Funding aimed at ensuring the emergency rooms in Merritt, Oliver and Salmon Arm, B.C., don’t close due to doctor shortages is on its way.
After a year of regular emergency room shutdowns due to physician shortages at some small-town hospitals, the province is kicking in $7.5 million of permanent funding to help stabilize the situation.
“B.C., like all jurisdictions in Canada, is facing recruitment and retention challenges that were exacerbated by the recent COVID-19 pandemic, the ongoing toxic drug crisis and the rising number of patients with complex health-care needs, and we know that these challenges are more prominent in rural and remote communities,” Minister of Health Adrian Dix said.
“That is why we are taking immediate actions to bolster the recruitment of more physicians for our patients and their care teams.”
The provincial commitment to “new compensation models for physicians in rural communities” was approved on Oct. 10 for the Nicola Valley Hospital and Health Centre in Merritt and the Shuswap Lake General Hospital in Salmon Arm, the latter of which has not experienced closures in the way the first two have.
The funding was approved on Sept. 29 for the South Okanagan General Hospital in Oliver. Interior Health is working with local physicians on the three service contracts for emergency services at these hospitals.
The new contracts are expected to help the province’s efforts to recruit more physicians in rural communities by offering compensation to doctors for their time spent at the hospital caring for patients with complex and time-intensive needs.
It’s a shift from the fee-for-service payment model under which physicians are paid based primarily on the number of patients they see in a day.
This is one measure the mayor of Oliver said last month he wanted to see come into place after his community suffered a string of ER closures due to physician shortages.
“The payment model that we have at the South Okanagan General Hospital is a fee for service. And that just is an antiquated way of dealing with physicians in being able to fill their time, especially in an older community,” Oliver Mayor Martin Johansen said in an interview with Global News, last month.
“To work a night shift where you might see two patients make $100, it doesn’t make any sense. And that thing has just been percolating and percolating for a while where the doctors have finally said we need to get this alternative payment program in place.”
The mayor of Merritt had become so frustrated with the number of closures his community was seeing that he planned to withhold tax money from the provincial government until the issue was dealt with.
“We pay this every year at the beginning of every year. For 2023 we already paid, but for 2024 we will recalculate the 365 days of the year that we pay our taxes and then we will pull back the number of days we were closed because it was a service we didn’t get, or I would expect the government would credit us coming into the next year,” Michael Goetz said earlier this month.
With these service contracts, all patients and nurses will get more regular on-site physician presence, which will help emergency rooms in these hospitals remain open.
The new contracts build on short-, medium- and long-term efforts that the province and Interior Health are taking to stabilize emergency department services in rural and remote communities.
“This investment will help ensure patients have stable access to emergency care, while we know there is more to do,” Dix said.
“Through our Health Human Resources Strategy, we are also committed to train, recruit and retain more people into our workforce, including providing incentives to attract physicians working in rural communities such as Merritt, Salmon Arm and Oliver.”
To get more health-care workers, the province is also providing temporary compensation supports to attract physician locums in the short term, working with GoHealthBC to recruit registered nurses, advertising with Health Match BC and implementing a targeted social media and marketing campaign for nurses and physicians.
It will also explore team-based care models, positions for Indigenous patient navigators, rural Indigenous community incentives for physicians and innovative solutions, such as child-care support.