then, Alberta has lost not only clinic staff but those providing training as well, Shepard said, creating deficits in the professionals needed to keep ERs open.

“People should be able to expect that their emergency department is going to be there when they need. It should not be running like a fast-food restaurant where it closes in the evening,” he said.

Cost borne by rural Albertans

People in rural Alberta are often far more likely to turn to the emergency department for care, and the temporary loss of these care centres is a sign of deeper problems in the health-care system. Communities like Lac La Biche, Consort, Boyle and Swan Hills all went several weeks, or even months, without an ER last year.

The local populations also have emergency visit rates for semi-urgent or non-urgent problems between 2.8 and 6.5 times the provincial average, according to Government of Alberta data released in 2022.

 

 

“There are people who rely on that emergency department for every other gap in the health-care system,” Thirsk said.

If their family doctor or specialist is unavailable, the ER is often the only alternative.

“I think that is a cost borne more by the rural communities in terms of time. Because it’ll take them a lot longer to get to the next care facility that might be open,” he said.

Researchers from the University of Alberta’s Faculty of Rehabilitation Medicine have estimated that rural patients pay an extra $450 out of pocket every time they have to travel to Edmonton to see a specialist.

Taking a patient out of their community also removes them from their support network and puts additional pressure on already-strained hospitals in larger centres, said Mike Parker, president of the Health Sciences Association of Alberta.

During Covid when hospitals in Calgary and Edmonton were overrun, they were overrun with Albertans, not just Calgarians are Edmontonians, Parker said, because the high-level resources and intensive care required didn’t exist anywhere else.

“It all started right back where there was no community care in the areas that needed it most, that are hours and hours away,” he said.

Every year, Parker said, he sees a loss of front-line professionals. The cheapest fix would be to take care of staff that are already hired who are “the experts in the system.”

“Covid devastated our health-care system to the point where people cannot come back to work anymore. And the response from government is that we’re going to reduce hours, we’re going to reduce people, and we’re going to privatize services.”

 

 

Promises to recruit, promises to cut

“Work is currently underway to attract more doctors to rural communities. This includes increasing the number of physicians educated and trained in the province, strengthening programs to attract and retain physicians, conducting targeted recruitment campaigns, streamlining registration processes for international medical graduates to work in Alberta,” Alberta’s Ministry of Health said in a statement.

The province is also establishing regional training centres for physicians in Lethbridge and Grande Prairie, which will serve as hubs for the surrounding communities, the statement said.

“Once developed, the training centres will include interprofessional teaching clinics and the ability for medical students to complete most of their medical education outside the metropolitan regions.”

Thirsk said health-care professionals are highly skilled and the time frame to train and subspecialize new workers is measured in years.

“And we make decisions, and budget cuts are made, on a very short-term basis. And that’s where the gap is happening. It’s happening to our nursing colleagues right now,” he said.

A recent AHS memo, obtained by the United Nurses of Alberta, asks management to cut nurse overtime by 10 per cent and reduce the use of private agency relief staff — a move the union has said could put additional strains on remaining workers and worsen patient care.

Shepard said it is almost a universal truth that if you train people in a rural area, they are far more likely to return to work in a rural area. But the rural physician recruitment incentives and new training programs “mean nothing in an environment and in a province where health-care professionals know they cannot trust their government.”

 

 

What the data doesn’t show

The AHS data used to map ER closures gives some indication of the health-care crisis in Alberta. Missing from these statistics, however, is the dire situation faced by staff and patients in the ERs that have stayed open.

Alberta Medical Association president Paul Parks has said ERs are critically overcrowded, with patient wait times hitting record lengths this winter.

Last year, 190 Calgary doctors signed an open letter calling for the government to respond to “collapsing” emergency departments, which they blamed on a combination of pandemic aftermath and government policy that destabilized primary care and caused critical labour shortages.

