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New Brunswick

Saint John loses gastroenterologist and after-hours on-call specialist service

The Saint John region has lost one of its gastroenterologists and with him, the after-hours on-call service provided by digestive system specialists for emergency room and hospitalized patients, CBC News has learned.

General internists and general surgeons helping bridge gap until replacement recruited

A doctor wearing a white coat and stethoscope.
There are currently about 60 or 70 gastroenterologists in training programs across the country. However, all programs are west of Atlantic Canada. (David Donnelly/CBC)

The Saint John region has lost one of itsgastroenterologistsand with him, the after-hours on-call service provided by digestive system specialistsfor emergency room andhospitalizedpatients, CBC News has learned.

Dr. Chad Williams recently took a position at Dartmouth General Hospital in order to be closer to family, making the around-the-clock call schedule "unsustainable" for the remaining three gastroenterologists, said Dr. David Marr, medical director for the Horizon Health Network's Saint John area.

"For the forseeable future there will not be a GI specialist available beyond 8-5 M-F," states an internal email obtained by CBC News.

But local general internists and general surgeons, who are "comfortable inmanaging most of the GI problems," have stepped up to help bridge the gap until the vacancy can be filled, said Marr.
Dr. David Marr, Horizon's medical director for the Saint John area, said he is actively recruiting to fill the gastroenterology vacancy and is seeking permission to add a fifth position. (Horizon Health Network)

Gastroenterologistsare specialists who deal with the diagnosis and treatment of a wide range of conditions related to the digestive system, such as stomach bleeds, blocked esophagus and abdominal pain, as well asinflammatory bowel diseases, such asCrohn'sanddiverticulitis.

If the internist or surgeon providing primary callis not able to adequately deal with a patient,which Marrcontends will be "uncommon," the three local gastroenterologistswill provide "secondary call."

If they are unavailable, the patientcan be transferred to a gastroenterologistin Moncton or Fredericton, he said.

"So I think we have the issues covered as best we can."

'Optimistic' about candidate

Horizon is actively recruiting to replace Williams and Marrsaid he is "optimistic" about one candidate who has expressed interest in the fee-for-service position.

Marris also seeking approval from Horizon and the provincial government to have a fifth gastroenterologist.

As it stands, only one of the three gastroenterologistsin the Saint John area works full-time.Another works about 0.6 and the third is due back from maternity leave next month, he said.

We're just going to keep working away at it and I hope we'll have the problem solvedsooner rather than later.- David Marr, medical director

Having a fifth specialist would provide the capacity to deliver the service around the clock, every day of the year,said Marr.

There are currently about 60 or 70 gastroenterologistsin training programs across the country, he said. But all of the programs are west of Atlantic Canada, which makes recruitment a challengesince many people prefer to set up a practicenear where they've already established roots.

"We recognize the stress on our gastroenterology colleagues when there's a shortage.I get it, and we're going to push very hard to get the complement here that meets patient needs in New Brunswick and helps our colleagues do their work," said Marr.

"So we're just going to keep working away at it and I hope we'll have the problem solvedsooner rather than later."