Doctors across Calgary are sounding the alarm over the state of emergency care in the city.
“Signs of a capacity crisis are everywhere,” an open letter to Albertans signed by more than 180 emergency physicians reads.
“Our emergency departments are collapsing and frontline healthcare workers have truly had enough. We cannot bear to watch our patients suffer any longer with no end in sight.”
The letter points to three “critical areas of concern” the emergency doctors said are directly impacting patient care: insufficient primary health care, lack of hospital beds and labour shortages.
“There’s lots of areas of the health-care system right now that are not functioning as well as they should,” Dr. Marc Francis, who works at the Alberta Children’s Hospital, said.
“And the challenge in the emergency department is if there’s a health care storm going on, we are truly in the eye of that storm. If there’s challenges in other areas of health care, we feel that in the emergency department every day.”
Dr. Sean Fair is an emergency doctor at the Foothills and Rocky View hospitals. He said the system is suffering alongside its patients.
“We are witness right now to what has essentially been a prolonged health care collapse that has resulted in patients experiencing inhumane wait times, frequently well over eight hours, 15 hours,” he said. “And even after they receive care, patients who are admitted to hospital languishing in the emergency department because there’s no space for them in the hospital system upstairs.”
Francis said many of the expectations as health-care professionals, navigating the stresses of a once-in-a-century pandemic, were to to see some light on the other side.
“I honestly feel like it’s kind of the opposite. It feels like we’ve just come through the pandemic and we should be breathing and taking a break and instead we’re just getting doubled down and pounded again, largely, I think, because of issues with staffing.”
The doctors’ letter said in addition to emergency nurses regularly having to work mandatory overtime, being denied holiday requests and a suggestion of a pay cut from the government, more and more nurses are cutting back the hours they spend in the ER or have left it altogether.
“We’re losing nurses that have 10 or 15 years of emergency experience, and you do not replace that nurse overnight,” Francis said. “You could have three junior nurses who are freshly graduated or from other areas of the health care system that are not going to be as effective as that senior nurse nurse with 10 or 15 years experience.”
The open letter added that the AHS decision to hire temporary travel nurses who lack experience in emergency care experience but are getting paid multiples of what ER nurses would normally be paid has “fueled discontent.”
Fair did note the ER doctors have seen some improvements in the system, like the increased rapidity of getting ambulances back on the road.
“The government has set a target in line with national targets to try and get ambulances back on the road within 45 minutes. And a lot of the time we are able to achieve that, which is fantastic news for Albertans who need help. But changes like these come with a cost,” he said.
“We’ve got great infrastructure in Calgary, we’ve got lots of treatment spaces. And the reality is that most of us (doctors) have not experienced a day where the hospital is fully staffed in a year,” Fair said. “We always have beds that are sitting empty with no nurses to look after them, no staff that are there.”
The doctor group says emergency doctors — an already high-stress branch of medicine — are burning out in high numbers.
“If you haven’t been in an emergency department recently, you’re in for a shock. There are days where we have 40 people in the waiting room and we have nine or 10-hour waits to see patients,” Francis said.
“You feel for those patients that wait nine, 10 hours in the waiting room and you know that out there there are heart attacks, there are strokes, there are patients who are quite sick that we can’t get to. And that creates a significant moral dilemma. And it makes you want to go to more functional areas of the healthcare system.”
In the face of increased wait times, reduced staff, high staff burnout and an unrelenting demand for their services, Fair had a message for his potential patients.
“My message to Albertans is that the health care system is struggling. We in the emergency department will always be there to look after you on your worst day,” Fair said. “And we are trying our best to be our best and to be providing the care that we can. But we are struggling.”
The doctors are calling for the government and AHS to “recognize the current crisis.”
The letter takes care to note it is not written on behalf of AHS or the Alberta Medical Association.
“This crisis will require resources and innovative solutions to move forward,” the doctors write. “It is a long road ahead to recovery. There are multiple paths we can take as we set about repairing a system that has degraded significantly over the past four years.”
The doctors also recognized that health care is a top priority for parties in the provincial election. Polling also bears out its importance for voters.
“It is our sincere hope that whomever forms the next government will begin the process of repair, starting with the restoration of what was once a respectful relationship with frontline healthcare workers.”
Party leaders respond
Wednesday morning, leaders for the United Conservatives and Alberta NDP responded to some of the concerns raised by the doctors.
“One of the very first things that I did (as UCP leader) was to make health care reform our top priority,” Smith said, pointing to replacing the AHS board with a sole administrator.
Smith said in recent months, wait times at hospitals and for ambulances have gone down, and that the surgical backlog has decreased by around 3,000 surgeries a month.
“The next thing that we have to work on — and everybody agrees on this — is that we need to look at a different approach for how we do team-based practice for primary care. There’s some great models out there for primary care networks. It’s part of the reason why we’ve dedicated more money to that.”
Smith said she “appreciates” the concerns raised by the doctors in the letter, and that “help on the way.”
“We had a lot of progress that we made in six months, which is why we need four more years to continue on the great progress.”
Rachel Notley said there’s a need to restore respect with frontline healthcare workers.
“I look forward to meeting with the folks that signed that letter,” she said.
Notley highlighted the NDP’s “ambitious” plan to expand access to family doctors to 800,000 Albertans and a similarly aspirational plan to ramp up recruitment and training of healthcare professionals in the province.
“We will not refer to them as ‘tyrants.’ We will not rip up their contracts. We will not demonize the science that drives their professionalism,” Notley said. “We will support them and we will celebrate them for the very, very important work that they do for all of us in the community.”
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