“It is now common to have 40 to 50 people waiting to be seen by a doctor at any given time in any of our emergency waiting rooms. Frail, elderly patients languish on stretchers in hospital hallways. Patients with mental health crises are housed in the emergency room, often for several days, while awaiting inpatient beds,” the letter reads.

Hidden behind the number of hours each department was closed is also a personal cost that data can’t capture, Thirsk said.

“It’s the cost borne by every patient who’s suffering in a waiting room anywhere or driving another two hours in pain down the road,” he said.

“I challenge you to go into any emergency department in any facility or find any Albertan waiting for any aspect of health care. And to actually ask them how much they’re suffering as they wait.

“That’s where the real cost is. Because it’s not really dollars. It’s humans and human suffering that we’re missing.”

 

 

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Health-care planning needs drastic changes

Concerned about the coming changes to health care? Worried about the current state of health care in southern Alberta?

The Alberta government is giving you a chance to express yourself this Wednesday evening at the Heritage Inn. Not that many of us likely knew about this. Indeed, most Pincher Creek readers of Shootin’ will have to rush to register for this event, since it is at 5 p.m. Wednesday (that is, today). Readers in the Pass have probably missed their chance, since that meeting is set for 10 a.m.

The discussion seems to be focused on the upcoming changes to the structure and function of what is currently known as AHS. We are to get that behemoth chopped up into four pieces. Which might be fine if our problem was just the way that management is structured.

But, it is not.

As a retired physician with 26 years of practice in Crowsnest Pass, I lived through multiple reorganizations (or, more accurately, redisorganization). Each created its own special kind of chaos for at least a couple of years. The system, if you can call it that, kept functioning due to the goodwill of the front-line troops.

After years of being overworked and being told that they are not worth whatever their wage might be, there is very little goodwill left. If chaos follows a management shuffle, there will not be goodwill to pull function out of the chaos.

 

 

Anyone who has contact with health-care workers knows that what is lacking is not managers. What we need are workers and “stuff.” In case our politicians have not noticed, health-care workers are in short supply across Canada and indeed throughout the world.  You do not get them by tearing up contracts, offering lower salaries than the competition, and promising to make huge but unspecified changes to how the system is run.

Similarly, the system needs “stuff,” starting with long-term and acute-care beds, plus the technical equipment to support them.

None of those people and things will come to be just because a politician is unhappy with the current state of affairs. Training a doctor takes at least nine years after high school. A nurse requires at least four years. Lab and X-ray techs need two years for the basics, and more for extra skills.

Building hospitals is a 10-year process, from idea through planning, construction, staffing, commissioning, and receiving patients. The new long-term care building in Crowsnest Pass took a couple of years to plan, and another couple to build. Not to mention the years of asking that preceded approval to build.

 

 

Alberta is growing rapidly, with nearly 200,000 new residents moving here last year. Not to mention the babies that were born here. Since every thousand folks require about two doctors of varying types, the province needs close to a net of 500 new doctors each year, just to stand still. And, that 500 does not account for retirements and other losses. We are not building any giant new hospitals in the near future, and not many smaller ones.

Unless we make drastic changes to how we plan for our health-care system — from training, recruiting and retaining staff to planning and building infrastructure — our health-care system cannot improve. Splitting up the management team will not do that, at least not for a few years.

Hopefully, many locals will come out Wednesday evening to tell the government to make changes that will actually improve our health care.

Allan Garbutt
Resident of Cowley, Alberta

 

 

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. 

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.

Note asking "who cares?" pinned to a cork board

Who cares?

On the heels of recent temporary closures of emergency services at the Pincher Creek hospital, Alberta Health Services hosted an information session at the Community Hall on the evening of Aug. 15. The meeting was intended to update local residents on what is being done to improve the health-care situation and to give us the opportunity to voice our concerns and suggestions directly with AHS officials.

The hall was pretty much full, a clear indicator that there are many in the community who care and are concerned about the state of, and future of, health care in Pincher Creek.

