Emergency room (ER) doctors are calling for the health minister to re-think his plan to open super clinics. A report published last week found Quebec already has the worst wait times in the western world, and doctors say these clinics could make the problem even worse.
There is a dangerous myth preventing the country’s lawmakers from reducing ER wait times, said Dr. Jill McEwan, president of the Canadian Association of Emergency Physicians (CAEP).
“There’s a misconception that we keep hearing that it’s the minor patients that come in that should be going to the family doctor’s office that are causing the problem. That is not the problem,” she said.
The real problem, she said, is a backlog of beds. Quebec’s ER doctors’ associations agree.
“Emergency room wait times are a symptom of a disease of people who are getting in the hospital and people who are waiting for beds,” explained Dr. Elise Berger Pelletier, head of the Association of Specialized Emergency Physicians of Quebec .
ER doctors want Quebec to adopt a British model called “the four-hour rule.”
“Once the decision had been made to admit them to the hospital, the patient had to be removed from the emergency department within four hours,” Dr. McEwan said.
Quebec’s health ministry has maximum wait times already, but they’re not enforced. A recent health commissioner report showed last year, Quebecers spent 13 million hours above the wait time limits. Those lost work hours cost the Quebec economy more than $300 million. What’s more, 10 percent of the people waiting left before they ever saw a doctor.
McEwan believes the four-hour rule is likely the only solution.
Despite that message, the health minister says he’s going to open even more walk-in clinics, called “super clinics,” by 2018 and reduce the number of doctors in ERs. The association’s doctors say such clinics could cause even longer wait times.
“(He’s) hoping the population will not go to emergency departments. That’s not going to happen. Our prediction is that the volumes are going to increase,” said Dr. Bernard Mathieu, president of Association Des Medecins D’Urgence du Quebec.
“They are wrong on this. They are obviously wrong on this,” Health Minister Gaetan Barrette said.
Barrette said reducing the number of people going to ERs will mean less crowding.
“I don’t see the logic in their reasoning by which it is fine for low priority patients to go to the emergency room,” he said.
The health commissioner also suggested increasing the number of hours clinics are open.
“If you consider opening a dossier going to the emergency room, it’s very expensive compared to private practice,” Robert Salois said.
It’s unlikely the government will find a compromise – the minister refused the emergency doctors’ invitations to meet with them and spend time on the ground in a hospital.
“I don’t see the point,” he said.