One got a sense that the AHS officials and hospital administration leading the meeting have the same understanding of the issues as the audience and legitimately care about implementing solutions. They seem to be struggling for answers; their hands are somewhat tied by regulation and funding, but they care and are trying to improve things.

The meeting was attended by the MD reeve and at least one councillor. (I’m unsure of town council attendance as I don’t really know them.) It seems our local government cares.

Local doctors (even one on maternity leave) were in attendance. They care.

Many were there in EMS uniform. They care.

Many hospital staff and retirees were there. They care.

 

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The Piikani care. An elder spoke eloquently about their issues and how much they value the Pincher Creek hospital and clinic.

However, a key person, someone who might be able to actually do something, was not in attendance. Not unlike what we had come to expect from her predecessor, our MLA was MIA when we needed her support. During the election campaign she missed a similar engagement because of more pressing matters. I wonder what kept her away this time. I wonder if she cares.

I personally don’t have any answers around improving the health-care system but can offer AHS one suggestion: choose your dates carefully. If you would have held the meeting on Saturday instead of Tuesday, there’s a good chance the MLA might have attended. It seems it takes the smell of pancakes or the noise of a parade to bring a Livingstone-Macleod MLA out of hiding.

Cornell Van Ryk

MD of Pincher Creek Resident

white and red megaphone on green background announcing weekend closure of Pincher Creek Emergency Department

Pincher Creek ER closed overnight Saturday and Sunday

Pincher Creek will be without emergency room service overnight Saturday and Sunday this weekend, a second closure necessary this month due to a physician shortage.

This impacts both local residents and visitors to the community.

Alberta Health Services issued a notice this morning stating that the emergency department of the Pincher Creek Health Centre will close at 7:30 p.m. on Saturday, July 22 and reopen at 7:30 Sunday morning.

The ER will close again at 7:30 p.m. Sunday and reopen Monday morning at 7:30.

Nursing staff will remain on-site to care for inpatients and will have physician support by phone.

Residents are advised that the health centres in Crowsnest Pass, Fort Macleod and Cardston, along with Chinook Regional Hospital in Lethbridge, will accept patients from the area, and to call 911 in the case of an emergency.

Health Link 811 is also available for non-emergency, health-related questions at any time.

Pincher Creek Emergency Services will respond as usual and facilitate transfers to neighbouring sites as necessary.

 

Red sign with white arrow and text directing to emergency room

Pincher Creek ER temporarily closed on long weekend

The Friday afternoon of the Canada Day long weekend is not when anyone wants to hear of an emergency room closure that would impact both local residents and visitors to the community.

Alberta Health Services issued a notice around 2:30 stating that the emergency department of the Pincher Creek Health Centre would close at 8 a.m. Saturday and not be accessible until Monday at 8 a.m.

Residents were advised that the health centres in Crowsnest Pass, Fort Macleod and Cardston, along with Chinook Regional Hospital in Lethbridge, would accept patients from the area, and to call 911 in the case of an emergency.

Pincher Creek Emergency Services was charged with responding as usual and facilitating transfers to neighbouring sites as necessary.

 

 

“These closures only happen after exhausting all other options,” AHS said in a written statement Tuesday. “Alberta Health Services (AHS) is committed to maintaining ongoing access to health care in Pincher Creek, including the Emergency Department (ED), and are doing all we can to ensure patients receive the care they need when they need it.”

Specific questions regarding the number of patients turned away at the door or sent to other locations did not receive a response. 

Nor did the more pressing question: is this a sign of things to come?

white and red megaphone on green background announcing weekend closure of Pincher Creek Emergency Department

Pincher Creek ED closed Saturday and Sunday

The emergency department of Pincher Creek Health Centre will close Saturday, July 1, at 8 a.m. and reopen Monday, July 3, at 8 a.m.

The temporary closure is the result of a physician shortage to cover the department over the weekend, and regular 24-hour service will resume Monday morning.

Inpatient care will be provided by nursing staff, who will have access to physician support by phone.

In the event of a medical emergency, Alberta Health Services advises residents and visitors to the community to call 911. Pincher Creek Emergency Services will respond as usual and facilitate transfers to neighbouring sites as necessary.

Emergency services are also available at the health centres in Crowsnest Pass, Fort Macleod and Cardston, as well as 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.”

 

Woman with shoulder-length dark brown curly hair speaks into a microphone as one other woman and two men look on

Pincher Creek health-care forum draws large audience

Alberta’s rural health-care system needs more public funding, more efficiency and much more local autonomy, residents and esteemed panellists said at Pincher Creek’s health-care forum in late April.

Upwards of 150 people came for a one-hour discussion that saw residents, politicians and one riding candidate engage local doctors and public health policy researchers from the University of Calgary.

Between panellists who said the status quo isn’t holding and residents who said they felt ignored by the province, the conversation registered an uneasy mix of frustration and hope for the future. 

‘If you want to find someone who can fix this, find a mirror’

Drs. Gavin Parker and Kristy Penner, both of whom practise family and emergency medicine in Pincher Creek and neighbouring Crowsnest Pass, repeatedly called for more community involvement. 

“If anybody can help solve this, or at least start to work on this, it’s the people in this room,” Parker started off. 

“I do think there is hope,” he continued, qualifying in the next breath that “Clearly, what I’m doing and what we’re doing isn’t working.”

Penner’s prognosis was no less sparing.

“If we keep doing the same thing, we’re only going to be waiting longer” for routine medical services, she told the packed forum, painting graver implications for women and the elderly. 

“You’re going to have to leave [home] to have a baby — you won’t be able to get surgery in Pincher Creek or Crowsnest Pass. You won’t be able to get home care or long-term care in your community. And as a senior, you’ll have to move out of your community to access long-term geriatric care.”

The College of Physicians and Surgeons of Alberta is working to fast-track foreign-trained doctors’ credentials, while licensed practical nurses are picking up the slack at Pincher Creek’s medical clinic, according to Parker.

But the system can’t build capacity when there aren’t enough doctors to train med school graduates, much less foreign doctors. 

“Our voice is stronger when it’s collective,” Parker said, acknowledging the residents on Pincher Creek’s Attraction and Retention Committee, the citizen/council body that helps settle incoming doctors within the community, among other functions.

Parker also noted that Albertans who work outside of medicine make up a significant proportion of the CPSA’s board of directors.  

“So, if you want to find someone who can fix this, find a mirror. That’s who,” he said. 

It’s Friday night: Do you know where your MLA is?

Audience speakers questioned how civic participation could reverse the Government of Alberta’s concentration of authority in a sclerotic Alberta Health Services, the provincial health authority that executes government policy. 

“I’ll vote for any party that starts taking that system apart and returning power to the community so that we can make a difference with some of the things you’re asking us to make a difference on,” one speaker said. 

Another speaker noted that United Conservative MLA Roger Reid, who represents Livingstone-Macleod, was conspicuously absent. 

“Where’s our MLA?” the speaker asked, drawing groans from the crowd.  

“Is anybody from the Alberta government here?” another speaker asked. “Maybe that’s part of the problem,” the speaker suggested, drawing thunderous applause.

In the crowd were town Coun. Sahra Nodge, MD Coun. Dave Cox and Reeve Rick Lemire, and a host of doctors and nurses from Pincher Creek Health Centre. 

The NDP’s Kevin Van Tighem, the only riding candidate to show, suggested that Pincher Creek has the talent and the grit to restore the health centre to a model of rural health care. 

“Do we have to change ourselves? Or can we change medicine so it fits into our community without the community changing?” he asked from the mic. 

The UCP’s 2023 provincial budget funds public health care to the tune of $24.5 billion, a roughly four per cent annual increase. This year’s budget includes $105 million for capital projects under the UCP’s Rural Health Facilities Revitalization Program. 

Don’t expect a quick fix 

Funding and educational programs need to deliver a robust, “team-based” rural health-care model that empowers Indigenous and rural learners to practise medicine, Dr. Penner explained. 

More immediately, Penner said, doctors-in-training have complained about a lack of affordable housing and limited child-care options in Crowsnest Pass.

Melissa Fredette, a registered nurse at the health centre, vice-chair of the town’s Attraction and Retention Committee and mother of three, implored the community to promote Pincher Creek as a career destination for young health-care providers. But Fredette and her colleagues need more local support.  

“We’ve just come out of a pandemic. We’re tired in health care,” she said. “We would love to have more help from the people here.”

Once it’s gone, it may never come back

Aaron Johnston, associate dean of rural medicine at the U of C, warned after the forum that many rural health-care teams are on the verge of collapse. 

An under-resourced team “works until it doesn’t work — until there’s the loss of that last one person,” he said. “Lose a rural anesthetist and say goodbye to that town’s surgical team. Lose a team, and good luck restoring the services it was designed to provide.”

“Imagine how difficult it is to recruit 10 highly-trained medical staff at the exact same time,” he suggested, “because that’s what it takes to reboot these services once they’re gone.” 

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.

 

 

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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Whooping cough outbreak declared in south zone

AHS declared the outbreak last Thursday, when the health authority reported 16 confirmed cases of the disease spanning Lethbridge County, Coaldale, Taber, Vauxhall, Grassy Lake and Bow Island. 

A case had been identified as far west as Fort Macleod, with no cases confirmed in Pincher Creek, Dr. Vivienne Suttorp, AHS South Zone’s medical officer of health, told Shootin’ the Breeze the next morning.

“We suspect there are many more (cases) out there,” Suttorp cautioned, noting that whooping cough is “typically under-reported” because infected people tend to show symptoms associated with other respiratory diseases like Covid-19 and the seasonal flu.

Whooping cough can lead to pneumonia and encephalitis, especially in kids under two. But it’s easily preventable through a safe, reliable and easily accessible vaccine against Bordetella pertussis, the bacterium that causes the disease.

 

 

An unvaccinated baby girl in southern Alberta died of whooping cough in 2012. The vaccine is not approved for newborns, but Suttorp said babies take on their mother’s immunity if expecting moms get vaccinated in their third trimester.

Herd immunity set in when communities hit 98 per cent vaccine coverage. Immunization rates in some south zone communities dropped from 86 per cent in 2008 to 23 per cent in 2021, according to Alberta Health statistics quoted by Suttorp. 

Vaccination rates in Pincher Creek held at an annual average of roughly 83 per cent over the same period. For comparison, coverage was just over 90 per cent in 2008, falling just under 70 per cent in 2021. 

Rates were generally lower across Crowsnest Pass, which maintained an average annual rate of roughly 75 per cent. 

 

 

Whooping cough outbreaks tend to hit southern Alberta every three to five years, and Suttorp noted that the current outbreak is “right on time.” But the disease is more likely to persist wherever immunization levels are low. 

Suttorp attributes “vaccine hesitancy” to complacency, the need for booster shots, and a lack of trust in vaccines and vaccine providers. 

Complacency sets in when parents assume that whooping cough isn’t serious. Small children acquire comprehensive immunity after four doses of the vaccine, and it can be difficult for parents to stay on top of the recommended schedule. 

As to the lack of trust, Suttorp noted that vaccine coverage started to dip well before the Covid-19 pandemic, although conspiracy theories claiming that mRNA vaccines are harmful or ineffective likely played a part.

 

 

In the meantime, AHS anticipates that the regional outbreak will last for months. 

No vaccine is 100 per cent effective, and Suttorp qualified that vaccinated people can develop infections, especially in communities where vaccine rates are low. 

Breakthrough infections tend to be much less severe than in people who haven’t had the vaccine, she said. 

AHS recommends that people stay home if they develop symptoms or if they come into contact with an infected person. 

For more information about vaccinations, including clinic locations, visit AHS’s website at ImmunizeAlberta.ca or the province’s website at myhealth.alberta.ca. 

The same information is available through the province’s 24-hour Health Link hotline, 811.

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. 

 

More from the Breeze:

Maternity care on the ropes in Pincher Creek

Alberta government reaches tentative deal with AMA

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.

 

Man with his arm around smiling woman kisses her on the side of the head in the doorway of a barn.
 

 

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

 

 

 

 

Laurie Tritschler author information. Photo of red-haired man with moustache, beard and glasses, wearing a light blue shirt in a circle over a purple accent line with text details and connection links

 

Alberta Health Minister Jason Copping giving bill 4 announcement from a podium in front of a background of provincial and Canadian flags.

Bill 4 announcement met with skepticism at Pincher Creek hospital

 

Pincher Creek’s chief doctor remains skeptical about prospects for an enduring partnership between Alberta doctors and the provincial government after Bill 4 announcement.

Dr. Gavin Parker, community medical director at Pincher Creek Health Centre, spoke with Shootin’ the Breeze Dec. 5, shortly after Health Minister Jason Copping vowed to repeal the province’s authority to unilaterally scrap its funding commitments to the Alberta Medical Association, which represents roughly 1,600 practising physicians across the province.

Copping said the Alberta Health Care Insurance Amendment Act, 2022 (Bill 4) heralds “a collaborative environment founded on mutual respect and trust” more than two years after the United Conservatives, under then-premier Jason Kenney, ended the AMA’s contract and imposed a new one.

The amendment, which Copping endorsed alongside AMA president Dr. Fredrykka Rinaldi, underscores a deal that the two sides brokered over the summer and which was ratified in September by 70 per cent of doctors, Copping said.

The UCP government will undo section 40.2 of the original act, used by former health minister Tyler Shandro in February 2020 to terminate the AMA’s last contract. In return, the AMA will drop its pending lawsuit against the government.

The proposed legislation comes roughly a week after Edmonton removed a cap on the number of daily patient visits that doctors can charge to Alberta Health Services.

 

 

The amendment pledges $750 million to “stabilize the health-care system” over the next four years, delivering a more than five per cent pay bump for family doctors. It also holds out “the potential” for binding arbitration should future contract negotiations break down, according to Copping.

Rinaldi thanked Copping for making a show of good faith, but stopped short of a glowing prognosis.

“It’s a step in the right direction, but it’s not a panacea,” she told reporters. 

Over at Pincher Creek Health Centre, Dr. Parker was less optimistic. Most of Bill 4’s substance had been hammered out months earlier, he said. Meanwhile, the medical community is perhaps less willing to trust the UCP than Copping let on.

“That’s great that they’ve said they’d take (section 40.2) off the books. But, I don’t think we can safely assume this kind of legislation will never come back,” Parker said. 

The health centre and attached medical clinic now have five full-time doctors, less than half of the 11 docs that were on-staff when Shandro tore up their contract.

 

 

“It was pretty disastrous at the time,” Parker remembered.

Two doctors left the health centre to practise in urban centres in Alberta. One left the province altogether, highlighting the AMA’s aborted contract in their resignation letter. Others left to retrain in other medical specializations, while another doctor retired, according to Parker.

The health centre has recently brought on extra staff and “Alberta is still a great place to practise medicine,” Parker said, noting that doctors are paid well.

Surgeries are still performed at the health centre. “We’re one of a few places that still provide obstetric care,” while there’s none to be had in neighbouring Fort Macleod or Cardston, Parker said.

And the clinic has held on to its patients, despite the shortage of doctors.

“But, it’s been really tough,” Parker said, “because we haven’t been able to provide the same level of service and efficiency that people have come to expect.”

 

 

Emergency room patients with routine health concerns can wait up to eight hours to see a doctor if that doctor is busy performing a cesarean section, he said.

The health director also praised former health minister Shandro for his role in bringing a new CT scanner to the health centre.

“I’m glad to see the province’s finances are better now than when we were looking at contract negotiations a few years ago,” Parker said.

Watch news conference

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.